Management of bone and metabolic effects of androgen deprivation therapy

Nicholas Russell; Mathis Grossmann

doi:10.1016/j.urolonc.2018.10.007

Management of bone and metabolic effects of androgen deprivation therapy

Urol Oncol. 2021 Oct;39(10):704-712. doi: 10.1016/j.urolonc.2018.10.007. Epub 2018 Nov 13.

Authors

Nicholas Russell¹, Mathis Grossmann²

Affiliations

¹ Department of Medicine Austin Health, University of Melbourne, Heidelberg, Victoria, Australia; Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia. Electronic address: nicholas.russell@austin.org.au.
² Department of Medicine Austin Health, University of Melbourne, Heidelberg, Victoria, Australia; Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia.

PMID: 30446463
DOI: 10.1016/j.urolonc.2018.10.007

Abstract

Androgen deprivation therapy (ADT) is commonly given to men with prostate cancer. Both its benefits as well as its adverse effects are a direct consequence of sex steroid withdrawal. While ADT improves oncologic outcomes in appropriately selected men, it is associated with adverse effects, including accelerated bone loss leading to increased fracture risk, and with metabolically unfavorable body composition changes that predispose to diabetes and may increase cardiovascular risk. In this review, we will describe the pathophysiology behind these ADT-associated adverse effects, and discuss the clinical evidence guiding clinical assessment and management. A proactive approach is important to minimize ADT-associated adverse sequelae, so that the benefit-risk ratio of this treatment is optimized.

Keywords: Androgen deprivation therapy; Diabetes; Osteoporosis; Prostate cancer.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Androgen Antagonists / adverse effects*
Bone Diseases / chemically induced*
Humans
Male
Prostatic Neoplasms / complications*
Prostatic Neoplasms / drug therapy
Risk Factors

Substances

Androgen Antagonists