Long-term side effects of androgen deprivation therapy in men with non-metastatic prostate cancer: A systematic literature review

Alibhai, Shabbir M.H.; Gogov, Sven; Allibhai, Z.

doi:10.1016/j.critrevonc.2006.06.006

Cited by 158 publications

(119 citation statements)

References 139 publications

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“…1 Unfortunately, ADT has significant side effects that compromise physical and psychological well-being, including increased fat mass, and reduced muscle mass and bone density, as well as worsened fatigue and quality of life. [1][2][3] In addition to the overt manifestations of androgen suppression, fundamental aspects of endocrine balance are altered through increased fat mass, which contributes to chronic comorbidities and may facilitate tumour progression. Specifically, alternate growth factors, or local adipokines, may support a mitogenic environment and impair disease control with ADT.…”

Section: Introductionmentioning

confidence: 99%

Exercise effects on adipokines and the IGF axis in men with prostate cancer treated with androgen deprivation: A randomized study

Mina

Connor²,

Alibhai³

et al. 2013

CUAJ

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Background: Androgen deprivation therapy (ADT) has significant deleterious effects on body composition that may be accompanied by unfavourable changes in adipokine levels. While exercise has been shown to improve a number of side effects associated with ADT for prostate cancer, no studies have assessed the effect of exercise on adiponectin and leptin levels, which have been shown to alter the mitogenic environment. Methods: Twenty-six men with prostate cancer treated with ADT were randomized to home-based aerobic exercise training or resistance exercise training for 24 weeks. Adiponectin, leptin, insulin-like growth factor 1 (IGF-1), insulin-like growth factor binding protein 3 (IGFBP-3) were analyzed by ELISA (enzyme-linked immunosorbent assay), in addition to physical activity volume, peak aerobic capacity, and anthropometric measurements, at baseline, 3 months and 6 months. Results: Resistance exercise significantly reduced IGF-1 after 3 months (p = 0.019); however, this change was not maintained at 6 months. At 6 months, IGFBP-3 was significantly increased compared to baseline for the resistance training group (p = 0.044).In an exploratory analysis of all exercisers, favourable changes in body composition and aerobic fitness were correlated with favourable levels of leptin, and favourable leptin:adiponectin and IGF-1:IGFBP-3 ratios at 3 and 6 months. Conclusions: Home-based exercise is correlated with positive changes in adipokine levels and the IGF-axis that may be related to healthy changes in physical fitness and body composition. While the improvements of adipokine markers appear to be more apparent with resistance training compared to aerobic exercise, these findings must be considered cautiously and require replication from larger randomized controlled trials to clarify the role of exercise on adipokines and IGF-axis proteins for men with prostate cancer.

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Section: Introductionmentioning

confidence: 99%

Exercise effects on adipokines and the IGF axis in men with prostate cancer treated with androgen deprivation: A randomized study

Mina

Connor²,

Alibhai³

et al. 2013

CUAJ

Self Cite

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“…Alibhai et al 10 performed the first prospective longitudinal study with a relatively large study of 87 patients with non-metastatic PCa who were starting on ADT, and two matched control groups of 86 men each: one group with PCa but not on ADT, and one group of healthy controls without a diagnosis of PCa. Over the course of 1-year study, grip strength in the ADT group declined significantly by the 3-month mark and remained low for the remainder of the study.…”

Section: Physical Healthmentioning

confidence: 99%

“…To offset these untoward effects, the authors recommend initiating a physical exercise programme in all patients starting ADT. 10 Exercise, which helps to maintain bone strength, muscle mass and normal weight for patients on ADT, can also reduce fatigue, leading to improvements in mood, motivation and sexual functioning. 59 A systematic literature review found grade A evidence that regular exercise, especially group-based and including some resistance training, improved muscular strength, aerobic endurance and overall QoL, as well as reduced fatigue.…”

Section: Physical Healthmentioning

confidence: 99%

“…8 Documented adverse effects of ADT include hot flashes/flushes, loss of libido, sexual dysfunction, gynaecomastia, decrease in bone mineral density with potential increased risk of fractures 9 and increase in fat mass plus loss of lean muscle mass. 10 ADT is also associated with metabolic syndrome (increased cholesterol, triglycerides and insulin resistance), diabetes and, possibly myocardial infarction and sudden cardiac death. 11 It has also recently been reported that men with a previous history of myocardial infarction or congestive heart disease who undergo brachytherapy-based radiation treatment, may be harmed by ADT in terms of all-cause mortality.…”

Section: Introductionmentioning

confidence: 99%

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

Casey¹,

Corcoran²,

Goldenberg³

2012

Asian J Androl

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Androgen deprivation therapy (ADT) has been an essential treatment option for treating prostate cancer (PCa). The role for hormonal treatment initially was restricted to men with metastatic and inoperable, locally advanced disease. Now it has been extended to neoadjuvant or adjuvant therapy for surgery and radiotherapy, for biochemical relapse after surgery or radiation, and even as primary therapy for non-metastatic disease. Fifty percent of PCa patients treated will receive ADT at some point. There is growing concern about the adverse effects and costs associated with more widespread ADT use. The adverse effects on quality of life (QoL), including physical, social and psychological well-being when men are androgen-deprived, may be considerable. This review examines the QoL issues in the following areas: body feminisation, sexual changes, relationship changes, cognitive and affective symptoms, fatigue, sleep disturbance, depression and physical effects. Further suggestions for therapeutic approaches to reduce these alterations are suggested.

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“…5,6 These domains may also be affected by androgen receptor blockade in the presence of normal serum testosterone. For example, the prevalence of erectile dysfunction (ED) has shown a steady increase during the initial years of monotherapy with the nonsteroidal AA flutamide.…”

Section: Introductionmentioning

confidence: 99%

Definitive radiotherapy with adjuvant long-term antiandrogen treatment for locally advanced prostate cancer: health-related quality of life and hormonal changes

Berg

Dahl

Bruland

et al. 2009

Prostate Cancer Prostatic Dis

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We assessed self-reported health-related quality of life (HRQoL) and longitudinal changes in sex hormones among 86 prostate cancer (PCa) patients without distant metastases 5 years after radiotherapy (RT) combined with ongoing antiandrogen (AA) treatment. HRQoL outcomes were compared with scores from age-matched controls without a cancer diagnosis (NORM). Compared with NORM, patients scored statistically (Po0.05) and clinically (effect size X0.4) lower on sexual domains, and statistically (Po0.05) lower on physical function and vitality. Estimated free testosterone and measured serum estradiol had increased from baseline in most patients, but did not correlate with HRQoL outcomes 5 years after the start of treatment.

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Long-term side effects of androgen deprivation therapy in men with non-metastatic prostate cancer: A systematic literature review

Cited by 158 publications

References 139 publications

Exercise effects on adipokines and the IGF axis in men with prostate cancer treated with androgen deprivation: A randomized study

Exercise effects on adipokines and the IGF axis in men with prostate cancer treated with androgen deprivation: A randomized study

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

Definitive radiotherapy with adjuvant long-term antiandrogen treatment for locally advanced prostate cancer: health-related quality of life and hormonal changes

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