Androgen deprivation therapy complications

医学 雄激素剥夺疗法 前列腺癌 性功能障碍 骨质疏松症 不利影响 勃起功能障碍 辅助治疗 内科学 疾病 生活质量(医疗保健) 性功能 糖尿病 睾酮(贴片) 肿瘤科 内分泌学 癌症 护理部
作者
Carolyn A. Allan,Veronica Collins,Mark Frydenberg,Robert I. McLachlan,Kati L. Matthiesson
出处
期刊:Endocrine-related Cancer [Bioscientifica]
卷期号:21 (4): T119-T129 被引量:50
标识
DOI:10.1530/erc-13-0467
摘要

Androgen deprivation therapy (ADT) is increasingly used to treat advanced prostate cancer and is also utilised as adjuvant or neo-adjuvant treatment for high-risk disease. The resulting suppression of endogenous testosterone production has deleterious effects on quality of life, including hot flushes, reduced mood and cognition and diminished sexual function. Cross-sectional and longitudinal studies show that ADT has adverse bone and cardio-metabolic effects. The rate of bone loss is accelerated, increasing the risk of osteoporosis and subsequent fracture. Fat mass is increased and lean mass reduced, and adverse effects on lipid levels and insulin resistance are observed, the latter increasing the risk of developing type 2 diabetes. ADT also appears to increase the risk of incident cardiovascular events, although whether it increases cardiovascular mortality is not certain from the observational evidence published to date. Until high-quality evidence is available to guide management, it is reasonable to consider men undergoing ADT to be at a higher risk of psychosexual dysfunction, osteoporotic fracture, diabetes and cardiovascular disease, especially when treated for extended periods of time and therefore subjected to profound and prolonged hypoandrogenism. Health professionals caring for men undergoing treatment for prostate cancer should be aware of the potential risks of ADT and ensure appropriate monitoring and clinical management.

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