2007
DOI: 10.1097/med.0b013e32814db88c
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Androgen deprivation therapy for prostate cancer: new concepts and concerns

Abstract: Purpose of review-The aim of this review is to summarize new concepts and concerns regarding treatment-related osteoporosis, diabetes, and cardiovascular disease in men receiving androgen deprivation therapy for prostate cancer.Recent findings-Gonadotropin-releasing hormone agonists increase bone turnover, decrease bone mineral density, and increase fracture risk. Bisphosphonates, selective and estrogen receptor modulators significantly increase bone mineral density during androgen deprivation therapy. Ongoing… Show more

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Cited by 148 publications
(134 citation statements)
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“…Since such men have excellent rates of cancer-specific survival (up to 90%), the benefits of ADT need to be carefully balanced against the toxicities, which are a direct consequence of the induced hypogonadism. 1 Adverse effects of ADT include firstly, loss of bone mineral density leading to fractures; secondly, weight gain, insulin resistance and diabetes; [5][6][7] thirdly, sexual symptoms such as sexual dysfunction, gynecomastia, decrease in testicular and penile size, loss of sexual hair; and, fourthly, general and constitutional symptoms including neurophysiological symptoms (reduced mood cognition, quality of life (QoL)), hot flushes, fatigue and anemia. 1,8 Given that prostate cancer is a disease predominantly of ageing men, age itself and associated comorbidities may contribute to increased vulnerability of the hemopoietic system to ADT, although this assumption has not been formally tested in clinical studies.…”
Section: Introductionmentioning
confidence: 99%
“…Since such men have excellent rates of cancer-specific survival (up to 90%), the benefits of ADT need to be carefully balanced against the toxicities, which are a direct consequence of the induced hypogonadism. 1 Adverse effects of ADT include firstly, loss of bone mineral density leading to fractures; secondly, weight gain, insulin resistance and diabetes; [5][6][7] thirdly, sexual symptoms such as sexual dysfunction, gynecomastia, decrease in testicular and penile size, loss of sexual hair; and, fourthly, general and constitutional symptoms including neurophysiological symptoms (reduced mood cognition, quality of life (QoL)), hot flushes, fatigue and anemia. 1,8 Given that prostate cancer is a disease predominantly of ageing men, age itself and associated comorbidities may contribute to increased vulnerability of the hemopoietic system to ADT, although this assumption has not been formally tested in clinical studies.…”
Section: Introductionmentioning
confidence: 99%
“…3,4 Over 600 000 men with PCa in the United States are treated annually with ADT. 5 Osteoporosis is a serious complication of long-term ADT. 6 Bisphosphonates are agents that inhibit proliferation and differentiation of osteoclasts and repress bone resorption by osteoclasts, and have already been used for treatment of primary osteoporosis.…”
Section: Introductionmentioning
confidence: 99%
“…Several agents are known to have a positive effect on BMD in the extreme event of acute hypogonadism due to chemical castration, including bisphosphonates and denosumab (discussed below) [83,84]. It seems reasonable to use these agents to avoid bone loss in men receiving androgen deprivation therapy, particularly when baseline BMD is low or if other fracture risk factors are present.…”
Section: Sex Hormonesmentioning
confidence: 99%