Side effects of endocrine treatment and their mechanisms: Castration, antiandrogens, and estrogens

Hedlund, Per Olov

doi:10.1002/1097-0045(2000)45:10+<32::aid-pros7>3.0.co;2-v

Cited by 37 publications

(22 citation statements)

References 26 publications

(30 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Estimates of the incidence of gynaecomastia vary from 13 to 22% for flutamide CAB, versus 8-13% for LHRH agonist. 9,10 Diarrhoea was included because it is a relatively common side effect of flutamide. 2 Haematuria has been reported to occur significantly more frequently for metastatic patients on bicalutamide plus an LHRH agonist compared with patients on flutamide plus an LHRH agonist (Po0.007).…”

Section: Study Measuresmentioning

confidence: 99%

Eliciting patient preferences for hormonal therapy options in the treatment of metastatic prostate cancer

Lloyd

Penson

Dewilde³

et al. 2007

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

Treatment choices for metastatic prostate cancer are complex and can involve men balancing survival versus quality of life. The present study aims to elicit patient preferences with respect to the attributes of treatments for metastatic prostate cancer through a discrete choice experiment (DCE) questionnaire. Men with recently diagnosed localized prostate cancer were asked to envisage that they had metastatic disease when completing a survey. As expected, men with prostate cancer placed considerable importance on gains in survival; however, avoiding side effects of treatment was also clearly important. Survival gains should be considered alongside side effects when discussing treatment options in metastatic disease.

show abstract

Section: Study Measuresmentioning

confidence: 99%

Eliciting patient preferences for hormonal therapy options in the treatment of metastatic prostate cancer

Lloyd

Penson

Dewilde³

et al. 2007

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

show abstract

“…7 All these factors together have been named "castration syndrome" and have a significant impact on quality of life. 31 It is estimated that the optimal dietary calcium for middle aged men (age Ͻ 65years) and women (premenopausal) is 1000 mg per day or, for older individuals, 1200 -1500 mg per day. 32 Our patients had a mean (Ϯ SD) daily dietary calcium intake of 1066.1 mg Ϯ 443.3 mg. We did not find any statistically significant correlation between dietary calcium and BMD, although a weakly positive correlation was observed (r ϭ 0.208, P ϭ 0.165).…”

Section: Discussionmentioning

confidence: 99%

Factors affecting bone mineral density in patients with prostate carcinoma before and after orchidectomy

Agarwal

Khandelwal

Mandal

et al. 2005

Cancer

View full text Add to dashboard Cite

BACKGROUNDOrchidectomy is an accepted form of androgen‐deprivation therapy (ADT) for prostate carcinoma. Osteoporosis is common in elderly individuals and is accelerated by ADT. The authors studied changes in bone mineral density (BMD) after ADT and factors that affected those changes.METHODSFifty patients with prostatic adenocarcinoma who opted to undergo orchidectomy were studied prospectively. All patients completed 6 months of follow‐up, and 20 of those patients completed 12 months of follow‐up. Patients' age, weight, height, body mass index (BMI), physical activity, addiction (smoking, alcohol), dietary calcium intake, and lactose tolerance status were noted. Lumbar spinal (L1–L3) trabecular BMD was measured with quantitative computed tomography (QCT) at baseline and every 6 months for 1 year and was compared with preoperative values. The effects of various patient characteristics on preoperative BMD and changes in BMD also were analyzed.RESULTSThe mean ± standard deviation (SD) age of the patients was 69.5 ± 8.1 years, BMI was 23.5 ± 3.9 kg/m2, dietary calcium intake was 1066.1 ± 443.3 mg per day. Thirty‐eight percent of patients were lactose intolerant. Sixty‐two percent of patients were in the light weight‐bearing activity group. The mean ± SD preoperative BMD was 119.2 ± 34.9 mg/cc, with T‐scores of − 1.77 ± 1.22 and Z‐scores of 0.43 ± 1.27. A decrease in BMD during the first 6 months (≈ 13%) was statistically significant (P = 0.0001) and continued further during next 6 months (BMD loss of ≈ 18% at 12 months). Patients with osteoporosis, as defined by T‐scores ≤ − 2.5, increased from 24% at baseline to 48% at 6 months. Nonsmokers, nonalcoholics, patients with higher physical activity, and patients with a BMI > 25 kg/m2 had statistically significant higher BMD compared with their counterparts (P < 0.05). Body weight < 60 kg and BMI < 25 kg/m2 were significant risk factors for loss of BMD (P < 0.05). Dietary calcium had a discernible but statistically insignificant effect on BMD (P = 0.16). Lactose intolerance had no significant effect on BMD or bone loss.CONCLUSIONSOsteoporosis was common in the population affected by prostate carcinoma. Orchidectomy led to accelerated bone loss. Periodic measurement of BMD after ADT would help in the early detection of osteoporosis. Maintenance of high BMI, weight‐bearing physical activity, avoidance of alcohol and smoking, and possibly high dietary calcium intake help in maintaining bone mass. Cancer 2005. © 2005 American Cancer Society.

show abstract

“…The physical side effects of castration are related to the pharmacology of the treatment (that is, fatigue, decreased libido, sexual dysfunction, hot flashes, loss of bone mineral density and anemia). 42 Although the toxicity of castration is not as severe as cytotoxic chemotherapy, increasing recognition of these adverse effects must be acknowledged and balanced against the benefits they provide. There have been relatively few investigations of quality of life for patients receiving castration-based therapies, however, increasing recognition of the impact that side effects have on patients' lifestyles has resulted in interest in time-limited treatment strategies.…”

Section: Challenging the Historical Paradigm Of Androgen Deprivation mentioning

confidence: 99%

Adjuvant androgen deprivation therapy augments cure and long-term cancer control in men with poor prognosis, nonmetastatic prostate cancer

Fleshner

Keane

Lawton

et al. 2007

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

Historically, adjuvant androgen deprivation therapy has been viewed as a palliative treatment option for patients with poor-prognosis non-metastatic prostate cancer. In addition, guidelines from bodies such as the European Association of Urology and American Society for Clinical Oncology do not specifically categorize adjuvant hormonal therapy as being curative in intent. We propose that adjuvant androgen deprivation therapy should now be classified as a treatment of curative intent in patients with poor-prognosis, non-metastatic prostate cancer. By applying a carefully considered definition of cure (based on long-term (10-to 15-year) disease-free survival curves) to the findings from randomized controlled clinical trials that have studied adjuvant hormonal treatments in nonmetastatic prostate cancer, we challenged whether this viewpoint should now be considered redundant. According to our review of relevant studies and our definition of cure, goserelin appears to augment cure in a sizeable proportion of men with poor-prognosis non-metastatic prostate cancer when given adjuvant to radical prostatectomy or radiotherapy. Across several trials, the relevant survival curves for the goserelin-treated population became indefinitely flat after long-term followup. This indicates that these patients have a mortality risk comparable to the general population without prostate cancer. On the basis of the evidence presented within this review, we believe that, given it can control disease for a long period of time, adjuvant goserelin should be reclassified as a treatment of curative intent for patients with poor-prognosis non-metastatic prostate cancer.

show abstract

Side effects of endocrine treatment and their mechanisms: Castration, antiandrogens, and estrogens

Cited by 37 publications

References 26 publications

Eliciting patient preferences for hormonal therapy options in the treatment of metastatic prostate cancer

Eliciting patient preferences for hormonal therapy options in the treatment of metastatic prostate cancer

Factors affecting bone mineral density in patients with prostate carcinoma before and after orchidectomy

Adjuvant androgen deprivation therapy augments cure and long-term cancer control in men with poor prognosis, nonmetastatic prostate cancer

Contact Info

Product

Resources

About