How Are Patients With Prostate Cancer Managing Androgen Deprivation Therapy Side Effects?

Clin Genitourin Cancer. 2019 Jun;17(3):e408-e419. doi: 10.1016/j.clgc.2018.12.006. Epub 2018 Dec 20.

Abstract

Background: Androgen deprivation therapy (ADT) for prostate cancer has numerous side effects. Clinical guidelines for side effect management exist; however, these are not always integrated into routine practice. What remains undocumented and therefore the objective of this study, is to describe patients' willingness to employ established strategies.

Patients and methods: Study participants were 91 men who had attended an educational program (ie, attend a class plus read a book), designed to prepare patients for managing ADT side effects. Three months later, patients completed the ADT Management Strategies Inventory, to determine use of strategies. Descriptive analyses were conducted.

Results: At the time of class attendance, the average ADT duration was 133 days. Patient preferences for a variety of strategies for each side effect are presented. Highlights include: a high degree (> 65%) of patients using or willing to use exercise to manage medical risks and physical side effects. Forty percent of patients continued to engage in non-penetrative sexual activities, despite reduced sexual desire and erectile dysfunction.

Conclusions: When educated about options, patients are willing to use a wide array of ADT management strategies. Consequently, health care providers should ensure that patients know about side effects and how to manage them. Exercise appears to be the single best strategy to encourage, because it is helpful in managing many side effects (eg, weight gain, muscle weakening, fatigue) and reducing medical risks of ADT (eg, cardiovascular disease, type II diabetes, and osteoporosis). A general trend was patient's preference for behavioral and lifestyle strategies over pharmacologic interventions.

Keywords: Hormone therapy; Patient education; Patient perspectives; Quality of life; Self-management; Side effect management.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Androgen Antagonists / administration & dosage
  • Androgen Antagonists / adverse effects*
  • Cognitive Behavioral Therapy / methods*
  • Disease Management
  • Drug-Related Side Effects and Adverse Reactions / etiology
  • Drug-Related Side Effects and Adverse Reactions / prevention & control*
  • Follow-Up Studies
  • Humans
  • Male
  • Osteoporosis / chemically induced
  • Osteoporosis / prevention & control*
  • Patient Education as Topic*
  • Prognosis
  • Prostatic Neoplasms / drug therapy*
  • Quality of Life
  • Sexual Dysfunctions, Psychological / chemically induced
  • Sexual Dysfunctions, Psychological / prevention & control*

Substances

  • Androgen Antagonists