The effect of androgen deprivation therapy on body composition in men with prostate cancer: Systematic review and meta-analysis

Haseen, Farhana; Murray, Liam; Cardwell, Christopher; O’Sullivan, Joe M.; Cantwell, Marie

doi:10.1007/s11764-009-0114-1

Cited by 132 publications

(88 citation statements)

References 58 publications

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“…A recent systematic review reported data from eight longitudinal studies (208 total patients) on the effects of ADT on body composition and BMI. 102 The right panel of Figure 3 displays these data as an annualized percent change in BMI in studies with at least 1-year exposure.…”

Section: Bmimentioning

confidence: 99%

“…The right panel of Figure 5 illustrates the annualized percent change in fat mass reported in four prospective, longitudinal studies with at least 1-year exposure to ADT. These studies, reviewed in a recent meta-analysis, 102 included patients in a wide range of PCa stages with treatment durations of 3-12 months. All studies showed statistically significant increases in fat mass with an average annualized change of 11.1%.…”

Section: Relative Body Fat (% Fat)mentioning

confidence: 99%

“…Table 3B 99,103,104,107,111,112 were summarized in a recent systematic review that included 261 patients in aggregate and observation periods of 3-24 months. 102 Changes in lean mass in these studies ranged between 21.4% and 23.86%, the latter reported in a 24-month study, one of the longest studies of ADT effects on body composition in the literature. The mean change (95% CI) in percent lean mass was 22.82% (23.64%22.01%).…”

mentioning

confidence: 92%

“…The right panel of Figure 4 displays annualized differences in percent change from studies with at least 1-year exposure. 102 The mean annualized change was 22.0%. These changes typically occurred without significant changes in BMI.…”

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confidence: 95%

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Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy

Storer¹,

Miciek²,

Travison³

2012

Asian J Androl

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Prostate cancer (PCa) is the most common visceral malignancy in men with androgen deprivation therapy (ADT) the preferred therapy to suppress testosterone production and hence tumor growth. Despite its effectiveness in lowering testosterone, ADT is associated with side effects including loss of muscle mass, diminished muscle strength, decrements in physical performance, earlier fatigue and declining quality of life. This review reports a survey of the literature with a focus on changes in muscle strength, physical function and body composition, due to short-term and long-term ADT. Studies in these areas are sparse, especially well-controlled, prospective randomized trials. Cross-sectional and longitudinal data (up to 2 years) for men with PCa treated with ADT as well as patients with PCa not receiving ADT and age-matched healthy men are presented when available. Based on limited longitudinal data, the adverse effects of ADT on muscle function, physical performance and body composition occur shortly after the onset of ADT and tend to persist and worsen over time. Exercise training is a safe and effective intervention for mitigating these changes and initial guidelines for exercise program design for men with PCa have been published by the American College of Sports Medicine. Disparities in study duration, types of studies and other patient-specific variables such as time since diagnosis, cancer stage and comorbidities may all affect an understanding of the influence of ADT on health, physical performance and mortality. Keywords: androgen deprivation therapy; androgen suppression; exercise prescription; exercise training; functional assessment; lean body mass; older men; prostate cancer INTRODUCTION Prostate cancer (PCa) is the most common visceral malignancy in men.1 Since the tumor is initially testosterone dependent, androgen deprivation therapy (ADT) is the preferred modality to suppress testosterone production in men with this disease. ADT has been extensively studied with surgical and chemical castration achieved via bilateral orchiectomy, use of a gonadotropin hormone-releasing hormone (GnRH) agonist or anti-androgens. Annually, about 500 000 men in the United States are treated with GnRH agonists.2 Though their effectiveness in lowering serum testosterone to castrate levels is well established, side effects are common.Testosterone and its metabolites are essential for the maintenance of muscle mass and bone mineral content. Body composition changes in men undergoing ADT place them at increased risk not only for diminished physical capacity, but also for coronary artery disease, type II diabetes and the metabolic syndrome, 3 though a recent meta-analysis suggests no increase in cardiovascular mortality. 4 In addition, ADTassociated decreases in muscle and bone mass are thought to be associated with increased fracture risk, diminished muscle strength, decrements in physical performance, earlier fatigue and declining quality of life (Figure 1).This narrative review focuses on changes in muscle strength, physi...

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Section: Bmimentioning

confidence: 99%

Section: Relative Body Fat (% Fat)mentioning

confidence: 99%

mentioning

confidence: 92%

mentioning

confidence: 95%

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Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy

Storer¹,

Miciek²,

Travison³

2012

Asian J Androl

View full text Add to dashboard Cite

show abstract

“…Testosterone also directly influences changes in body composition by its effects on skeletal muscle. The loss of lean mass and BMD as well as an increase in fat mass following AST are well documented, 6,8,10,51 and although both fat mass and lean mass are both positively associated with bone density because of the effects of gravitational loading on the skeleton, 52,53 the relationship between lean mass and BMD is more powerful owing to the added effect of muscle pull on the skeleton.…”

Section: Osteoporosis and Fractures During And Following Astmentioning

confidence: 99%

AST-induced bone loss in men with prostate cancer: exercise as a potential countermeasure

Bolam

Galvão

Spry

et al. 2012

Prostate Cancer Prostatic Dis

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Androgen suppression treatment (AST) for men with prostate cancer is associated with a number of treatment-related side effects including an accelerated rate of bone loss. This loss of bone is greatest within the first year of AST and increases the risk for fracture. Pharmaceutical treatment in the form of bisphosphonates is currently used to counter the effects of hormone suppression on bone but is costly and associated with potential adverse effects. Recently, exercise has been shown to be an important adjuvant therapy to manage a range of treatment-related toxicities and enhance aspects of quality of life for men receiving AST. We propose that physical exercise may also have an important role in not only attenuating the bone loss associated with AST but in improving bone health and reducing fracture risk. In this review, the rationale underlying exercise as a countermeasure to AST-induced bone loss is provided.

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Castration induces satellite cell activation that contributes to skeletal muscle maintenance

Klose

Liu

Paris

et al. 2018

JCSM Rapid Communications

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Background Sarcopenia, the age-related loss of skeletal muscle, is a side effect of androgen deprivation therapy (ADT) for prostate cancer patients. Resident stem cells of skeletal muscle, satellite cells (SCs), are an essential source of progenitors for the growth and regeneration of skeletal muscle. Decreased androgen signaling and deficits in the number and function of SCs are features of aging. Although androgen signaling is known to regulate skeletal muscle, the cellular basis for ADT-induced exacerbation of sarcopenia is unknown. Furthermore, the consequences of androgen deprivation on SC fate in adult skeletal muscle remain largely unexplored. Methods We examined SC fate in an androgen-deprived environment using immunofluorescence and fluorescence-activated cell sorting (FACS) with SC-specific markers in young castrated mice. To study the effects of androgen deprivation on SC function and skeletal muscle regenerative capacity, young castrated mice were subjected to experimental regenerative paradigms. SC-derived-cell contributions to skeletal muscle maintenance were examined in castrated Pax7CreER/+; ROSA26mTmG/+ mice. SCs were depleted in Pax7CreER/+; ROSA26DTA/+ mice to ascertain the consequences of SC ablation in sham and castrated skeletal muscles. Confocal immunofluorescence analysis of neuromuscular junctions (NMJs), and assessment of skeletal muscle physiology, contractile properties, and integrity were conducted. Results Castration led to SC activation, however this did not result in a decline in SC function or skeletal muscle regenerative capacity. Surprisingly, castration induced SC-dependent maintenance of young skeletal muscle. The functional dependence of skeletal muscles on SCs in young castrated mice was demonstrated by an increase in SC-derived-cell fusion within skeletal muscle fibers. SC depletion was associated with further atrophy and functional decline, as well as the induction of partial innervation and the loss of NMJ-associated myonuclei in skeletal muscles from castrated mice. Conclusion The maintenance of skeletal muscles in young castrated mice relies on the cellular contributions of SCs. Considering the well-described age-related decline in SCs, the results in this study highlight the need to devise strategies that promote SC maintenance and activity to attenuate or reverse the progression of sarcopenia in elderly androgen-deprived individuals.

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The effect of androgen deprivation therapy on body composition in men with prostate cancer: Systematic review and meta-analysis

Cited by 132 publications

References 58 publications

Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy

Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy

AST-induced bone loss in men with prostate cancer: exercise as a potential countermeasure

Castration induces satellite cell activation that contributes to skeletal muscle maintenance

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