Quality of sleep in patients receiving androgen deprivation therapy for prostate cancer

AbstractOver the past 60 years, androgen deprivation therapy has been the mainstay of treatment of metastatic prostate cancer. However, research findings suggest that androgen deprivation therapy inflicts serious adverse effects on overall health and reduces the quality of life. Among the adverse effects known to date are insulin resistance, diabetes, metabolic syndrome fatigue, erectile dysfunction, and cardiovascular disease. In this clinical perspective, we discuss the relationship between induced androgen deficiency and a host of pathologies in the course of treatment with androgen deprivation therapy for prostate cancer patients.

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Biopsychosocial impact of prostate cancer and androgen-deprivation therapy

Canadian Urological Association Journal ◽

10.5489/cuaj.4499 ◽

2017 ◽

Vol 11 (10) ◽

pp. 338-43 ◽

Cited By ~ 2

Author(s):

Dean A. Tripp ◽

Phylicia Verreault ◽

Steven Tong ◽

Jason Izard ◽

Angela Black ◽

...

Keyword(s):

Prostate Cancer ◽

Depressive Symptoms ◽

Androgen Deprivation Therapy ◽

Watchful Waiting ◽

Routine Care ◽

Androgen Deprivation ◽

Limited Sample ◽

Adenocarcinoma Of The Prostate ◽

Localized Disease

Introduction: Prostate cancer is the most non-cutaneous malignancy in men, and androgen-deprivation therapy (ADT) is a cornerstone of management in advanced disease. The aim of this study was to evaluate the association of ADT with changes in depression and mental and physical quality of life (QoL) within a prospective patient cohort design.Methods: Patients were prospectively recruited and consented at a single academic health sciences centre in Ontario, Canada. Inclusion criteria included those men with adenocarcinoma of the prostate and either on watchful waiting or initiating ADT as palliation or as an adjuvant therapy for high-risk localized disease. All three cohorts were followed in routine care and completed psychosocial evaluations, including depression, social support, anxiety, and QoL measures.Results: In comparison to the control cohort of patients with prostate cancer on watchful waiting, initiation of ADT over a two-year period of time was not associated with any changes in depression or mental QoL. Instead, all patients, regardless of treatment cohort, showed increased depression scores and reduced mental QoL scores over time; however, for patients receiving ADT, a significant reduction in physical QoL compared to patients who did not receive ADT was demonstrated.Conclusions: ADT does not appear to significantly impact depressive symptoms and mental QoL over a two-year period; however, the depressive symptoms in this limited sample of men with prostate cancer was higher than expected and monitoring for these may be advisable for those who care for such patients.

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Quality of Life in Prostate Cancer Patients Taking Androgen Deprivation Therapy

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.2005.00567.x ◽

2006 ◽

Vol 54 (1) ◽

pp. 85-90 ◽

Cited By ~ 85

Author(s):

Kirsten Dacal ◽

Susan M. Sereika ◽

Susan L. Greenspan

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Cancer Patients ◽

Androgen Deprivation Therapy ◽

Androgen Deprivation

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Effects of Exercise on Treatment-Related Adverse Effects for Patients With Prostate Cancer Receiving Androgen-Deprivation Therapy: A Systematic Review

Journal of Clinical Oncology ◽

10.1200/jco.2013.49.5523 ◽

2014 ◽

Vol 32 (4) ◽

pp. 335-346 ◽

Cited By ~ 141

Author(s):

Jason R. Gardner ◽

Patricia M. Livingston ◽

Steve F. Fraser

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Systematic Review ◽

Adverse Effects ◽

Androgen Deprivation Therapy ◽

Bone Health ◽

Cardiometabolic Risk ◽

Androgen Deprivation ◽

Cochrane Library

Purpose Androgen-deprivation therapy is a commonly used treatment for men with prostate cancer; however, the adverse effects can be detrimental to patient health and quality of life. Exercise has been proposed as a strategy for ameliorating a range of these treatment-related adverse effects. We conducted a systematic review of the literature regarding the effects of exercise on treatment-related adverse effects in men receiving androgen-deprivation therapy for prostate cancer. Methods An online electronic search of the Cochrane Library, EMBASE, MEDLINE, CINAHL, SPORTDiscus, and Health Source databases was performed to identify relevant peer-reviewed articles published between January 1980 and June 2013. Eligible study designs included randomized controlled trials as well as uncontrolled trials with pre- and postintervention data. Information was extracted regarding participant and exercise intervention characteristics as well as the effects of exercise on bone health, body composition, physical performance, cardiometabolic risk, fatigue, and quality of life. Results Ten studies were included, with exercise interventions involving aerobic and/or resistance training. Exercise training demonstrated benefits in muscular strength, cardiorespiratory fitness, functional task performance, lean body mass, and fatigue, with inconsistent effects observed for adiposity. The impact of exercise on bone health, cardiometabolic risk markers, and quality of life are currently unclear. Conclusion Among patients with prostate cancer treated with androgen-deprivation therapy, appropriately prescribed exercise is safe and may ameliorate a range of treatment-induced adverse effects. Ongoing research of high methodologic quality is required to consolidate and expand on current knowledge and to allow the development of specific evidence-based exercise prescription recommendations.

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