Does Baseline Serum Testosterone Influence Androgen Deprivation Therapy Outcomes in Hormone Naïve Patients with Advanced Prostate Cancer?

Author(s):  
Anup Patel
2018 ◽  
Vol 14 (10) ◽  
pp. 580-587 ◽  
Author(s):  
Dipti Gupta ◽  
Katherine Lee Chuy ◽  
Ji Can Yang ◽  
Megan Bates ◽  
Marissa Lombardo ◽  
...  

Androgen-deprivation therapy (ADT) entails lowering serum testosterone levels to castrate levels and forms a cornerstone of the management of hormone-sensitive advanced prostate cancer; however, the benefit of ADT is partially offset by its detrimental metabolic and cardiovascular adverse effects. ADT decreases insulin sensitivity while promoting dyslipidemia and sarcopenic obesity, which leads to an increased risk of cardiovascular morbidity and potentially mortality. The risk seems to be highest in elderly patients who have had recent cardiovascular events before starting ADT. It is prudent to engage in an individualized risk–benefit discussion and develop a cohesive multidisciplinary management plan to medically optimize and closely observe these patients before and during treatment with ADT.


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