Androgen Deprivation Therapy for Prostate Cancer: Effects on Body Composition and Metabolic Health

Abstract

Prostate cancer (PCa) is the most common malignancy diagnosed in American men. Androgen-deprivation therapy (ADT) has become the standard treatment for locally invasive, recurrent and metastatic PCa. Despite its effectiveness in lowering testosterone levels and improving survival in a subset of patients, ADT is associated with adverse effects including sexual dysfunction, vasomotor symptoms, anemia, osteoporosis and decreased quality of life. Altered body composition, resulting in reduced muscle mass and increased fat mass, is also frequently encountered in patients receiving ADT. As a result of these adverse changes in body composition, metabolic complications such as insulin resistance, diabetes, dyslipidemia and metabolic syndrome have also increased. These metabolic disturbances might be responsible for the increased cardiovascular morbidity and mortality seen in this patient population. Thus, screening, monitoring and treatment for cardiovascular risk factors (i.e. hyperglycemia, diabetes, hyperlipidemia, hypertension, obesity) in men receiving ADT might be prudent. Here we review the literature evaluating body composition changes as well as metabolic and cardiovascular complications of ADT.