BERKELEY, CA (UroToday.com) - In recent years, androgen deprivation therapy (ADT) has been increasingly used in patients with prostate cancer (Pca).
Despite the improved survival reported in some studies, ADT is associated with different side effects.
Recent studies have shown significant changes in lipid profiles of patients undergoing ADT. An adverse lipid profile could increase the cardiovascular risk of this population. Recent evidence suggests that ADT increases cardiovascular morbidity, and it is well known that serum lipids are a main factor in the pathogenesis of atherosclerosis. Moreover, hyperlipidemia is a recognised factor for cardiovascular disease. Recently an advisory recommending an initial evaluation of patients in whom ADT is planned to be initiated has been published. This evaluation should include assessment of blood pressure, glucose level, and lipid profile.
The aim of our study was to analyse the changes in lipid profiles and the atherogenic risk observed in patients receiving ADT and to evaluate differences between medical castration and maximal androgen blockade (MAB). There are some limitations in our study. First, we designed a retrospective study with a control group. Second, the sample size of some study subgroups was small. This could explain the absence of significant differences in some parameters analysed. Third, we did not measure insulin levels, and we did not take into account the BMI (body mass index) of the subjects, and patients treated with estatins were not excluded.
Our study has a few strengths. First, the sample size. Second, the follow-up period of our study are slightly higher compared to other published studies. Finally, in our study, we tried to assess for the first time the differences between both treatment modalities when lipids are analysed.
In summary, the increase in cardiovascular morbidity observed in patients receiving ADT cannot be explained according to the changes observed in the lipid profile.
In the future, large and long-term prospective studies are needed to assess changes in lipid profiles and other cardiovascular risk factors.
C. Salvador Lacambra as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.