Prostate Cancer and Androgen Deprivation Therapy: Metabolic, Cardiovascular and Psychological Side Effects.
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Date
2016-07
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Abstract
Exposure to androgen deprivation therapy (ADT) by prostate cancer (PCa) patients is
increasing, either in early-stage and in metastatic disease. Frequently, ADT becomes
a long-term treatment, lasting even more than 10 years, starting with gonadotropin
releasing hormone (GnRH) agonists or antagonists, until the newest hormonal
treatments as Abiraterone and Enzalutamide. As a consequence, ADT related adverse
events occurred. We reviewed the medical literature using Pubmed search terms
“prostate cancer”, “androgen deprivation”, “metabolic syndrome”, “cardiovascular
diseases” and “psychological assessment”. The search was limited to manuscripts
published in English language between 1999 and 2016, preferring more recent review
articles. Metabolic syndrome, diabetes and cardiovascular diseases, rather than
PCa itself, are the most common causes of mortality, particularly in early stage PCa
patients. All these adverse eff ects synergistically increase morbidity in patients taking
ADT. Psychological-cognitive implications emerging during ADT result in a signifi
cant reduction of health-related quality of life of PCa patients. ADT is associated
with several adverse events, which physicians andpatients should evaluate when
recommending ADT. Multidisciplinary approach, with diff erent clinicians such as
Urologist, Radiotherapist, Oncologist, Endocrinologist, Cardiologist, Psychologist, is
mandatory for the suitable clinical management of patients with PCa submitted to ADT.
Description
Keywords
Prostate cancer, Androgen deprivation, Metabolic syndrome, Cardiovascular event, Psychological assessment, Abbreviations:, ADT: androgen deprivation therapy, BMI: body mass index, CV: cardiovascular, GnRH: gonadotropin releasing hormone, HDL: high-density lipoprotein, LDL: low-density lipoprotein, LHRH: luteinizing hormone releasing hormone, MS: metabolic syndrome, PCa: prostate cancer
Citation
Mosca Alessandra, Volpe Alessandro, Beldì Debora, Bozzola Cristina, Palma Romeo, Rubinelli Sara, Pagano Loredana, D’Avanzo Francesca, Stratica Florian, Alabiso Oscar, Terrone Carlo. Prostate Cancer and Androgen Deprivation Therapy: Metabolic, Cardiovascular and Psychological Side Effects. Acta Medica International. 2016 Jul-Dec; 3(2): 158-164.