Article Figures & Data
Tables
Side Effects Duration of Deprivation Percent Change or Hazard Ratio Bone mineral density and fracture risk Bone mineral density 6 months −3.5%17 12 months −5.3%15 12 months −3.3%16 12 months −4.9% and −6.8%4 Any fracture* 5 years 1.45 (95% CI: 1.36–1.56)21 Fracture resulting in hospitalization* 5 years 1.66 (95% CI: 1.47–1.87)21 Glucose and lipid metabolism Weight and body mass index 6 months +0.8%17 11 months +2.4%23 Fat body mass 3 months +8.4%18 11 months +9.4%23 Lean body mass 3 months −2.8%18 11 months −2.7%23 Muscle area 11 months −3.2%23 Total cholesterol level 6 months +6.1%17 11 months +9.0%23 High-density lipoproteins cholesterol level 11 months −11.3%23 Low-density lipoproteins cholesterol level 11 months +7.3%23 Triglyceride level 6 months +8.2%17 11 months +27%23 Fasting insulin level 3 months +64%18 Incident diabetes 4.6 years 1.44 (95% CI: 1.34–1.55)32 Incident coronary heart disease 4.6 years 1.16 (95% CI: 1.10–1.21)32 Incident myocardial infarction 4.6 years 1.11 (95% CI: 1.01–1.21)32 Incident sudden cardiac death 4.6 years 1.16 (95% CI: 1.05–1.27)32 Mood disturbances Depression (or other affective disorder) 4.3 years 1.08 (95% CI: 1.02–1.15)49 Constitutional symptoms (e.g., fatigue, malaise, anorexia, abnormal weight gain, debility) 4.3 years 1.17 (95% CI: 1.13–1.22)49 * Among those receiving nine or more doses of gonadotropin-releasing hormone agonist in the first 12 months after diagnosis of prostate cancer.
- Table 2
Recommended Clinical Assessment of Men Before the Start of Androgen Deprivation Therapy and During Follow-up
Risk assessment before the initiation of ADT: History taking: prior fractures, prior cardiovascular events, family history of osteoporosis and cardiovascular disease, alcohol consumption, and smoking habits Rule out or treat affective disorders Advise lifestyle modification, including weight-bearing exercise, healthful dietary pattern, and abstinence from smoking and excessive alcohol use Physical examination: especially weight, height, blood pressure Complete laboratory screen, with fasting glucose (to detect incident diabetes), lipid profile, hemoglobin, and hematocrit level DEXA Clinical assessment after the initiation of ADT: History taking and physical examination (every six months): especially evaluate for signs and symptoms of weight gain, hypertension, hot flushes, depression, emotional disturbances, and other constitutional symptoms Laboratory examination: fasting glucose, lipid profile, hemoglobin, and hematocrit level DEXA (every one or two years)
