Androgen deprivation therapy for prostate cancer

Area of Science:

• Oncology
• Urology

Background:

• Prostate cancer is a leading cause of cancer mortality in US men.
• Androgen deprivation therapy (ADT) is a primary treatment for advanced prostate cancer and an adjuvant for high-risk localized disease.

Purpose of the Study:

• To systematically review the evidence on risks and benefits of ADT for prostate cancer.
• To examine the clinical management of ADT's adverse effects.

Main Methods:

• MEDLINE searches of English-language literature from 1966 to March 2005.
• Keywords included "androgen deprivation therapy," "hormone treatment," and "prostate cancer."
• Literature review focused on clinical pertinence and controlled study designs.

Main Results:

• ADT is effective for palliation in advanced prostate cancer and improves outcomes with radiation for high-risk localized disease.
• Benefits of ADT for rising PSA post-local treatment without metastasis are unclear.
• Adverse effects include decreased libido, impotence, hot flashes, osteopenia, metabolic changes, and cognitive/mood alterations.

Conclusions:

• ADT has established roles in managing advanced and high-risk localized prostate cancer.
• The benefits of ADT in other clinical settings must be carefully weighed against its substantial risks and impact on quality of life.