Prostate Cancer and Androgen Deprivation Therapy: Metabolic, Cardiovascular and Psychological Side Effects

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Acta Medica International,2016,3,2,158-164.
Published:September 2016
Type:Review Article

Prostate Cancer and Androgen Deprivation Therapy: Metabolic, Cardiovascular and Psychological Side Effects

Alessandra Mosca1, Alessandro Volpe2, Debora Beldì3, Cristina Bozzola4, Romeo Palma5, Sara Rubinelli6, Loredana Pagano7, Francesca D’Avanzo1, Florian Stratica8, Oscar Alabiso1, Carlo Terrone2

1Oncology, 2Urology, 3Radiotherapy, 4Pathology, 5Radiology, 6PsychoOncology, 7Endocrinology, 8Data Management, Urological Tumors Multidisciplinary Team, Maggiore Della Carità University Hospital, East Piedmont University, Novara, Italy

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.

Alessandra Mosca