The potential role of follicle-stimulating hormone in the cardiovascular, metabolic, skeletal, and cognitive effects associated with androgen deprivation therapy.

To explore how follicle-stimulating hormone (FSH) may contribute to cardiovascular, metabolic, skeletal, and cognitive events in men treated for prostate cancer, with various forms of androgen deprivation therapy (ADT).

A colloquium of prostate cancer experts was convened in May 2015, to discuss the role of FSH in the development of unwanted effects associated with ADT. Subsequently, a literature review (Medline, PubMed, and relevant congress abstract databases) was performed to further explore and evaluate the collected evidence.

It has become evident that, in the setting of ADT, FSH can promote the development of atherosclerotic plaque formation, metabolic syndrome, and insulin resistance. Data also suggest that FSH is an important mediator of bone remodeling, particularly bone resorption, and thereby increases the risk for bone fracture. Additional evidence implicates a role for FSH in bone metastasis as well. The influence of FSH on ADT-induced cognitive deficits awaits further elucidation; however, the possibility that FSH may be involved therein cannot be ruled out.

The widespread molecular and physiological consequences of FSH system activation in normal and pathological conditions are becoming better understood. Progress in this area has been achieved by the development of additional investigative and clinical measures to better evaluate specific adverse effects. More research is needed on FSH function in the development of cancer as well as its association with cardiovascular, metabolic, musculoskeletal, and cognitive effects in ADT.

Urologic oncology. 2017 Mar 18 [Epub]

E David Crawford, Andrew V Schally, Jehonathan H Pinthus, Norman L Block, Ferenc G Rick, Marc B Garnick, Robert H Eckel, Thomas E Keane, Neal D Shore, David N Dahdal, Thomas J R Beveridge, Dennis C Marshall

Department of Urologic Oncology, School of Medicine, University of Colorado, Denver, Denver, CO. Electronic address: ., Endocrine, Polypeptide and Cancer Institute, Miami Veterans Affairs Medical Center, Miami, FL; Department of Pathology, University of Miami School of Medicine, Miami, FL; Department of Medicine, University of Miami School of Medicine, Miami, FL., Department of Surgery, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada., Endocrine, Polypeptide and Cancer Institute, Miami Veterans Affairs Medical Center, Miami, FL; Department of Urology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL., Department of Medicine, Harvard Medical School, Boston, MA., Division of Endocrinology, Metabolism and Diabetes, University of Colorado, Denver, CO., Department of Urology, Medical University of South Carolina, Charleston, SC., Carolina Urologic Research Center, Myrtle Beach, SC., Ferring Pharmaceuticals Inc., Parsippany, NJ.