A Holistic Approach to Androgen Deprivation Therapy: Treating the Cancer without Hurting the Patient

Abstract

Introduction: Androgen deprivation therapy (ADT) for advanced prostate cancer can be associated with side effects which may negatively impact quality of life (QoL) and induce serious medical problems. Aim: The aim is to give practical recommendations on how to monitor and counsel patients and effectively manage side effects based on relevant original articles, review articles and abstracts. Results: Urologists should be aware of side effects and adapt their practice patterns to rapidly recognize these and administer appropriate treatment. Proper counseling of ADT-treated patients is needed to help them recognize and prevent and/or manage side effects. Patients should be encouraged to adopt a healthy lifestyle such as a healthy diet and physical exercise. In addition, bone mineral density and metabolic and cardiovascular parameters need to be carefully monitored. Conclusions: Urologists should take appropriate measures to prevent and manage ADT-related side effects to promote the general health and overall QoL of patients.

Effects of Radiation and Total Androgen Blockade on Serum Hemoglobin, Testosterone, and Erythropoietin in Patients with Localized Prostate Cancer

“…effects on serum testosterone and hemoglobin 1,[7][8][9][10] . Recent studies have confirmed a decline in serum hemoglobin attributable to these newer approaches to tab-and also a variety of other side effects, including metabolic disorders, cardiovascular disease, hot flashes, sexual dysfunction, depressed mood, muscle weakness, and osteoporosis 2,7,[11][12][13][14][15][16][17] .…”

Quality of life issues in men undergoing androgen deprivation therapy: a review

“…92 Therefore, whenever possible, partners should be included in the treatment decision and consent process and provided adequate and appropriate support. 93 A multidisciplinary 'survivorship' team approach should exist for the management of ADT patients and their partners. Such a programme, should probably be called an 'ADT management programme' since the word 'survivorship' is not always properly understood and may lead patients to think that they may not survive ADT.…”

The side effects of hormonal therapy at the patients with carcinoma of prostate cancer

“…They are considered one of the most common and the most troublesome side effects since they appear in more than 80% of patients with prostate cancer treated with hormonal therapy [10]. Hot flashes are often caused by so-called trigger factors, which include stress, heat, a sudden change in body position, stimulants (coffee, cigarettes, alcohol) and consumption of spicy food [11, 12]. As non-pharmacological measures it is advised to avoid the aforementioned generative triggers, wear clothes made of natural fibers such as linen or cotton, use cold compresses to the neck or drink a glass of cold drink at the onset of symptoms and take regular exercise [11].…”

“…Hot flashes are often caused by so-called trigger factors, which include stress, heat, a sudden change in body position, stimulants (coffee, cigarettes, alcohol) and consumption of spicy food [11, 12]. As non-pharmacological measures it is advised to avoid the aforementioned generative triggers, wear clothes made of natural fibers such as linen or cotton, use cold compresses to the neck or drink a glass of cold drink at the onset of symptoms and take regular exercise [11]. If burdensome symptoms keep occurring even after the change of lifestyle according to the recommendations mentioned above, it is advisable to include hormonal drugs: megestrol, cyproterone, nadroxyprogesterone or diethylstilbestrol in low doses.…”

“…Of interest to researchers were also new antidepressants, especially citalopram and venlafaxine, but their effectiveness is lower than that of hormonal drugs. Studies to assess the effect of other neuropsychiatric drugs such as gabapentin or clonidine are ongoing [11]. …”