Quality of life decrements in men with prostate cancer undergoing androgen deprivation therapy

Abstract

Within 12 months, ADT is associated with clinically significant decreased QoL, particularly physical and sexual aspects, independent of the confounding effects of a cancer diagnosis or radiotherapy. As QoL is a crucial aspect of prostate cancer treatment, addressing hot flushes, sexual dysfunction and exercise may potentially improve outcomes for men undergoing ADT.

Persisting adverse body composition changes 2 years after cessation of androgen deprivation therapy for localised prostate cancer

“…There were no significant differences in mental component of QoL. During ADT, AMS score increased reflecting worse QoL, which was related to an increase in hot flushes (9). Two years after cessation of ADT, AMS was also no longer different to controls likely related to an improvement in hot flushes (MAD: 3.3 (−0.8 to 7.6), P = 0.12).…”

“…QoL was measured by the 12-item Short-Form QoL Survey, version 2 (SF-12), which generates a physical and mental component score and the Aging Males' Symptoms (AMS) Scale as previously described (9,17).…”

“…Computerised musculoskeletal modelling combined with 3D gait analysis demonstrated a selective loss of muscle function during ADT, which leads to functional deficits evident during normal walking (8). In association with these objective deficits, self-reported QoL decreases significantly, particularly with respect to physical and sexual domains (5,9). Whether adverse effects of ADT persist after cessation of treatment is of major relevance, given the overall low prostate cancer-specific mortality in such men (10) and impact on QoL as well as cardiovascular mortality, particularly as these individuals typically have high baseline prevalence of obesity and cardiovascular risk factors (11).…”

Estradiol for the mitigation of adverse effects of androgen deprivation therapy

“…They are often mild and abate, but may persist and be severe enough to warrant pharmacotherapy (Karling et al 1994, Sharifi et al 2005, Jones et al 2012. Hot flushes may interfere with sleep and, along with other side effects of ADT, reduce quality of life (Cheung et al 2016). Men undergoing ADT generally experience loss of libido, erectile dysfunction and reduced sexual activity (Grossmann & Zajac 2011).…”

Clinical pathway improves implementation of evidence‐based strategies for the management of androgen deprivation therapy‐induced side effects in men with prostate cancer

“…Despite the survival improvement , ADT also negatively influences bone, metabolic, cardiovascular, sexual and cognitive health as well as body composition, fatigue and vasomotor flushing . These side effects are detrimental for the patient's health and quality of life , therefore, it is imperative to mitigate them through the introduction of treatments aimed at reducing them. Evidence‐based guidelines have been drawn up to reduce the impact of ADT‐induced side effects , but a European study showed that these guidelines are not sufficiently applied in clinical routine .…”