The impact of androgen deprivation on quality of life after radical prostatectomy for prostate carcinoma

Abstract

Dolichospondylic dysplasia (DD) is a rare skeletal dysplasia primarily characterized by tall vertebral bodies and disproportionate short stature. Radiographic manifestations include tall vertebral bodies and gracile bones of the hands. Patients usually have eye and ear findings in addition to borderline mental retardation; however, tall vertebral bodies and slender tubular bones are also seen in the 3‐M syndrome. Patients with the 3‐M syndrome have a characteristic face with a triangular shape, frontal bossing, a flattened malar region, full eyebrows, a short nose with a bulbous tip, upturned nares, and full lips. We present two unrelated patients who share a distinct phenotype and have tall vertebral bodies, overtubulation of long bones, and short tubular bones of the hands and feet. We discuss the overlapping and distinguishing features between DD and the 3‐M syndrome. Patient 1 was a 13‐year‐old female, and patient 2 was an unrelated adult female. These patients had normocephaly and short stature. They shared a common phenotype consisting of mild malar hypoplasia, a narrowed nasal body with a fleshy tip, full lips, and normal intelligence. In addition, they showed mild hand and foot abnormalities. These two patients lack many of the typical clinical features of both DD and the 3‐M syndrome. They share a common phenotype and likely represent a distinct disorder. The spectrum of disorders with tall vertebral bodies as a key feature may include different entities that may be further defined with the characterization of the molecular defect(s). © 2002 Wiley‐Liss, Inc.

The Natural History of Men Treated With Deferred Androgen Deprivation Therapy in Whom Metastatic Prostate Cancer Developed Following Radical Prostatectomy

“…However, they do demonstrate that hormone naïve patients with metastasis after RP, when closely followed in the interval after biochemical failure, may have an excellent response to deferred ADT and a long survival. When treating patients who may survive longer than a decade after surgery, the complications of ADT become 14,20 We have identified prognostic factors (presence of pain and short PSADT at the time of metastasis) which predict worse outcome. Patients with these negative prognostic indicators may benefit from therapies in addition to ADT at the time of metastasis.…”

“…When treating patients who may survive longer than a decade after surgery, the complications of ADT become significant. 14,20 We have identified prognostic factors (presence of pain and short PSADT at the time of metastasis) which predict worse outcome. Patients with these negative prognostic indicators may benefit from therapies in addition to ADT at the time of metastasis.…”

Impact of androgen deprivation on physical well‐being in patients with prostate cancer

“…Similarly, in a study of 3144 Medicare beneficiaries who reported cross-sectional, age-adjusted health-related quality of life responses to treatment, concerns over body image, mental health, general health, activities, and worry about cancer demonstrated significant decrements in men undergoing ADT compared with active treatment only. 33 Although there were differences in magnitude, results from this study suggest that both primary and combination use of ADT is associated with a decline in physical well-being in most patients. Patients undergoing multimodal therapy reported having worse health-related quality of life compared with monotherapy, 21,34 whereas ADT significantly affected physical function compared with active treatments.…”

“…These findings are consistent with some of the previous studies that demonstrated declines in 1 or more aspects of physical health in patients receiving ADT. 9,19,33 Dacal et al reported that men receiving ADT had significantly poorer physical function and general health, which was reflected by lower physical health component score. However, after controlling for significant joint predictors of comorbidity and total testosterone, they concluded that these 2 factors, and not ADT, contributed to the difference in physical health component summary.…”

Influence of Different Regimens of Prostate Cancer Androgen Deprivation on Metabolic Syndrome and Sexual Dysfunction

“…Низкий уровень те-стостерона ассоциирован со снижением либидо и низ-ким уровнем энергии. Снижение уровня тестостерона оказывает серьезное негативное влияние на качество жизни мужчин [5]. В проспективном исследовании мы попытались оценить роль различных режимов гормональной терапии РПЖ в возникновении и степени выраженности метаболическо-го синдрома и влияние на сексуальную активность.…”