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Journal of General Internal Medicine
Published in: Journal of General Internal Medicine 2/2009

Open Access 01-11-2009 | Clinical Review

Prostate Cancer Survivorship: Prevention and Treatment of the Adverse Effects of Androgen Deprivation Therapy

Authors: Philip J. Saylor, MD, Nancy L. Keating, MD, MPH, Matthew R. Smith, MD, PhD

Published in: Journal of General Internal Medicine | Special Issue 2/2009

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ABSTRACT

BACKGROUND

More than one-third of the estimated 2 million prostate cancer survivors in the United States receive androgen deprivation therapy (ADT). This population of mostly older men is medically vulnerable to a variety of treatment-associated adverse effects.

MEASUREMENTS AND RESULTS

Androgen-deprivation therapy (ADT) causes loss of libido, vasomotor flushing, anemia, and fatigue. More recently, ADT has been shown to accelerate bone loss, increase fat mass, increase cholesterol and triglycerides, and decrease insulin sensitivity. Consistent with these adverse metabolic effects, ADT has also recently been associated with greater risks for fractures, diabetes and cardiovascular disease.

CONCLUSION

Primary care clinicians and patients should be aware of the potential benefits and harms of ADT. Screening and intervention to prevent treatment-related morbidity should be incorporated into the routine care of prostate cancer survivors. Evidence-based guidelines to prevent fractures, diabetes, and cardiovascular disease in prostate cancer survivors represent an important unmet need. We recommend the adapted use of established practice guidelines designed for the general population.
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Metadata
Title
Prostate Cancer Survivorship: Prevention and Treatment of the Adverse Effects of Androgen Deprivation Therapy
Authors
Philip J. Saylor, MD
Nancy L. Keating, MD, MPH
Matthew R. Smith, MD, PhD
Publication date
01-11-2009
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue Special Issue 2/2009
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-009-0968-y

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