Skip to main content
SpringerLink
Log in

Pitfalls of Androgen Deprivation Therapy

  • Chapter
  • First Online:
Management of Prostate Cancer

Part of the book series: Current Clinical Urology ((CCU))

  • 1439 Accesses

Abstract

Androgen deprivation therapy (ADT) is a widely used method of treatment for men with prostate cancer. In men with metastatic disease, primary ADT improves quality of life and extends overall survival. ADT improves both progression free and overall survival in men with intermediate and high risk early stage disease. More recently, it has been used in men who have a PSA only recurrence after definitive treatment with radiation or surgery. With earlier use of ADT, it is important to understand the potential consequences of this intervention. Well-recognized adverse effects of ADT include loss of libido, fatigue, vasomotor flushing, and anemia. This chapter reviews some of the more recently described adverse effects, including the impact of ADT on bone, insulin sensitivity, muscle mass, and lipids, and the implications for risks of diabetes and cardiovascular disease. We will also outline strategies to prevent treatment-related morbidity in prostate cancer survivors.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Altekruse SF, Kosary CL, Krapcho M, et al. SEER cancer statistics review, 1975–2007 based on November 2009 SEER data submission, posted to the SEER web site; 2010. http://seer.cancer.gov/csr/1975_2007/.

  2. Huggins C, Hodges CV. Studies on prostatic cancer, I: the effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of prostate. Cancer Res. 1941;1:293–7.

    CAS  Google Scholar 

  3. Huggins C, Stevens Jr RE, Hodges CV. Studies on prostatic cancer, II: the effects of castration on advanced carcinoma of prostate gland. Arch Surg. 1941;43:209–23.

    Article  CAS  Google Scholar 

  4. Gilbert SM, Kuo Y, Shahinian VB. Prevalent and incident use of androgen deprivation therapy among men with prostate cancer in the United States. Urol Oncol. 2011;29(6):847–53 (corrected proof).

    Google Scholar 

  5. Smith MR. Androgen deprivation therapy for prostate cancer: new concepts and concerns. Curr Opin Endocrinol Diabetes Obes. 2007;14(3):247–54.

    Article  PubMed  Google Scholar 

  6. Basaria S. Androgen deprivation therapy, insulin resistance, and cardiovascular mortality: an inconvenient truth. J Androl. 2008;29(5):534–9.

    Article  PubMed  Google Scholar 

  7. Sharifi N, Gulley JL, Dahut WL. Androgen deprivation therapy for prostate cancer. JAMA. 2005;294(2): 238–44.

    Article  PubMed  CAS  Google Scholar 

  8. Chodak GW, Keane T, Klotz L, Hormone Therapy Study Group. Critical evaluation of hormonal therapy for carcinoma of the prostate. Urology. 2002;60(2): 201–8.

    Article  PubMed  Google Scholar 

  9. Keating NL, O’Malley AJ, Smith MR. Diabetes and cardiovascular disease during androgen deprivation therapy for prostate cancer. J Clin Oncol. 2006;24(27):4448–56.

    Article  PubMed  CAS  Google Scholar 

  10. National Osteoporosis Foundation. Osteoporosis: men. http://www.nof.org/osteoporosis/diseasefacts.htm#gender. Updated 2010. Accessed 21 July 2010.

  11. Seeman E. The structural basis of bone fragility in men. Bone. 1999;25(1):143–7.

    Article  PubMed  CAS  Google Scholar 

  12. Berruti A, Dogliotti L, Terrone C, et al. Changes in bone mineral density, lean body mass and fat content as measured by dual energy X-ray absorptiometry in patients with prostate cancer without apparent bone metastases given androgen deprivation therapy. J Urol. 2002;167(6):2361–7.

    Article  PubMed  Google Scholar 

  13. Maillefert JF, Sibilia J, Michel F, Saussine C, Javier RM, Tavernier C. Bone mineral density in men treated with synthetic gonadotropin-releasing hormone agonists for prostate carcinoma. J Urol. 1999;161(4):1219–22.

    Article  PubMed  CAS  Google Scholar 

  14. Daniell HW, Dunn SR, Ferguson DW, Lomas G, Niazi Z, Stratte PT. Progressive osteoporosis during androgen deprivation therapy for prostate cancer. J Urol. 2000;163(1):181–6.

    Article  PubMed  CAS  Google Scholar 

  15. Bilezikian JP. Osteoporosis in men. J Clin Endocrinol Metab. 1999;84(10):3431–4.

    Article  PubMed  CAS  Google Scholar 

  16. Looker AC, Orwoll ES, Johnston Jr CC, et al. Prevalence of low femoral bone density in older U.S. adults from NHANES III. J Bone Miner Res. 1997;12(11):1761–8.

    Article  PubMed  CAS  Google Scholar 

  17. Orwoll ES, Klein RF. Osteoporosis in men. Endocr Rev. 1995;16(1):87–116.

    PubMed  CAS  Google Scholar 

  18. Orwoll ES. Osteoporosis in men. Endocrinol Metab Clin North Am. 1998;27(2):349–67.

    Article  PubMed  CAS  Google Scholar 

  19. Schuit SC, van der Klift M, Weel AE, de Laet CE, Burger H, Seeman E, et al. Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study. Bone. 2004;34(1): 195–202.

    Article  PubMed  CAS  Google Scholar 

  20. Leder BZ, Smith MR, Fallon MA, Lee MT, Finkelstein JS. Effects of gonadal steroid suppression on skeletal sensitivity to parathyroid hormone in men. J Clin Endocrinol Metab. 2001;86(2):511–6.

    Article  PubMed  CAS  Google Scholar 

  21. Diamond T, Campbell J, Bryant C, Lynch W. The effect of combined androgen blockade on bone turnover and bone mineral densities in men treated for prostate carcinoma: longitudinal evaluation and response to intermittent cyclic etidronate therapy. Cancer. 1998;83(8):1561–6.

    Article  PubMed  CAS  Google Scholar 

  22. Shahinian VB, Kuo Y, Freeman JL, Goodwin JS. Risk of fracture after androgen deprivation for prostate cancer. N Engl J Med. 2005;352(2):154–64.

    Article  PubMed  CAS  Google Scholar 

  23. Smith MR, Lee WC, Brandman J, Wang Q, Botteman M, Pashos CL. Gonadotropin-releasing hormone agonists and fracture risk: a claims-based cohort study of men with nonmetastatic prostate cancer. J Clin Oncol. 2005;23(31):7897–903.

    Article  PubMed  CAS  Google Scholar 

  24. Smith MR, Boyce SP, Moyneur E, Duh MS, Raut MK, Brandman J. Risk of clinical fractures after gonadotropin-releasing hormone agonist therapy for prostate cancer. J Urol. 2006;175(1):136–9.

    Article  PubMed  CAS  Google Scholar 

  25. Oefelein MG, Ricchiuti V, Conrad W, Resnick MI. Skeletal fractures negatively correlate with overall survival in men with prostate cancer. J Urol. 2002;168(3):1005–7.

    Article  PubMed  Google Scholar 

  26. Smith MR, McGovern FJ, Zietman AL, et al. Pamidronate to prevent bone loss during androgen-deprivation therapy for prostate cancer. N Engl J Med. 2001;345(13):948–55.

    Article  PubMed  CAS  Google Scholar 

  27. Smith MR, Eastham J, Gleason DM, Shasha D, Tchekmedyian S, Zinner N. Randomized controlled trial of zoledronic acid to prevent bone loss in men receiving androgen deprivation therapy for nonmetastatic prostate cancer. J Urol. 2003;169(6):2008–12.

    Article  PubMed  CAS  Google Scholar 

  28. Diamond TH, Winters J, Smith A, et al. The antiosteoporotic efficacy of intravenous pamidronate in men with prostate carcinoma receiving combined androgen blockade: a double blind, randomized, placebo-controlled crossover study. Cancer. 2001;92(6):1444–50.

    Article  PubMed  CAS  Google Scholar 

  29. Saad F, Gleason DM, Murray R, et al. A randomized, placebo-controlled trial of zoledronic acid in patients with hormone-refractory metastatic prostate carcinoma. J Natl Cancer Inst. 2002;94(19):1458–68.

    Article  PubMed  CAS  Google Scholar 

  30. Michaelson MD, Kaufman DS, Lee H, et al. Randomized controlled trial of annual zoledronic acid to prevent gonadotropin-releasing hormone agonist-induced bone loss in men with prostate cancer. J Clin Oncol. 2007;25(9):1038–42.

    Article  PubMed  CAS  Google Scholar 

  31. Smith MR, Malkowicz SB, Chu F, et al. Toremifene increases bone mineral density in men receiving androgen deprivation therapy for prostate cancer: interim analysis of a multicenter phase 3 clinical study. J Urol. 2008;179(1):152–5.

    Article  PubMed  CAS  Google Scholar 

  32. Smith MR, Fallon MA, Lee H, Finkelstein JS. Raloxifene to prevent gonadotropin-releasing hormone agonist-induced bone loss in men with prostate cancer: a randomized controlled trial. J Clin Endocrinol Metab. 2004;89(8):3841–6.

    Article  PubMed  CAS  Google Scholar 

  33. Smith MR, Morton RA, Barnette KG, Sieber PR, Malkowicz SB, Rodriguez D. Toremifene to reduce fracture risk in men receiving androgen deprivation therapy for prostate cancer. J Urol. 2010;184(4): 1316–21.

    Article  PubMed  CAS  Google Scholar 

  34. Martin TJ. Paracrine regulation of osteoclast formation and activity: milestones in discovery. J Musculoskelet Neuroanal Interact. 2004;4(3):243–53.

    CAS  Google Scholar 

  35. McClung MR, Lewiecki EM, Cohen SB, et al. Denosumab in postmenopausal women with low bone mineral density. N Engl J Med. 2006;354(8): 821–31.

    Article  PubMed  CAS  Google Scholar 

  36. Miller PD, Bolognese MA, Lewiecki EM, et al. Effect of denosumab on bone density and turnover in postmenopausal women with low bone mass after long-term continued, discontinued, and restarting of therapy: a randomized blinded phase 2 clinical trial. Bone. 2008;43(2):222–9.

    Article  PubMed  CAS  Google Scholar 

  37. Ellis GK, Bone HG, Chlebowski R, et al. Randomized trial of denosumab in patients receiving adjuvant aromatase inhibitors for nonmetastatic breast cancer. J Clin Oncol. 2008;26(30):4875–82.

    Article  PubMed  CAS  Google Scholar 

  38. Smith MR, Egerdie B, Hernandez Toriz N, et al. Denosumab in men receiving androgen-deprivation therapy for prostate cancer. N Engl J Med. 2009;361(8):745–55.

    Article  PubMed  CAS  Google Scholar 

  39. Qaseem A, Snow V, Shekelle P, et al. Screening for osteoporosis in men: a clinical practice guideline from the American College of Physicians [Erratum appears in Ann Intern Med. 2008;148(11):888]. Ann Intern Med. 2008;148(9):680–4.

    Google Scholar 

  40. WHO Study Group. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser. 1994;843:1–129.

    Google Scholar 

  41. Kanis JA, Melton III LJ, Christiansen C, Johnston CC, Khaltaev N. The diagnosis of osteoporosis. J Bone Miner Res. 1994;9(8):1137–41.

    Article  PubMed  CAS  Google Scholar 

  42. Seeman E, Bianchi G, Khosla S, Kanis JA, Orwoll E. Bone fragility in men—where are we? Osteoporos Int. 2006;17(11):1577–83.

    Article  PubMed  CAS  Google Scholar 

  43. Watts NB, Lewiecki EM, Miller PD, Baim S. National Osteoporosis Foundation 2008 clinician’s guide to prevention and treatment of osteoporosis and the World Health Organization Fracture Risk Assessment Tool (FRAX): what they mean to the bone densitometrist and bone technologist. J Clin Densitom. 2008;11(4):473–7.

    Article  PubMed  Google Scholar 

  44. Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E. FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int. 2008;19(4):385–97.

    Article  PubMed  CAS  Google Scholar 

  45. Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999–2008. JAMA. 2010;303(3):235–41.

    Article  PubMed  CAS  Google Scholar 

  46. Hossain P, Kawar B, El Nahas M. Obesity and diabetes in the developing world—a growing challenge. N Engl J Med. 2007;356(3):213–5.

    Article  PubMed  CAS  Google Scholar 

  47. Deslypere JP, Vermeulen A. Leydig cell function in normal men: effect of age, life-style, residence, diet, and activity. J Clin Endocrinol Metab. 1984;59(5): 955–62.

    Article  PubMed  CAS  Google Scholar 

  48. Morley JE, Kaiser FE, Perry HM, et al. Longitudinal changes in testosterone, luteinizing hormone, and follicle-stimulating hormone in healthy older men. Metabolism. 1997;46(4):410–3.

    Article  PubMed  CAS  Google Scholar 

  49. Forbes GB, Reina JC. Adult lean body mass declines with age: some longitudinal observations. Metabolism. 1970;19(9):653–63.

    Article  PubMed  CAS  Google Scholar 

  50. Katznelson L, Finkelstein JS, Schoenfeld DA, Rosenthal DI, Anderson EJ, Klibanski A. Increase in bone density and lean body mass during testosterone administration in men with acquired hypogonadism. J Clin Endocrinol Metab. 1996;81(12):4358–65.

    Article  PubMed  CAS  Google Scholar 

  51. Smith MR. Changes in fat and lean body mass during androgen-deprivation therapy for prostate cancer. Urology. 2004;63(4):742–5.

    Article  PubMed  Google Scholar 

  52. Smith MR, Finkelstein JS, McGovern FJ, et al. Changes in body composition during androgen deprivation therapy for prostate cancer. J Clin Endocrinol Metab. 2002;87(2):599–603.

    Article  PubMed  CAS  Google Scholar 

  53. Zamboni M, Mazzali G, Fantin F, Rossi A, Di Francesco V. Sarcopenic obesity: a new category of obesity in the elderly. Nutr Metab Cardiovasc Dis. 2008;18(5):388–95.

    Article  PubMed  CAS  Google Scholar 

  54. Smith JC, Bennett S, Evans LM, et al. The effects of induced hypogonadism on arterial stiffness, body composition, and metabolic parameters in males with prostate cancer. J Clin Endocrinol Metab. 2001;86(9):4261–7.

    Article  PubMed  CAS  Google Scholar 

  55. Smith MR, Lee H, Nathan DM. Insulin sensitivity during combined androgen blockade for prostate cancer. J Clin Endocrinol Metab. 2006;91(4):1305–8.

    Article  PubMed  CAS  Google Scholar 

  56. Lee H, McGovern K, Finkelstein JS, Smith MR. Changes in bone mineral density and body composition during initial and long-term gonadotropin-releasing hormone agonist treatment for prostate carcinoma. Cancer. 2005;104(8):1633–7.

    Article  PubMed  CAS  Google Scholar 

  57. Borst SE. Interventions for sarcopenia and muscle weakness in older people. Age Ageing. 2004;33(6):548–55.

    Article  PubMed  Google Scholar 

  58. Segal RJ, Reid RD, Courneya KS, et al. Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol. 2003;21(9): 1653–9.

    Article  PubMed  Google Scholar 

  59. Tabak AG, Jokela M, Akbaraly TN, Brunner EJ, Kivimaki M, Witte DR. Trajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall II study. Lancet. 2009;373(9682): 2215–21.

    Article  PubMed  CAS  Google Scholar 

  60. Despres JP, Lamarche B, Mauriege P, et al. Hyperinsulinemia as an independent risk factor for ischemic heart disease. N Engl J Med. 1996;334(15): 952–7.

    Article  PubMed  CAS  Google Scholar 

  61. Pyorala M, Miettinen H, Laakso M, Pyorala K. Hyperinsulinemia predicts coronary heart disease risk in healthy middle-aged men: the 22-year follow-up results of the Helsinki Policemen Study. Circulation. 1998;98(5):398–404.

    Article  PubMed  CAS  Google Scholar 

  62. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33 Suppl 1:S62–9.

    Article  Google Scholar 

  63. Lakka HM, Laaksonen DE, Lakka TA, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002;288(21):2709–16.

    Article  PubMed  Google Scholar 

  64. Haffner SM, Valdez RA, Mykkanen L, Stern MP, Katz MS. Decreased testosterone and dehydroepiandrosterone sulfate concentrations are associated with increased insulin and glucose concentrations in nondiabetic men. Metabolism. 1994;43(5):599–603.

    Article  PubMed  CAS  Google Scholar 

  65. Haffner SM, Shaten J, Stern MP, Smith GD, Kuller L. Low levels of sex hormone-binding globulin and testosterone predict the development of non-insulin-dependent diabetes mellitus in men. MRFIT Research Group. Multiple Risk Factor Intervention Trial. Am J Epidemiol. 1996;143(9):889–97.

    Article  PubMed  CAS  Google Scholar 

  66. Muller M, Grobbee DE, den Tonkelaar I, Lamberts SW, van der Schouw YT. Endogenous sex hormones and metabolic syndrome in aging men. J Clin Endocrinol Metab. 2005;90(5):2618–23.

    Article  PubMed  CAS  Google Scholar 

  67. Bubley GJ, Carducci M, Dahut W, et al. Eligibility and response guidelines for phase II clinical trials in androgen-independent prostate cancer: recommendations from the Prostate-Specific Antigen Working Group [Erratum appears in J Clin Oncol. 2007;25(9):1154]. J Clin Oncol. 1999;17(11): 3461–7.

    Google Scholar 

  68. Smith MR, Lee H, Fallon MA, Nathan DM. Adipocytokines, obesity, and insulin resistance during combined androgen blockade for prostate cancer. Urology. 2008;71(2):318–22.

    Article  PubMed  Google Scholar 

  69. Matsuda M, DeFronzo RA. Insulin sensitivity indices (ISI) obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care. 1999;22:1462–70.

    Article  PubMed  CAS  Google Scholar 

  70. Dockery F, Bulpitt CJ, Agarwal S, Donaldson M, Rajkumar C. Testosterone suppression in men with prostate cancer leads to an increase in arterial stiffness and hyperinsulinaemia. Clin Sci (Colch). 2003;104(2):195–201.

    Article  CAS  Google Scholar 

  71. Basaria S, Muller DC, Carducci MA, Egan J, Dobs AS. Hyperglycemia and insulin resistance in men with prostate carcinoma who receive androgen-deprivation therapy. Cancer. 2006;106(3):581–8.

    Article  PubMed  CAS  Google Scholar 

  72. Lage MJ, Barber BL, Markus RA. Association between androgen-deprivation therapy and incidence of diabetes among males with prostate cancer. Urology. 2007;70(6):1104–8.

    Article  PubMed  CAS  Google Scholar 

  73. Keating NL, O’Malley AJ, Freedland SJ, Smith MR. Diabetes and cardiovascular disease during androgen deprivation therapy: observational study of veterans with prostate cancer. J Natl Cancer Inst. 2010;102(1):39–46.

    Article  PubMed  CAS  Google Scholar 

  74. Smith MR, Lee H, McGovern F, et al. Metabolic changes during gonadotropin-releasing hormone agonist therapy for prostate cancer: differences from the classic metabolic syndrome. Cancer. 2008;112(10):2188–94.

    Article  PubMed  CAS  Google Scholar 

  75. Braga-Basaria M, Dobs AS, Muller DC, et al. Metabolic syndrome in men with prostate cancer undergoing long-term androgen-deprivation therapy. J Clin Oncol. 2006;24(24):3979–83.

    Article  PubMed  Google Scholar 

  76. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of The National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486–97.

    Google Scholar 

  77. Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988;37(12): 1595–607.

    Article  PubMed  CAS  Google Scholar 

  78. Kahn R, Buse J, Ferrannini E, Stern M. The metabolic syndrome: time for a critical appraisal. Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia. 2005;48(9):1684–99.

    Article  PubMed  CAS  Google Scholar 

  79. Ferrannini E. Metabolic syndrome: a solution in search of a problem. J Clin Endocrinol Metab. 2007;92(2):396–8.

    Article  PubMed  CAS  Google Scholar 

  80. Dockery F, Bulpitt CJ, Agarwal S, Vernon C, Rajkumar C. Effect of androgen suppression compared with androgen receptor blockade on arterial stiffness in men with prostate cancer. J Androl. 2009;30(4):410–5.

    Article  PubMed  CAS  Google Scholar 

  81. Trujillo ME, Scherer PE. Adiponectin—journey from an adipocyte secretory protein to biomarker of the metabolic syndrome. J Intern Med. 2005;257(2):167–75.

    Article  PubMed  CAS  Google Scholar 

  82. Haffner SM. The metabolic syndrome: inflammation, diabetes mellitus, and cardiovascular disease. Am J Cardiol. 2006;97(2A):3A–11.

    Article  PubMed  CAS  Google Scholar 

  83. Eri LM, Urdal P, Bechensteen AG. Effects of the luteinizing hormone-releasing hormone agonist leuprolide on lipoproteins, fibrinogen and plasminogen activator inhibitor in patients with benign prostatic hyperplasia. J Urol. 1995;154(1):100–4.

    Article  PubMed  CAS  Google Scholar 

  84. Malkin CJ, Pugh PJ, Jones RD, Kapoor D, Channer KS, Jones TH. The effect of testosterone replacement on endogenous inflammatory cytokines and lipid profiles in hypogonadal men. J Clin Endocrinol Metab. 2004;89(7):3313–8.

    Article  PubMed  CAS  Google Scholar 

  85. Arrer E, Jungwirth A, Mack D, Frick J, Patsch W. Treatment of prostate cancer with gonadotropin-releasing hormone analogue: effect on lipoprotein[a]. J Clin Endocrinol Metab. 1996;81(7):2508–11.

    Article  PubMed  CAS  Google Scholar 

  86. Stamler J, Wentworth D, Neaton JD. Is relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? Findings in 356,222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT). JAMA. 1986;256(20):2823–8.

    Article  PubMed  CAS  Google Scholar 

  87. Prospective Studies Collaboration, Lewington S, Whitlock G, et al. Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet. 2007;370(9602):1829–39.

    Google Scholar 

  88. Smith MR, Malkowicz SB, Chu F, et al. Toremifene improves lipid profiles in men receiving androgen-deprivation therapy for prostate cancer: interim analysis of a multicenter phase III study. J Clin Oncol. 2008;26(11):1824–9.

    Article  PubMed  CAS  Google Scholar 

  89. National Heart Lung and Blood Institute, National Institutes of Health. National cholesterol education program risk assessment tool for estimating 10-year risk of developing hard CHD (Myocardial Infarction and Coronary Death). http://www.nhlbi.nih.gov/guidelines/cholesterol/index.htm. Updated 2004. Accessed 8 July 2010.

  90. Writing Group MEMBERS, Lloyd-Jones D, Adams RJ, et al. Executive summary: heart disease and stroke statistics—2010 update: a report from the American Heart Association. Circulation. 2010;121(7): 948–54.

    Google Scholar 

  91. Satariano WA, Ragland KE, Van Den Eeden SK. Cause of death in men diagnosed with prostate carcinoma. Cancer. 1998;83(6):1180–8.

    Article  PubMed  CAS  Google Scholar 

  92. Saigal CS, Gore JL, Krupski TL, et al. Androgen deprivation therapy increases cardiovascular morbidity in men with prostate cancer. Cancer. 2007;110(7):1493–500.

    Article  PubMed  CAS  Google Scholar 

  93. Alibhai SM, Duong-Hua M, Sutradhar R, et al. Impact of androgen deprivation therapy on cardiovascular disease and diabetes. J Clin Oncol. 2009;27(21):3452–8.

    Article  PubMed  Google Scholar 

  94. Roach III M, Bae K, Speight J, et al. Short-term neoadjuvant androgen deprivation therapy and external-beam radiotherapy for locally advanced prostate cancer: long-term results of RTOG 8610. J Clin Oncol. 2008;26(4):585–91.

    Article  PubMed  Google Scholar 

  95. Efstathiou JA, Bae K, Shipley WU, et al. Cardiovascular mortality after androgen deprivation therapy for locally advanced prostate cancer: RTOG 85-31. J Clin Oncol. 2009;27(1):92–9.

    Article  PubMed  Google Scholar 

  96. Efstathiou JA, Bae K, Shipley WU, et al. Cardiovascular mortality and duration of androgen deprivation for locally advanced prostate cancer: analysis of RTOG 92-02. Eur Urol. 2008;54(4): 816–24.

    Article  PubMed  CAS  Google Scholar 

  97. Studer UE, Whelan P, Albrecht W, Casselman J, de Reijke T, Hauri D, et al. Immediate or deferred androgen deprivation for patients with prostate cancer not suitable for local treatment with curative intent: European Organisation for Research and Treatment of Cancer (EORTC) trial 30891. J Clin Oncol. 2006;24(12):1868–76.

    Article  PubMed  Google Scholar 

  98. Bolla M, de Reijke TM, Van Tienhoven G, Van den Bergh ACM, Oddens J, Poortmans PMP, et al. Duration of androgen suppression in the treatment of prostate cancer. N Engl J Med. 2009;360:2516–27.

    Article  PubMed  CAS  Google Scholar 

  99. Tsai HK, D’Amico AV, Sadetsky N, Chen MH, Carroll PR. Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality. J Natl Cancer Inst. 2007;99(20):1516–24.

    Article  PubMed  Google Scholar 

  100. Nanda A, Chen M, Braccioforte MH, Moran BJ, D’Amico AV. Hormonal therapy use for prostate cancer and mortality in men with coronary artery disease-induced congestive heart failure or myocardial infarction. JAMA. 2009;302(8):866–73.

    Article  PubMed  CAS  Google Scholar 

  101. Levine GN, D’Amico AV, Berger P, Clark PE, Eckel RH, Keating NL, et al.; American Heart Association Council on Clinical Cardiology and Council on Epidemiology and Prevention, the American Cancer Society, and the American Urological Association. Androgen-deprivation therapy in prostate cancer and cardiovascular risk: a science advisory from the American Heart Association, American Cancer Society, and American Urological Association: endorsed by the American Society for Radiation Oncology. CA Cancer J Clin. 2010;60(3):194–201.

    Google Scholar 

  102. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al.; National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National High Blood Pressure Education Program Coordinating Committee. The seventh report of the Joint National Committee on Prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289(19):2560–72.

    Google Scholar 

  103. Ockene IS, Miller NH. Cigarette smoking, cardiovascular disease, and stroke: a statement for healthcare professionals from the American Heart Association. American Heart Association Task Force on Risk Reduction. Circulation. 1997;96(9): 3243–7.

    Article  PubMed  CAS  Google Scholar 

  104. D’Amico AV, Denham JW, Crook J, et al. Influence of androgen suppression therapy for prostate cancer on the frequency and timing of fatal myocardial infarctions. J Clin Oncol. 2007;25(17):2420–5.

    Article  PubMed  CAS  Google Scholar 

  105. Saylor PJ, Smith MR. Metabolic complications of androgen deprivation therapy for prostate cancer. J Urol. 2009;181(5):1998–2006.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Hematology/Oncology, Massachusetts General Hospital Cancer Center, 55 Fruit Street, POB Lawrence House, Room 221, Boston, MA, 02114, USA

    Alicia K. Morgans & Matthew R. Smith

Authors
  1. Alicia K. Morgans
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Matthew R. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alicia K. Morgans .

Editor information

Editors and Affiliations

  1. , Glickman Urological and Kidney, Cleveland Clinic, 9500 Euclid Ave, Cleveland, 44195, Ohio, USA

    Eric A. Klein

  2. Cleveland Clinic, Cleveland Clinic Lerner College of Medic, Department of Regional Urology, at Case Western Reserve, Cleveland, 44195, Ohio, USA

    J. Stephen Jones

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Morgans, A.K., Smith, M.R. (2012). Pitfalls of Androgen Deprivation Therapy. In: Klein, E., Jones, J. (eds) Management of Prostate Cancer. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-259-9_23

Download citation

  • DOI: https://doi.org/10.1007/978-1-60761-259-9_23

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60761-258-2

  • Online ISBN: 978-1-60761-259-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation