Androgen Deprivation Therapy for Prostate Cancer Does Not Increase Cardiovascular Mortality in the Long Term

Oncology ◽  
2012 ◽  
Vol 82 (1) ◽  
pp. 56-58 ◽  
Author(s):  
Chantelle Wilcox ◽  
Allison Kautto ◽  
Allison Steigler ◽  
James W. Denham
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Cardiovascular Mortality ◽  
Androgen Deprivation

scholarly journals Androgen Deprivation Therapy in Prostate Cancer and Metabolic Risk for Atherosclerosis

2008 ◽  
Vol 93 (6) ◽  
pp. 2042-2049 ◽  
Author(s):  
Sadeka Shahani ◽  
Milena Braga-Basaria ◽  
Shehzad Basaria
Keyword(s):  
Prostate Cancer ◽  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Androgen Deprivation Therapy ◽  
Cardiovascular Mortality ◽  
Prospective Studies ◽  
Androgen Deprivation ◽  
Negative Consequences ◽  
Metabolic Complications

Abstract Context: Prostate cancer (PCa) is the most common cancer in men. Androgen-deprivation therapy (ADT) is generally employed in the treatment of locally advanced and metastatic PCa. Although its use as an adjuvant therapy has resulted in improved survival in some patients, ADT has negative consequences. Complications like osteoporosis, sexual dysfunction, gynecomastia, and adverse body composition are well known. Recently, metabolic complications like insulin resistance, diabetes, dyslipidemia, and metabolic syndrome have emerged, which may be responsible for the increased cardiovascular mortality in this population. Evidence Acquisition: A MEDLINE search was conducted for articles published over the last 20 yr based on the key words androgen deprivation therapy AND insulin resistance, hyperglycemia, diabetes, dyslipidemia, metabolic syndrome, and cardiovascular disease. Relevant studies in non-PCa populations evaluating the association between testosterone and metabolism were also reviewed and briefly mentioned where relevant. Evidence Synthesis: Prospective studies evaluating early (3–6 months) metabolic changes of ADT show development of hyperinsulinemia; however, glucose levels remain normal. Cross-sectional studies of men undergoing long-term (≥12 months) ADT reveal higher prevalence of diabetes and metabolic syndrome compared with controls. Furthermore, men undergoing ADT also experience higher cardiovascular mortality. Conclusion: Long-term prospective studies of ADT are needed to determine the timing of onset of these metabolic complications and to investigate the mechanism behind them. In the meantime, we recommend baseline and serial screening for fasting glucose, lipids, and other cardiovascular risk factors in men receiving ADT. Glucose tolerance tests and cardiac evaluation may be required in selected cases.

Hormonal response recovery after long-term androgen deprivation therapy in patients with prostate cancer

2016 ◽  
Vol 50 (6) ◽  
pp. 425-428 ◽  
Author(s):  
Jacques Planas ◽  
Ana Celma ◽  
José Placer ◽  
Mercè Cuadras ◽  
Lucas Regis ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Hormonal Response ◽  
Response Recovery

scholarly journals Long-Term Management of Incidental Bladder Cancer Detected in Patients Undergoing Prostatectomy for Prostate Cancer

2019 ◽  
Vol 13 (3) ◽  
pp. 145-149
Author(s):  
Norihito Soga ◽  
Jun Furusawa ◽  
Yuji Ogura
Keyword(s):  
Prostate Cancer ◽  
Bladder Cancer ◽  
Androgen Deprivation Therapy ◽  
Androgen Deprivation ◽  
Routine Screening ◽  
Urinary Cytology ◽  
Urinary Sediment ◽  
Sediment Analysis ◽  
Observation Period

Introduction: At our institution, screening for incidental bladder cancer is routinely performed to avoid tumor cell dissemination caused by surgery in patients undergoing prostatectomy for prostate cancer (PCa). Here, we report the long-term clinical results in patients with incidental bladder cancer detected by routine screening prior to prostatectomy. Materials and Methods: Between January 2003 and December 2013, 430 patients undergoing prostatectomy for resection of PCa were enrolled in this cohort study. All patients underwent screening with cystoscopy, urinary sediment analysis, and urinary cytology to detect incidental bladder cancer. The clinical outcomes of cases with incidental bladder cancer were evaluated. Results: The incidence of incidental bladder cancer was 2.1% (9/430). All tumors were single papillary tumors located around the urinary orifice or lateral side and were diagnosed as urothelial cancer (UC). No significant findings were detected by urinary sediment analysis or urinary cytology. Pathological results of transurethral resections revealed 5 cases of pTa with Grade 1 UC and 4 cases of pTa with Grade 2 UC. Androgen-deprivation therapy was administered to 8/9 patients. During the observation period (average of 7.2 years), UC recurrence was detected in 2 cases (2 and 7.3 years). However, transurethral resection successfully removed the tumor completely. After an average of 19.6 months (12-25 months) without UC recurrence, 7 patients (77.8%) underwent prostatectomy, and 2 patients received radiation or androgen-deprivation therapy. Prostatectomy was carried out without dissemination of UC during the observation period. Conclusion: Incidental UC was detected in 2.1% of prostatectomy candidates. Preoperative routine screening with flexible cystoscopy was useful to detect early incidental UC.

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