Side effects of androgen deprivation therapy: monitoring and minimizing toxicity

Urology ◽  
2003 ◽  
Vol 61 (2) ◽  
pp. 32-38 ◽  
Author(s):  
Celestia S Higano
Keyword(s):  
Side Effects ◽  
Androgen Deprivation Therapy ◽  
Therapy Monitoring ◽  
Androgen Deprivation

scholarly journals Androgen deprivation therapy promotes an obesity-like microenvironment in periprostatic fat

2019 ◽  
Vol 8 (5) ◽  
pp. 547-558 ◽  
Author(s):  
Stefano Mangiola ◽  
Ryan Stuchbery ◽  
Patrick McCoy ◽  
Ken Chow ◽  
Natalie Kurganovs ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Adipose Tissue ◽  
Side Effects ◽  
Androgen Deprivation Therapy ◽  
Cancer Progression ◽  
Tissue Level ◽  
Androgen Deprivation ◽  
Clinical Settings ◽  
Prostate Cancer Development ◽  
Transcriptional Changes

Prostate cancer is a leading cause of morbidity and cancer-related death worldwide. Androgen deprivation therapy (ADT) is the cornerstone of management for advanced disease. The use of these therapies is associated with multiple side effects, including metabolic syndrome and truncal obesity. At the same time, obesity has been associated with both prostate cancer development and disease progression, linked to its effects on chronic inflammation at a tissue level. The connection between ADT, obesity, inflammation and prostate cancer progression is well established in clinical settings; however, an understanding of the changes in adipose tissue at the molecular level induced by castration therapies is missing. Here, we investigated the transcriptional changes in periprostatic fat tissue induced by profound ADT in a group of patients with high-risk tumours compared to a matching untreated cohort. We find that the deprivation of androgen is associated with a pro-inflammatory and obesity-like adipose tissue microenvironment. This study suggests that the beneficial effect of therapies based on androgen deprivation may be partially counteracted by metabolic and inflammatory side effects in the adipose tissue surrounding the prostate.

scholarly journals Prevalence and predictors of cannabis use among men receiving androgen-deprivation therapy for advanced prostate cancer

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Ahmad Mousa ◽  
Michele Petrovic ◽  
Neil E. Fleshner
Keyword(s):  
Prostate Cancer ◽  
Side Effects ◽  
Androgen Deprivation Therapy ◽  
Advanced Prostate Cancer ◽  
Symptom Relief ◽  
Therapeutic Benefit ◽  
Androgen Deprivation ◽  
Cannabis Use ◽  
Testosterone Levels ◽  
Treatment Side Effects

Introduction: Prostate cancer patients receiving androgen-deprivation therapy (ADT) often experience a combination of disease symptoms and treatment side effects. The therapeutic use of cannabis to alleviate these side effects has not been studied, despite increasing patient interest. With the increasing availability of cannabis, it is important for clinicians to understand the prevalence, predictors, and perceived benefits of cannabis use among patients with prostate cancer. Methods: A total of 222 men undergoing ADT were assessed in this two-part study. In part one, the cannabis-use questionnaire was administered to 56 men, probing demographics, usage habits, perspectives, and degrees of symptom relief related to cannabis use. In part two, 191 cryopreserved urine samples were retrieved and analyzed for the presence of tetrahydrocannabidiol (THC) metabolite 11-nor-Δ9-THC-COOH. The respondents were then stratified into two groups, users vs. non-users, and statistical analyses were conducted. Results: Questionnaire data revealed that 23.2% of surveyed men had recently used cannabis. In contrast, 5.8% of men had detectable levels of THC metabolite in their urine. Combined questionnaire and urine data revealed that cannabis users were significantly younger (p=0.003) and had lower testosterone levels (p=0.003) than non-users. The majority of men experiencing common ADT side effects reported some degree of relief following cannabis use. Conclusions: Cannabis use among men with advanced prostate cancer receiving ADT is more prevalent than in the general population and the majority of other oncological cohorts. Lower testosterone levels and reported therapeutic benefit among cannabis users warrants confirmation in appropriate clinical trials.

scholarly journals An Educational Program to Help Patients Manage Androgen Deprivation Therapy Side Effects: Feasibility, Acceptability, and Preliminary Outcomes

2020 ◽  
Vol 14 (1) ◽  
pp. 155798831989899 ◽  
Author(s):  
Erik Wibowo ◽  
Richard J. Wassersug ◽  
John W. Robinson ◽  
Pablo Santos-Iglesias ◽  
Andrew Matthew ◽  
...  
Keyword(s):  
Side Effects ◽  
Androgen Deprivation Therapy ◽  
Program Implementation ◽  
Self Efficacy ◽  
Side Effect ◽  
Educational Program ◽  
Management Strategies ◽  
Androgen Deprivation ◽  
Post Intervention ◽  
Implementation Model

Androgen deprivation therapy (ADT), a common treatment for prostate cancer, is associated with physical, psychological, and sexual side effects that reduce patients’ quality of life. The authors designed an educational program to prepare patients for managing these side effects. This paper describes an implementation model for national dissemination of the program, testing its feasibility and acceptability at the institutional and patient level. Postprogram changes in patients’ self-efficacy to manage side effects and side effect bother are also explored. Patients on or anticipating ADT enrolled in the educational program. Pre and post intervention questionnaires measured patient satisfaction with the program, side effect bother, and self-efficacy to manage ADT side effects. The ADT Educational Program was deemed feasible and acceptable. Five of six targeted sites successfully launched the program with sufficient patient enrolment. Patient attendees were highly satisfied. Self-efficacy, bother, and use of management strategies were interrelated. Lower bother was associated with increased self-efficacy and more use of management strategies, and increased bother was associated with lower self-efficacy and less use of management strategies. Based on pre–post scores, improvements in patients’ self-efficacy to manage ADT side effects were also observed. Results demonstrate that this brief educational program is feasible and acceptable to patients and cancer care institutions. The program appears to promote self-efficacy and the uptake of ADT management strategies for ADT side effects. The results of this study support the program implementation and suggest that improvements in self-efficacy after program participation may help patients adapt to ADT side effects.

A preliminary evaluation of the TrueNTH androgen deprivation therapy educational program.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 219-219
Author(s):  
Erik Wibowo ◽  
Richard J Wassersug ◽  
John W Robinson ◽  
Andrew Matthew ◽  
Deborah L McLeod ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Weight Gain ◽  
Side Effects ◽  
Androgen Deprivation Therapy ◽  
Self Efficacy ◽  
Educational Program ◽  
Hot Flashes ◽  
Androgen Deprivation ◽  
Dyadic Relationship

219 Background: Androgen deprivation therapy (ADT) is the most common systemic treatment for prostate cancer (PCa), but has many adverse effects that reduce patients’ quality of life and that of their partners. In 5 Canadian cities, we offer an educational program designed to help PCa patients and their partners manage ADT side effects as well as maintain a strong dyadic relationship despite changes that accompany ADT. Methods: Patients on or about to start ADT and their partners participate in a 1.5 hour educational session. Patients receive a copy of the 2014 book, Androgen Deprivation Therapy: An essential guide for men with prostate cancer and their partners (DEMOS Health, NY) which discusses how to manage ADT side effects and how to make effective lifestyle changes to maintain a good quality of life. To date, 358 patients and 220 partners have attended the ADT class. A subset (32%) of participants elected to complete questionnaires at baseline and again 2 to 3 months later to assess the program efficacy. Results: At the time of the ADT class, patients who have been on ADT for ≥ 2 months had more frequent side effects (e.g., hot flashes and breast tenderness), and were more bothered by hot flashes. They also reported worse self-efficacy for managing weight gain and diabetes than those who have been on ADT for < 2 months. However, at 2 to 3 months after the class, patients’ self-efficacy for managing ADT side effects improved, despite experiencing more side effects and more bother associated with those side effects. Notably, patients who were on ADT for a shorter duration (< 2 months), who have attended the class, had less bother associated with hot flashes and better self-efficacy for managing weight gain than those who had been on ADT longer before attending the class. Conclusions: The TrueNTH ADT Educational Program potentially dampens side effect bother and improves self-efficacy for two of the most troublesome adverse effects of ADT, hot flashes and weight gain respectively. The program is most beneficial when offered to patients just starting on ADT. Future analyses will focus on exercise behaviour and dyadic relationship to assess the program’s effectiveness in encouraging a healthy lifestyle and maintain strong dyadic bonds in the face of ADT.

Clinical pathway improves implementation of evidence-based strategies for the management of androgen deprivation therapy-induced side effects in men with prostate cancer

2018 ◽  
Vol 121 (4) ◽  
pp. 610-618 ◽  
Author(s):  
Renée Bultijnck ◽  
Inge Van de Caveye ◽  
Elke Rammant ◽  
Sofie Everaert ◽  
Nicolaas Lumen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Side Effects ◽  
Androgen Deprivation Therapy ◽  
Clinical Pathway ◽  
Androgen Deprivation ◽  
Evidence Based
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