Aim : To study the change of lipid metabolism by antiandrogen therapy in patients with prostate cancer. Materials and methods : We studied with a 2.5 years follow-up the changes in plasma cholesterols (C), triglycerides (TG), lipoproteins (LP), and apolipoproteins (Apo) B-100, A-I, and A-II profiles in 24 patients of mean age 60 years with low risk prostate cancer (stage: T1cN 0 M 0 , Gleason score: 2-5) during treatment with cyproterone acetate (CPA) without surgical management or radiation therapy.Results : Significant decreases of HDL-C, Apo A-I and Apo A-II and an increase of triglyceride levels in VLDL were induced by CPA. After a period of 2.5 years on CPA treatment, four patients out of twenty-four were found to be affected by coronary heart disease. Conclusions : Ischaemic coronary arteriosclerosis with an incidence rate of 16.6% as caused by prolonged CPA therapy is mediated through changes in HDL cholesterol, Apo A-I and Apo A-II profiles, other than the well-known hyperglyceridemic effect caused by estrogen.
According to the findings of this study, it may be desirable for administrators to prioritize the implementation of the FWR policy in regional hospitals. We recommend affording the factors of positive attitudes and subjective norms high priority to improve the medical staff's behavioural intentions of FWR practice.
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