Metabolic health for patients with prostate cancer during androgen deprivation therapy

Abstract

Androgen deprivation therapy (ADT) continues to be widely used for the treatment of prostate cancer despite the appearance of new-generation androgen receptor-targeting drugs after 2000. ADT can alleviate symptoms in patients with metastatic prostate cancer and may have a survival benefit in some patients, but it causes undesirable changes in lipid and sugar metabolism. Moreover, these metabolic changes could be related to new onset or worsening of diseases such as diabetes mellitus or cardiovascular disease. Several studies examining the influence of ADT in Japanese patients with prostate cancer also showed that metabolic changes such as weight gain, dyslipidemia, or fat accumulation can occur as in patients in Western countries. Efforts to decrease these unfavorable changes and events are important. First, overuse of ADT for localized or elderly prostate cancer patients should be reconsidered. Second, intermittent ADT may be beneficial for selected patients who suffer from impaired quality of life (QOL) due to continuous ADT. Third, education and instruction, such as diet or exercise, to decrease metabolic changes before initiating ADT are important, because metabolic changes can occur in the early ADT period.