Prostate Cancer: Androgen Deprivation Therapy
Welcome to this month’s Men’s Health newsletter. Our topic: Prostate cancer therapy may affect heart and bones. Although testosterone-lowering androgen deprivation therapy is an effective treatment for prostate cancer, it may also raise the risk of men developing bone fractures and fatal cardiovascular disease.
A study in the medical journal, Cancer, says the likelihood of having either side effect remains low, but the study does raise the question of how best to weigh the potential benefits of androgen deprivation therapy, or ADT, against serious complications that could happen. Study lead author and doctoral candidate Lockwood Taylor says it’s important to remember that these adverse outcomes, due to ADT, are all preventable. He advises doctors to watch their patients for changes in either cardiovascular or skeletal health that might develop as a result of the therapy.
To assess side effects from ADT, Taylor and his team reviewed 14 studies, from 1966 to 2008. The studies focused on skeletal and cardiovascular side effects linked to ADT among men with prostate cancer. They found that ADT boosted the risk for overall fracture by 23 percent, compared to men with prostate cancer not undergoing treatment. Similarly, the chances of dying from heart disease were 17 percent higher among men with cancer on ADT than those who were not.
The researchers also mentioned two large studies that had indicated a substantial increase in the risk for developing diabetes among ADT patients. Taylors says doctors should monitor their patients on ADT for changes in bone mineral density. If they see a decrease, they should consider some preventative therapies. Doctors should also watch for abnormal serum levels of cholesterol and insulin, which are markers for both cardiovascular and skeletal fracture. They can prescribe statin drugs to help lower cholesterol while encouraging lifestyle changes to improve diet and increase physical activity.
Dr. Nelson Neal Stone says that it is well-known that ADT boosts a patient’s risk for fracture. Women experience the same risk when they undergo anti-estrogen therapy for breast cancer. The bottom line, says Dr. Stone, is that doctors need to be careful about who receives androgen deprivation therapy.
For more information, always consult your doctor. Thank you for listening. Please visit our website for more information on health and wellness topics.