1
|
Shao W, Zhang H, Qi H, Zhang Y. The effects of exercise on body composition of prostate cancer patients receiving androgen deprivation therapy: An update systematic review and meta-analysis. PLoS One 2022; 17:e0263918. [PMID: 35167609 PMCID: PMC8846498 DOI: 10.1371/journal.pone.0263918] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/29/2022] [Indexed: 12/24/2022] Open
Abstract
Androgen deprivation therapy is a common treatment for prostate cancer. However, this therapy is associated with various adverse effects, such as increased body fat and decreased bone mineral density. Exercise may be useful for ameliorating these adverse effects, although it is not completely effective. This review aimed to clarify how exercise interventions influenced body composition and bone mineral density and to explore the most effective exercise program among prostate cancer patients who received androgen deprivation therapy. We searched the PubMed, EMBASE, Web of Science, EBSCO, and Cochrane Library databases for reports of randomised controlled trials that were published until October 2021. All studies involved prostate cancer patients who received androgen deprivation therapy and completed aerobic exercise, resistance exercise, and/or impact exercise training. Outcomes were defined as lean body mass, body fat mass, body fat rate, regional and whole-body bone mineral density. Thirteen reports regarding 12 randomised clinical trials (715 participants) were included. Relative to the control group, exercise intervention provided a higher lean body mass (mean difference: 0.88, 95% confidence interval: 0.40 to 1.36, P<0.01), a lower body fat mass (mean difference: -0.60, 95% confidence interval: -1.10 to -0.10, P<0.05), and a lower body fat rate (mean difference: -0.93, 95% confidence interval: -1.39 to -0.47, P<0.01). Subgroup analyses revealed greater efficacy for exercise duration of ≥6 months (vs. <6 months) and exercise immediately after the therapy (vs. delayed exercise). No significant differences were observed in the bone mineral density outcomes. Exercise can help ameliorate the adverse effects of androgen deprivation therapy in body composition, with combination exercises including resistance exercise, 8–12 repetition maximum of resistance exercise intensity, prolonged exercise duration, and performing exercise immediately after therapy providing better amelioration. And the combination of resistance and impact exercise appears to be the best mode for improving the bone mineral density.
Collapse
Affiliation(s)
- Wenjuan Shao
- School of Sport Science, Beijing Sport University, Beijing, China
| | - Hanyue Zhang
- Key Laboratory of the Ministry of Education of Exercise and Physical Fitness, Beijing Sport University, Beijing, China
| | - Han Qi
- School of Sport Science, Beijing Sport University, Beijing, China
| | - Yimin Zhang
- Key Laboratory of the Ministry of Education of Exercise and Physical Fitness, Beijing Sport University, Beijing, China
- * E-mail:
| |
Collapse
|
2
|
The relationship between sleep hygiene, mood, and insomnia symptoms in men with prostate cancer. Support Care Cancer 2022; 30:4055-4064. [PMID: 35064327 DOI: 10.1007/s00520-021-06680-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/03/2021] [Indexed: 01/27/2023]
Abstract
PURPOSE Insomnia symptoms are commonly experienced by men after prostate cancer (PCa) treatment. Here we explored how sleep hygiene behaviours and psychological symptoms are associated with insomnia symptoms in PCa patients. METHODS An online survey was posted on social media and sent to mailing lists of PCa and general cancer organisations. The survey collected information on demographic, sleep hygiene, and psychological symptoms using validated questionnaires. RESULTS Data from 142 participants were compared based on the absence (age = 68.3 ± 8.9 years) and presence (age = 66.6 ± 9.0 years) of insomnia symptoms. Participants with insomnia symptoms had significantly higher levels of anxiety, depression, fatigue, and sleepiness as well as poorer sleep hygiene than those without insomnia symptoms. Control variables (age, number of comorbidities, and BMI) accounted for 11.9% of the variance in insomnia symptoms. Including treatment history contributed to an additional 1.6% of the variance in insomnia symptoms. Adding sleepiness, fatigue, anxiety, and depressive symptoms to the model explained an additional 44.6% of the variance in insomnia symptoms. Furthermore, including the sleep hygiene item 'I think, plan, or worry when I am in bed' and 'I sleep in an uncomfortable bedroom' explained an additional 3.6% of the variance in insomnia symptoms. CONCLUSIONS Poor sleep hygiene, fatigue, sleepiness, anxiety, and depressive symptoms were all associated with worse insomnia symptoms in PCa patients. Improving sleep hygiene and treating psychological conditions may potentially help prevent and/or alleviate insomnia symptoms in PCa patients.
Collapse
|
3
|
Mainwaring JM, Walker LM, Robinson JW, Wassersug RJ, Wibowo E. The Psychosocial Consequences of Prostate Cancer Treatments on Body Image, Sexuality, and Relationships. Front Psychol 2021; 12:765315. [PMID: 34744944 PMCID: PMC8568796 DOI: 10.3389/fpsyg.2021.765315] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/22/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
- Joanna M Mainwaring
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Lauren M Walker
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - John W Robinson
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Richard J Wassersug
- Department of Cellular & Physiological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Erik Wibowo
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| |
Collapse
|
4
|
Newton RU, Mavropalias G, Fragala MS, Kraemer WJ, Häkkinen K, Taaffe DR, Spry N, Joseph D, Galvão DA. Radiotherapy before or during androgen-deprivation therapy does not blunt the exercise-induced body composition protective effects in prostate cancer patients: A secondary analysis of two randomized controlled trials. Exp Gerontol 2021; 151:111427. [PMID: 34052346 DOI: 10.1016/j.exger.2021.111427] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/07/2021] [Accepted: 05/25/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Androgen deprivation therapy (ADT) contributes to lean mass loss and adiposity increases in prostate cancer patients. Radiotherapy during ADT might act synergistically and further worsen body composition. Previous investigations have shown that resistance training is an effective method of preserving body composition during ADT, however, most have not accounted for direct or indirect effects of other therapies, such as radiotherapy. Therefore, the purpose of this study was to examine training adaptations of the tissue composition in patients receiving radiation therapy (RT) prior or during ADT. METHODS Analyses were performed by combining data from two previous trials for a total of 131 prostate cancer patients who underwent a combination of resistance and aerobic exercise training (N = 70, age: 68.9 ± 6.6y, RT-before: 13%, RT-during: 14%) or usual care (N = 61, age: 67.5 ± 7.9y, RT-before: 16%, RT-during: 20%) for 3 months upon ADT onset. Whole-body lean mass (LM), fat percentage and appendicular LM were determined by dual energy x-ray absorptiometry, and lower-leg muscle area and density by peripheral computed tomography at baseline (onset of ADT) and at 3 months post-intervention. Covariates included RT prior and during the intervention, demographic characteristics, physical symptoms, and chronic conditions. RESULTS Radiotherapy before or during the intervention did not affect body composition. Only the usual care group experienced a significant decrease in whole-body LM (-994 ± 150 g, P < 0.001) and appendicular LM (-126 ± 19 g, P < 0.001), and an increase in whole-body fat percentage (1% ± 0.1%, P < 0.001). There was no change in lower-leg muscle area or density in either group. CONCLUSION We suggest that radiation prior to and during ADT does not interfere with the beneficial effects of exercise training on body composition in men with prostate cancer.
Collapse
Affiliation(s)
- Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.
| | - Georgios Mavropalias
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | | | - William J Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Keijo Häkkinen
- Neuromuscular Research Center, Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Nigel Spry
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - David Joseph
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| |
Collapse
|
5
|
Filippi L, Chiaravalloti A, Basile P, Schillaci O, Bagni O. Molecular and metabolic imaging of castration-resistant prostate cancer: state of art and future prospects. Curr Mol Med 2021; 22:25-36. [PMID: 33573553 DOI: 10.2174/1566524021666210211112423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/23/2020] [Accepted: 02/02/2021] [Indexed: 11/22/2022]
Abstract
Prostate cancer (PCa) represents the most common tumor in male and one of the most relevant causes of death in Western countries. Androgen deprivation therapy (ADT) constitutes a widely used approach in advanced PCa. When PCa progresses in spite of ADT and castrate levels of testosterone, the severe clinical condition termed as metastatic castration-resistant prostate cancer (mCRPC) takes place. The only approach to mCRPC has been represented by chemotherapy with taxanes for many years. Nevertheless, recently introduced treatments such as 2nd generation antiandrogens (i.e. enzalutamide and abiraterone), cell immunotherapy with sipuleucel-T or targeted alpha therapy with 223Ra-dichloride, have dramatically changed mCRPC prognosis. These novel therapies call for an unmet need for imaging biomarkers suitable for patients' pre-treatment stratification and response assessment. In this scenario, nuclear medicine can provide several metabolic and molecular probes for investigating pathological processes at a cellular and sub-cellular level. The aim of this paper is to review the most relevant findings of the literature published to date on this topic, giving particular emphasis to the pros and cons of each tracer and also covering future prospects for defining personalized therapeutic approaches.
Collapse
Affiliation(s)
- Luca Filippi
- Nuclear Medicine Department, "Santa Maria Goretti" Hospital, via Canova, 04100, Latina. Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133, Rome. Italy
| | - Pietro Basile
- Nuclear Medicine Department, "Santa Maria Goretti" Hospital, via Canova, 04100, Latina. Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133, Rome. Italy
| | - Oreste Bagni
- Nuclear Medicine Department, "Santa Maria Goretti" Hospital, via Canova, 04100, Latina. Italy
| |
Collapse
|
6
|
Zhou X, Jiao D, Dou M, Chen J, Han B, Li Z, Li Y, Liu J, Han X. Brachytherapy Combined With or Without Hormone Therapy for Localized Prostate Cancer: A Meta-Analysis and Systematic Review. Front Oncol 2020; 10:169. [PMID: 32140449 PMCID: PMC7042206 DOI: 10.3389/fonc.2020.00169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 01/30/2020] [Indexed: 11/16/2022] Open
Abstract
Purpose: The purpose of this study was to evaluate the efficacy of brachytherapy combined with or without hormone therapy in patients with localized prostate cancer. Methods and Materials: We systemically searched the Medline, Web of Science, Cochrane Library and Embase databases for studies published between the databases' dates of inception and February 2019. The primary endpoints were the 5-year overall survival (OS) rates, 5-year biochemical progression-free survival (bPFS) rates and 10-year bPFS rates. The results were expressed as the relative risk (RR) and 95% confidence interval (CI). Based on the heterogeneity evaluated with the I2 statistic, a meta-analysis was performed using either a random- or fixed-effects model. Results: A total of 16 cohort studies including 9,359 patients met all the criteria for inclusion in the analysis. Our data showed that brachytherapy (BT) combined with hormone therapy (HT) increased the patients' 5-year bPFS rates (RR = 1.04, 95% CI: 1.01–1.08, P = 0.005) and 10-year bPFS rates (RR = 1.12, 95% CI: 1.02–1.23, P = 0.001) compared with BT monotherapy. However, BT combined with HT did not increase the patients' 5-year OS rates (RR = 1.02, 95% CI: 0.99–1.095, P = 0.1) compared with BT monotherapy. Conclusions: BT combined with HT can increase the bPFS rates of patients with localized prostate cancer, but it does not improve patients' OS rates.
Collapse
Affiliation(s)
- Xueliang Zhou
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Dechao Jiao
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengmeng Dou
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jianjian Chen
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bin Han
- Radiotherapy Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhaonan Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yahua Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Juanfang Liu
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xinwei Han
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Xinwei Han
| |
Collapse
|
7
|
Gianatti EJ, Grossmann M. Testosterone deficiency in men with Type 2 diabetes: pathophysiology and treatment. Diabet Med 2020; 37:174-186. [PMID: 31006133 DOI: 10.1111/dme.13977] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2019] [Indexed: 12/12/2022]
Abstract
Epidemiological studies consistently demonstrate that lowered serum testosterone is not only common in men with established Type 2 diabetes, but also predicts future diabetic risks and increased mortality. Preclinical studies report plausible mechanisms by which low testosterone could mediate dysglycaemia. Exogenous testosterone treatment consistently reduces fat mass, increases muscle mass and improves insulin resistance in some studies, but the majority of currently available randomized controlled trials (RCTs) do not report a consistent glycaemic benefit. In men with diabetes, testosterone treatment effects on androgen deficiency-like clinical features are inconsistent, and effects on sexual dysfunction may be attenuated compared with men without diabetes. The long-term risks of testosterone treatment in older men without medical disease of the hypothalamic-pituitary-testicular axis are not known. Current RCTs are not definitive, owing to their small size, short duration and enrolment of men with mostly relatively good baseline glycaemic control not specifically selected for the presence of androgen deficiency symptoms. Although large, well-designed clinical trials are needed, given the benefit-risk ratio of testosterone treatment is not well understood, routine serum testosterone testing or testosterone treatment of asymptomatic men with Type 2 diabetes is currently not recommended. Carefully selected, symptomatic men with low testosterone who are informed of the lack of high-level evidence regarding the long-term benefits and risks of this approach may be offered a trial of testosterone treatment in combination with lifestyle measures, weight loss and optimization of comorbidities.
Collapse
Affiliation(s)
- E J Gianatti
- Department of Endocrinology, Fiona Stanley Fremantle Hospitals Group, Murdoch, Australia
| | - M Grossmann
- Department of Medicine Austin Health, University of Melbourne, Heidelberg, Australia
- Department of Endocrinology, Austin Health, Heidelberg, Australia
| |
Collapse
|
8
|
Chen Z, Zhang Y, Lu C, Zeng H, Schumann M, Cheng S. Supervised Physical Training Enhances Muscle Strength but Not Muscle Mass in Prostate Cancer Patients Undergoing Androgen Deprivation Therapy: A Systematic Review and Meta-Analysis. Front Physiol 2019; 10:843. [PMID: 31333495 PMCID: PMC6618665 DOI: 10.3389/fphys.2019.00843] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 06/19/2019] [Indexed: 02/05/2023] Open
Abstract
Introduction: Androgen deprivation therapy (ADT) is considered the basic treatment for advanced prostate cancer, but it is highly associated with detrimental changes in muscle mass and muscle strength. The aim of this meta-analysis was to investigate the effects of supervised physical training on lean mass and muscle strength in prostate cancer patients undergoing ADT. Methods: A systematic literature search was performed using MEDLINE, Embase, and ScienceDirect until October 2018. Only studies that examined both muscle mass and strength in prostate cancer patients undergoing ADT were included. Outcomes of interest were changes in lean body mass (surrogate for muscle mass) as well as upper and lower body muscle strength. The meta-analysis was performed with fixed-effects models to calculate mean differences between intervention and no-training control groups. Results: We identified 8,521 publications through the search of the following key words: prostate cancer, prostate tumor, prostate carcinoma, prostate neoplasm, exercise, and training. Out of these studies, seven randomized controlled trials met the inclusion criteria and where included in the analysis. No significant mean differences for changes in lean mass were observed between the intervention and control groups (0.49 kg, 95% CI: −0.76, 1.74; P = 0.44). In contrast, the mean difference for muscle strength was significant both in chest (3.15 kg, 95% CI: 2.46, 3.83; P < 0.001) and in leg press (27.46 kg, 95% CI: 15.05, 39.87; p < 0.001). Conclusion: This meta-analysis provides evidence that low- to moderate-intensity resistance and aerobic training is effective for increasing muscle strength but may not be sufficient to affect muscle mass in prostate cancer patients undergoing ADT. The underlying mechanisms for this maladaptation may in part be explained by an insufficient stimulus induced by the training regimens as well as a delayed initiation of training in relation to the start of ADT. When interpreting the present findings, one should bear in mind that the overall number of studies included in this review was rather low, emphasizing the need for further studies in this field.
Collapse
Affiliation(s)
- Ziyuan Chen
- Department of Physical Education, Exercise, Health and Technology Centre, Shanghai Jiao Tong University, Shanghai, China
| | - Yuan Zhang
- The Key Laboratory of Systems Biomedicine, Ministry of Education, and The Exercise Translational Medicine Centre, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chunyan Lu
- Department of Endocrinology, West China Hospital, Sichuan University, Chengdu, China
| | - Hao Zeng
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Moritz Schumann
- Department of Physical Education, Exercise, Health and Technology Centre, Shanghai Jiao Tong University, Shanghai, China.,The Key Laboratory of Systems Biomedicine, Ministry of Education, and The Exercise Translational Medicine Centre, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China.,Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University, Cologne, Germany
| | - Sulin Cheng
- Department of Physical Education, Exercise, Health and Technology Centre, Shanghai Jiao Tong University, Shanghai, China.,The Key Laboratory of Systems Biomedicine, Ministry of Education, and The Exercise Translational Medicine Centre, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| |
Collapse
|
9
|
Liu J, Mao R, Ren G, Liu X, Zhang Y, Wang J, Wang Y, Li M, Qiu Q, Wang L, Liu G, Jin S, Ma L, Ma Y, Zhao N, Yan J, Zhang H, Lin B. Whole Exome Sequencing Identifies Putative Predictors of Recurrent Prostate Cancer with High Accuracy. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2019; 23:380-388. [PMID: 31194651 DOI: 10.1089/omi.2019.0044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Prostate cancer (PCa) is a highly common cancer among men but lacks robust diagnostics that can predict disease recurrence after initial treatment, for example, with radical prostatectomy. Recent advances in genomics and next-generation sequencing heralded the discovery of biomarkers such as the androgen receptor gene (AR) splice events, the TMPRSS2:EGR gene fusion, long noncoding RNA MALAT-1 and SCHLAP1 for PCa prognosis. Still, the question of why some patients experience recurrence, whereas others do not introduce marked uncertainty for both patients and physicians. We report here the whole exome sequencing of 30 recurrent and 44 nonrecurrent PCa patients. We identified 72 and 34 specific somatic single nucleotide variations in the recurrent and the nonrecurrent group, respectively, and developed a classification model to forecast PCa recurrence using a random forest model. The model displayed a sensitivity and specificity of 87.8% and 94.4%, respectively, for identifying the patients with recurrent PCa. These observations warrant further research in independent and larger clinical samples so as to inform future diagnostics innovation for PCa prognosis and recurrence.
Collapse
Affiliation(s)
- Jie Liu
- 1College of Life Science, Zhejiang University, Hangzhou, China.,2Systems Biology Division, Zhejiang-California International Nanosystems Institute (ZCNI), Zhejiang University, Hangzhou, China
| | - Ruifang Mao
- 2Systems Biology Division, Zhejiang-California International Nanosystems Institute (ZCNI), Zhejiang University, Hangzhou, China
| | - Guoping Ren
- 3Department of Pathology, The First Affiliated Hospital, Zhejiang University Medical College, Hangzhou, China
| | - Xiaoyan Liu
- 3Department of Pathology, The First Affiliated Hospital, Zhejiang University Medical College, Hangzhou, China
| | - Yanling Zhang
- 3Department of Pathology, The First Affiliated Hospital, Zhejiang University Medical College, Hangzhou, China.,4Department of Gynecology and Obstetrics, Sir Run Run Shaw Hospital, Zhejiang University Medical College, Hangzhou, China
| | - Jili Wang
- 3Department of Pathology, The First Affiliated Hospital, Zhejiang University Medical College, Hangzhou, China
| | - Yan Wang
- 3Department of Pathology, The First Affiliated Hospital, Zhejiang University Medical College, Hangzhou, China
| | - Meiling Li
- 5Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Qingchong Qiu
- 2Systems Biology Division, Zhejiang-California International Nanosystems Institute (ZCNI), Zhejiang University, Hangzhou, China
| | - Lin Wang
- 2Systems Biology Division, Zhejiang-California International Nanosystems Institute (ZCNI), Zhejiang University, Hangzhou, China
| | - Guanfeng Liu
- 2Systems Biology Division, Zhejiang-California International Nanosystems Institute (ZCNI), Zhejiang University, Hangzhou, China
| | - Shanshan Jin
- 2Systems Biology Division, Zhejiang-California International Nanosystems Institute (ZCNI), Zhejiang University, Hangzhou, China
| | - Liang Ma
- 2Systems Biology Division, Zhejiang-California International Nanosystems Institute (ZCNI), Zhejiang University, Hangzhou, China
| | - Yingying Ma
- 2Systems Biology Division, Zhejiang-California International Nanosystems Institute (ZCNI), Zhejiang University, Hangzhou, China
| | - Na Zhao
- 2Systems Biology Division, Zhejiang-California International Nanosystems Institute (ZCNI), Zhejiang University, Hangzhou, China
| | - Jiajun Yan
- 6Department of Urology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China
| | - Hongwei Zhang
- 5Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Biaoyang Lin
- 1College of Life Science, Zhejiang University, Hangzhou, China.,2Systems Biology Division, Zhejiang-California International Nanosystems Institute (ZCNI), Zhejiang University, Hangzhou, China.,7Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,8Department of Urology, University of Washington, Seattle, Washington
| |
Collapse
|
10
|
Chistiakov DA, Myasoedova VA, Melnichenko AA, Grechko AV, Orekhov AN. Role of androgens in cardiovascular pathology. Vasc Health Risk Manag 2018; 14:283-290. [PMID: 30410343 PMCID: PMC6198881 DOI: 10.2147/vhrm.s173259] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Cardiovascular effects of android hormones in normal and pathological conditions can lead to either positive or negative effects. The reason for this variation is unknown, but may be influenced by gender-specific effects of androids, heterogeneity of the vascular endothelium, differential expression of the androgen receptor in endothelial cells (ECs) and route of androgen administration. Generally, androgenic hormones are beneficial for ECs because these hormones induce nitric oxide production, proliferation, motility, and growth of ECs and inhibit inflammatory activation and induction of procoagulant, and adhesive properties in ECs. This indeed prevents endothelial dysfunction, an essential initial step in the development of vascular pathologies, including atherosclerosis. However, androgens can also activate endothelial production of some vasoconstrictors, which can have detrimental effects on the vascular endothelium. Androgens also activate proliferation, migration, and recruitment of endothelial progenitor cells (EPCs), thereby contributing to vascular repair and restoration of the endothelial layer. In this paper, we consider effects of androgen hormones on EC and EPC function in physiological and pathological conditions.
Collapse
Affiliation(s)
- Dimitry A Chistiakov
- Department of Neurochemistry, Division of Basic and Applied Neurobiology, Serbsky Federal Medical Research Center of Psychiatry and Narcology, Moscow, Russia
| | - Veronika A Myasoedova
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Moscow, Russia,
| | - Alexandra A Melnichenko
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Moscow, Russia,
| | - Andrey V Grechko
- Federal Scientific Clinical Center for Resuscitation and Rehabilitation, Moscow, Russia
| | - Alexander N Orekhov
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Moscow, Russia, .,Institute for Atherosclerosis Research, Skolkovo Innovative Center, Moscow, Russia,
| |
Collapse
|
11
|
Association Between Androgen Deprivation Therapy and Patient-reported Depression in Men With Recurrent Prostate Cancer. Clin Genitourin Cancer 2018; 16:313-317. [DOI: 10.1016/j.clgc.2018.05.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 05/03/2018] [Accepted: 05/07/2018] [Indexed: 11/21/2022]
|
12
|
Wibowo E. Cognitive Impacts of Estrogen Treatment in Androgen-Deprived Males: What Needs to be Resolved. Curr Neuropharmacol 2018; 15:1043-1055. [PMID: 28294068 PMCID: PMC5652012 DOI: 10.2174/1570159x15666170313122555] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 02/10/2017] [Accepted: 03/08/2017] [Indexed: 12/13/2022] Open
Abstract
Background: Many prostate cancer (PCa) patients are on androgen deprivation therapy (ADT) as part of their cancer treatments but ADT may lead to cognitive impairments. ADT depletes men of both androgen and estrogen. Whether estradiol supplementation can improve cognitive impairments in patients on ADT is understudied. Objective: To summarize data on the effects of estradiol treatment on cognitive function of androgen-deprived genetic male populations (PCa patients and male-to-female transsexuals) and castrated male animals. Method: Publications were identified by a literature search on PubMed and Google Scholar. Results: While some studies showed that estradiol improves cognitive function (most notably, spatial ability) for castrated rats, what remains uninvestigated are: 1) whether estradiol can improve cognition after long-term androgen deprivation, 2) how estradiol affects memory retention, and 3) how early vs. delayed estradiol treatment after castration influences cognition. For androgen-deprived genetic males, estradiol treatment may improve some cognitive functions (e.g., verbal and visual memory), but the findings are not consistent due to large variability in the study design between studies. Conclusion: Future studies are required to determine the best estradiol treatment protocol to maximize cognitive benefits for androgen-deprived genetic males. Tests that assess comparable cognitive domains in human and rodents are needed. What particularly under-investigated is how the effects of estradiol on cognitive ability intersect with other parameters; sleep, depression and physical fatigue. Such studies have clinical implications to improve the quality of life for both PCa patients on ADT as well as for male-to-female transsexuals.
Collapse
Affiliation(s)
- Erik Wibowo
- Level 6, 2775 Laurel Street, Gordon & Leslie Diamond Health Care Centre, Vancouver, British Columbia, V5Z 1M9. Canada
| |
Collapse
|
13
|
Abstract
Sexual dysfunction is a common concern for many patients with cancer after treatment. Hormonal changes as a result of cancer-directed therapy can affect both male and female sexual health. This has the potential to significantly impact patients' quality of life, but is underreported and undertreated in the oncology setting. This review discusses commonly reported sexual issues and the role that hormonal changes play in this dysfunction. Although medical and psychosocial intervention strategies exist, there is a clear need for further research to formally develop programming that can assist people whose sexual health has been impacted by cancer treatment.
Collapse
Affiliation(s)
- Eric S Zhou
- Pediatric Oncology, Perini Family Survivors' Center, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA; Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Natasha N Frederick
- Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Pediatric Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA
| | - Sharon L Bober
- Pediatric Oncology, Perini Family Survivors' Center, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA; Sexual Health Program, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA; Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
| |
Collapse
|
14
|
Negative Impact of Testosterone Deficiency and 5α-Reductase Inhibitors Therapy on Metabolic and Sexual Function in Men. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1043:473-526. [DOI: 10.1007/978-3-319-70178-3_22] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
15
|
Maintaining intimacy for prostate cancer patients on androgen deprivation therapy. Curr Opin Support Palliat Care 2016; 10:55-65. [PMID: 26761788 DOI: 10.1097/spc.0000000000000190] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE OF REVIEW Androgen deprivation therapy (ADT) causes erectile dysfunction and increases patients' emotionality while diminishing their sexual interest. ADT has been linked to erosion of spousal bonds; however, this is not an invariant outcome. Understanding the factors that lead to these various outcomes may help couples deal with ADT. RECENT FINDINGS A subset of couples report that they became closer as a result of the patients going on ADT. Recent data suggest that what helps couples most is preemptive awareness of ADT's side-effects and congruence in how patients and their partners understand and accept the psychosexual impact of ADT. Sex therapy for prostate cancer patients divides along gendered lines, with distinctly 'male' (recovery of erections) and 'female' (promoting sexual practices that are not erection dependent) approaches. Unfortunately, neither is very effective for couples when the patient is on ADT. Options beyond the standard gendered framework, such as use of an external penile prosthesis, may be worth offering to ADT patients trying to find a 'new normal' that is sexually rewarding for them. SUMMARY Intimacy is sharing something with someone that one shares with no one else. Exploring novel sexual practices can help couples stay intimate, even when the patient is on ADT.
Collapse
|
16
|
Kwon YD, Lee CY, Hong SO, Lee YA, Ohe JY, Kim DY. Bisphosphonate related osteonecrosis of the jaws (BRONJ) in osteoporotic males. SPRINGERPLUS 2016; 5:1468. [PMID: 27652043 PMCID: PMC5007241 DOI: 10.1186/s40064-016-3138-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 08/23/2016] [Indexed: 12/02/2022]
Abstract
Background The purpose of this study was to describe the clinical characteristics of bisphosphonate related osteonecrosis of the jaws (BRONJ) in osteoporotic males. Methods The medical records of BRONJ patients from 2007 to 2014 were reviewed. The data from only the male patients was extracted, and demographic data was collected and biochemical markers were measured. Results 11 Patients out of 210 (5 %) being males. Among the 11 patients, the indication of bisphosphonate (BP) was osteoporosis in 9 patients, and cancer in two. In one of the osteoporosis patients, osteoporosis was thought to be secondary to hypogonadism after testicular tumor resection. Serum c-terminal telopetide crosslink of type I collagen (s-CTX) values ranged from 60 to 165 pg/mL (mean: 84.6 ± 36.8, median: 70). Serum osteocalcin (s-OC) ranged from 0 to 5.06 ng/mL (mean: 1.83 ± 1.66, median: 1.5) and vitamin D ranged from 0 to 11.9 (mean: 5.02 ± 4.92, median: 3.5). Conclusion BRONJ can be overlooked in male patients with osteoporosis. Although the incidence of BRONJ in males may be low, dentists should also check if their male patients are on osteoporosis treatment since osteoporosis in males can be manifested as a secondary disease to hypogonadism.
Collapse
Affiliation(s)
- Yong-Dae Kwon
- Department of Oral and Maxillofacial Surgery, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Chae-Yoon Lee
- Department of Oral and Maxillofacial Surgery, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Sung Ok Hong
- Department of Oral and Maxillofacial Surgery, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Yeon-Ah Lee
- Division of Rheumatology, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Joo-Young Ohe
- Department of Oral and Maxillofacial Surgery, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Deog-Yoon Kim
- Department of Nuclear Medicine, Kyung Hee University School of Medicine, Seoul, 02447 Republic of Korea
| |
Collapse
|
17
|
Changes in Body Image in Patients with Prostate Cancer over 2 Years of Treatment with a Gonadotropin-Releasing Hormone Analogue (Triptorelin): Results from a Belgian Non-Interventional Study. Drugs Real World Outcomes 2016; 3:183-190. [PMID: 27398297 PMCID: PMC4914546 DOI: 10.1007/s40801-016-0074-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Androgen deprivation therapy has been associated with worsened body image in prostate cancer patients. Body image and physical presentation changes were investigated in patients receiving a gonadotropin-releasing hormone analogue (triptorelin) as part of treatment for locally advanced or metastatic prostate cancer. Objective The aim was to evaluate the changes in self-perception of the body and to assess the relationship of these changes over a period of 2 years in men treated with triptorelin as primary therapy for advanced or locally advanced prostate cancer. Methods Data were collected for 2 years in accordance with routine clinical practice. Body image was assessed using the body image scale (BIS). Patient body mass index (BMI) and waist circumference were also measured. Results BIS and BMI data for both baseline and a least one post-baseline visit were available for 98 of the 145 patients enrolled. The median change in BIS score for patients assessed around 12 or 24 months after baseline and at the last observation was zero, indicating no body image deterioration in at least half of patients. Statistically significant BIS score increases were detected in assessments around 6, 12 and 18 months, but not after 2 years, indicating some patients experienced body image deterioration at some point during treatment. Changes in BMI from baseline were modest and generally not statistically significant. Waist circumference increased during the study (mean ± standard deviation increase of 1.00 ± 5.01 cm at the last observation). Positive correlations were determined between increases in BIS score and both BMI and waist circumference (r = 0.235 and 0.267, respectively; p = 0.020 and 0.008) at the last observation for all patients, as well as during the second year of the study. Conclusions Most patients did not experience clinically meaningful worsening of body image perception during the study. BMI and waist circumference had a modest impact on body image during study year 2.
Collapse
|
18
|
Vescini F, Attanasio R, Balestrieri A, Bandeira F, Bonadonna S, Camozzi V, Cassibba S, Cesareo R, Chiodini I, Francucci CM, Gianotti L, Grimaldi F, Guglielmi R, Madeo B, Marcocci C, Palermo A, Scillitani A, Vignali E, Rochira V, Zini M. Italian association of clinical endocrinologists (AME) position statement: drug therapy of osteoporosis. J Endocrinol Invest 2016; 39:807-34. [PMID: 26969462 PMCID: PMC4964748 DOI: 10.1007/s40618-016-0434-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 01/22/2016] [Indexed: 12/17/2022]
Abstract
Treatment of osteoporosis is aimed to prevent fragility fractures and to stabilize or increase bone mineral density. Several drugs with different efficacy and safety profiles are available. The long-term therapeutic strategy should be planned, and the initial treatment should be selected according to the individual site-specific fracture risk and the need to give the maximal protection when the fracture risk is highest (i.e. in the late life). The present consensus focused on the strategies for the treatment of postmenopausal osteoporosis taking into consideration all the drugs available for this purpose. A short revision of the literature about treatment of secondary osteoporosis due both to androgen deprivation therapy for prostate cancer and to aromatase inhibitors for breast cancer was also performed. Also premenopausal females and males with osteoporosis are frequently seen in endocrine settings. Finally particular attention was paid to the tailoring of treatment as well as to its duration.
Collapse
Affiliation(s)
- F. Vescini
- Endocrinology and Metabolic Disease Unit, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, P.le S.M. della Misericordia, 15, 33100 Udine, Italy
| | - R. Attanasio
- Endocrinology Service, Galeazzi Institute IRCCS, Milan, Italy
| | - A. Balestrieri
- Unit of Endocrinology and Diabetology, Department of Internal Medicine, M. Bufalini Hospital, Cesena, Italy
| | - F. Bandeira
- Division of Endocrinology, Diabetes and Bone Diseases, Agamenon Magalhães Hospital, University of Pernambuco Medical School, Recife, Brazil
| | | | - V. Camozzi
- Unit of Endocrinology, Department of Medicine, University of Padova, Padua, Italy
| | - S. Cassibba
- Endocrinology and Diabetology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - R. Cesareo
- Endocrinology, S. Maria Goretti Hospital, Latina, Italy
| | - I. Chiodini
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - C. Maria Francucci
- Post Acute and Long Term Care Department, I.N.R.C.A., Ancona, Italy
- San Pier Damiano Hospital, Villa Maria Group Care and Research, Faenza, Ravenna Italy
| | - L. Gianotti
- Endocrinology and Metabolic Diseases, S. Croce e Carle Hospital, Cuneo, Italy
| | - F. Grimaldi
- Endocrinology and Metabolic Disease Unit, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, P.le S.M. della Misericordia, 15, 33100 Udine, Italy
| | - R. Guglielmi
- Endocrinology Unit, Regina Apostolorum Hospital, Albano Laziale, Rome Italy
| | - B. Madeo
- Integrated Department of Medicine, Endocrinology and Metabolism, Geriatrics, University of Modena and Reggio Emilia, Modena, Italy
| | - C. Marcocci
- Endocrine Unit 2, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - A. Palermo
- Department of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, Italy
| | - A. Scillitani
- Endocrinology, Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy
| | - E. Vignali
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - V. Rochira
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - M. Zini
- Endocrinology Unit, Arcispedale S. Maria Nuova IRCCS, Reggio Emilia, Italy
| |
Collapse
|
19
|
Essien OE, Bassey IE, Gali RM, Udoh AE, Akpan UO, Glen EE. Cardiovascular Disease Risk Factors: How Relevant in African Men With Prostate Cancer Receiving Androgen-Deprivation Therapy? J Glob Oncol 2016; 3:7-14. [PMID: 28717736 PMCID: PMC5493230 DOI: 10.1200/jgo.2015.002790] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Cardiovascular disease risk factors have been associated with androgen-deprivation therapy (ADT) in white and Hispanic populations. It is therefore relevant to determine if there exists a relationship between these parameters in the African population. Patients and Methods The design of the study was cross sectional. Prostate-specific antigen concentration, waist circumference, body mass index (BMI), lipid profile, glucose level, and insulin level were determined in 153 patients with prostate cancer and 80 controls. The patients with prostate cancer were divided into subgroups of treatment-naïve patients and those receiving ADT. Results Mean total cholesterol (P = .010), LDL cholesterol (P = .021), BMI (P = .001), and waist circumference (P = .029) values were significantly higher in patients treated with ADT when compared with treatment-naïve patients. In patients treated with ADT for up to 1 year, only mean BMI was significantly higher than in treatment-naïve patients, whereas those treated with ADT for more than 1 year had significantly higher mean BMI, waist circumference, total cholesterol, and LDL cholesterol values when compared with treatment-naïve patients. There were no significant differences in insulin or glucose levels. Those undergoing hormone manipulation after orchiectomy had fewer cardiovascular risk factors compared with those undergoing hormone manipulation alone. Conclusion This study shows that ADT results in elevated total cholesterol, LDL cholesterol, BMI, and waist circumference values, all of which are risk factors of cardiovascular disease. Screening for cardiovascular risk factors should be included in treatment plans for patients with prostate cancer.
Collapse
Affiliation(s)
- Okon Ekwere Essien
- , , , and , University of Calabar College of Medical Sciences; , University of Calabar Teaching Hospital, Calabar; and , University of Maiduguri College of Medical Sciences, Maiduguri, Nigeria
| | - Iya Eze Bassey
- , , , and , University of Calabar College of Medical Sciences; , University of Calabar Teaching Hospital, Calabar; and , University of Maiduguri College of Medical Sciences, Maiduguri, Nigeria
| | - Rebecca Mtaku Gali
- , , , and , University of Calabar College of Medical Sciences; , University of Calabar Teaching Hospital, Calabar; and , University of Maiduguri College of Medical Sciences, Maiduguri, Nigeria
| | - Alphonsus Ekpe Udoh
- , , , and , University of Calabar College of Medical Sciences; , University of Calabar Teaching Hospital, Calabar; and , University of Maiduguri College of Medical Sciences, Maiduguri, Nigeria
| | - Uwem Okon Akpan
- , , , and , University of Calabar College of Medical Sciences; , University of Calabar Teaching Hospital, Calabar; and , University of Maiduguri College of Medical Sciences, Maiduguri, Nigeria
| | - Enakirerhi E Glen
- , , , and , University of Calabar College of Medical Sciences; , University of Calabar Teaching Hospital, Calabar; and , University of Maiduguri College of Medical Sciences, Maiduguri, Nigeria
| |
Collapse
|
20
|
Androgen actions on endothelium functions and cardiovascular diseases. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2016; 13:183-96. [PMID: 27168746 PMCID: PMC4854959 DOI: 10.11909/j.issn.1671-5411.2016.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The roles of androgens on cardiovascular physiology and pathophysiology are controversial as both beneficial and detrimental effects have been reported. Although the reasons for this discrepancy are unclear, multiple factors such as genetic and epigenetic variation, sex-specificity, hormone interactions, drug preparation and route of administration may contribute. Recently, growing evidence suggests that androgens exhibit beneficial effects on cardiovascular function though the mechanism remains to be elucidated. Endothelial cells (ECs) which line the interior surface of blood vessels are distributed throughout the circulatory system, and play a crucial role in cardiovascular function. Endothelial progenitor cells (EPCs) are considered an indispensable element for the reconstitution and maintenance of an intact endothelial layer. Endothelial dysfunction is regarded as an initiating step in development of atherosclerosis and cardiovascular diseases. The modulation of endothelial functions by androgens through either genomic or nongenomic signal pathways is one possible mechanism by which androgens act on the cardiovascular system. Obtaining insight into the mechanisms by which androgens affect EC and EPC functions will allow us to determine whether androgens possess beneficial effects on the cardiovascular system. This in turn may be critical in the prevention and therapy of cardiovascular diseases. This article seeks to review recent progress in androgen regulation of endothelial function, the sex-specificity of androgen actions, and its clinical applications in the cardiovascular system.
Collapse
|
21
|
What is causing this man's persistent low back pain? JAAPA 2016; 29:62-4. [DOI: 10.1097/01.jaa.0000482311.63562.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
22
|
Ahmed M, Eeles R. Germline genetic profiling in prostate cancer: latest developments and potential clinical applications. Future Sci OA 2016; 2:FSO87. [PMID: 28031937 PMCID: PMC5137984 DOI: 10.4155/fso.15.87] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 11/10/2015] [Indexed: 12/16/2022] Open
Abstract
Familial and twin studies have demonstrated a significant inherited component to prostate cancer predisposition. Genome wide association studies have shown that there are 100 single nucleotide polymorphisms which have been associated with the development of prostate cancer. This review aims to discuss the scientific methods used to identify these susceptibility loci. It will also examine the current clinical utility of these loci, which include the development of risk models as well as predicting treatment efficacy and toxicity. In order to refine the clinical utility of the susceptibility loci, international consortia have been developed to combine statistical power as well as skills and knowledge to further develop models that could be used to predict risk and treatment outcomes.
Collapse
Affiliation(s)
- Mahbubl Ahmed
- The Institute of Cancer Research, London SM2 5NG, UK
| | | |
Collapse
|
23
|
Ferzoco RM, Ruddy KJ. Optimal delivery of male breast cancer follow-up care: improving outcomes. BREAST CANCER-TARGETS AND THERAPY 2015; 7:371-9. [PMID: 26648754 PMCID: PMC4664432 DOI: 10.2147/bctt.s75630] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Male breast cancer is a rare disease. There are limited data to inform optimal treatment and follow-up strategies in this population. Currently, most follow-up guidelines are drawn from the vast literature on female breast cancer, despite the fact that male breast cancer has unique biological characteristics. In this review, we discuss clinical characteristics of male breast cancer as well as current best practices for long-term care with a focus on surveillance, screening, and treatment-related symptom management in male breast cancer survivors.
Collapse
|
24
|
Donovan KA, Walker LM, Wassersug RJ, Thompson LMA, Robinson JW. Psychological effects of androgen-deprivation therapy on men with prostate cancer and their partners. Cancer 2015; 121:4286-99. [PMID: 26372364 DOI: 10.1002/cncr.29672] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 07/24/2015] [Accepted: 07/29/2015] [Indexed: 01/07/2023]
Abstract
The clinical benefits of androgen-deprivation therapy (ADT) for men with prostate cancer (PC) have been well documented and include living free from the symptoms of metastases for longer periods and improved quality of life. However, ADT comes with a host of its own serious side effects. There is considerable evidence of the adverse cardiovascular, metabolic, and musculoskeletal effects of ADT. Far less has been written about the psychological effects of ADT. This review highlights several adverse psychological effects of ADT. The authors provide evidence for the effect of ADT on men's sexual function, their partner, and their sexual relationship. Evidence of increased emotional lability and depressed mood in men who receive ADT is also presented, and the risk of depression in the patient's partner is discussed. The evidence for adverse cognitive effects with ADT is still emerging but suggests that ADT is associated with impairment in multiple cognitive domains. Finally, the available literature is reviewed on interventions to mitigate the psychological effects of ADT. Across the array of adverse effects, physical exercise appears to have the greatest potential to address the psychological effects of ADT both in men who are receiving ADT and in their partners.
Collapse
Affiliation(s)
- Kristine A Donovan
- Supportive Care Medicine Department, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Lauren M Walker
- Department of Psychosocial Resources and Rehabilitation Oncology, Tom Baker Cancer Center, Calgary, Alberta, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Richard J Wassersug
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada.,Australian Research Center in Sex, Health, and Society, La Trobe University, Melbourne, Victoria, Australia
| | - Lora M A Thompson
- Supportive Care Medicine Department, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - John W Robinson
- Department of Psychosocial Resources and Rehabilitation Oncology, Tom Baker Cancer Center, Calgary, Alberta, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
25
|
Van Dam D, Wassersug RJ, Hamilton LD. Androgen deprivation therapy's impact on the mood of prostate cancer patients as perceived by patients and the partners of patients. Psychooncology 2015; 25:848-56. [PMID: 26332203 DOI: 10.1002/pon.3932] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 06/04/2015] [Accepted: 07/15/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess the relationship between of androgen deprivation therapy (ADT) and the mood of prostate cancer (PCa) patients and partners of PCa patients. METHODS PCa patients (n = 295) and partners of patients (n = 84) completed an online survey assessing the patients' current mood and mood prior to treatment, relationship adjustment, and sexual function. We compared men on ADT to men who received non-hormonal treatments for their PCa. RESULTS Patients currently treated with ADT (n = 82) reported worsened mood as measured by the Profile of Mood States compared to those not on ADT (n = 213). The negative impact of ADT on mood, however, was reduced in older patients. Partners of patients on ADT (n = 42) reported similar declines in the patient's mood that patients reported, but to a greater degree than patient-reported levels. CONCLUSIONS Our data support ADT's impact on PCa patients' mood and verify that partners concurrently see the effects. The psychological changes related to ADT can impact relationships and affect the quality of life of both PCa patients and partners. Patients and their partners are likely to benefit from being well informed about the psychological effects of androgen deprivation on men beginning ADT. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Dexter Van Dam
- Psychology Department, Mount Allison University, Sackville, NB, Canada
| | - Richard J Wassersug
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada.,Australian Research Centre in Sex, Health, and Society, La Trobe University, Melbourne, VIC, Australia
| | | |
Collapse
|
26
|
Tsai HT, Penson D, Luta G, Lynch JH, Zhou Y, Potosky AL. Adoption of Intermittent Androgen Deprivation Therapy for Advanced Prostate Cancer: A Population Based Study in American Urology Practice. UROLOGY PRACTICE 2015; 2:190-198. [PMID: 26925454 DOI: 10.1016/j.urpr.2014.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION In several developed countries intermittent androgen deprivation therapy has been accepted over continuous androgen deprivation therapy for advanced prostate cancer management. To our knowledge its adoption and predictors of use in American urology practice remain unknown. METHODS Using SEER-Medicare data we identified a cohort of men 66 years old or older who were newly diagnosed with prostate cancer with metastasis or with treated recurrence in whom androgen deprivation therapy was started during 2003 to 2007. We determined intermittent androgen deprivation therapy receipt based on interruptions longer than 3 months between scheduled and actual therapy injections, and physician visits and prostate specific antigen tests during the interruption. Predictors included patient and physician characteristics. We performed logistic regression analysis separately in the metastatic and treated recurrence groups using generalized estimating equations to account for the clustering effect of patients treated by the same physician. RESULTS Our cohort included 4,281 men, of whom 2,487 with metastasis and 1,794 with treated recurrence received intermittent androgen deprivation therapy. In patients who received intermittent rather than continuous therapy the median duration of therapy was by 6.4 and 9.0 months longer in those with metastasis and treated recurrence, respectively. Each patient group showed significant variation in intermittent therapy use by region (p <0.0001). There was lower intermittent androgen deprivation therapy use in the Eastern and Central regions than in the Mountain and Pacific regions. CONCLUSIONS Intermittent androgen deprivation therapy has not been widely used in American urology practice. Its adoption shows substantial variation by geographic regions. These regional differences likely reflect uncertainty regarding the efficacy of this therapy among providers as well as differences in patient preferences and involvement in treatment decision making.
Collapse
Affiliation(s)
- Huei-Ting Tsai
- Departments of Oncology (HTT, YZ, ALP) and Biostatistics, Bioinformatics and Biomathematics (GL), Georgetown University Medical Center and Department of Urology, MedStar Georgetown University Hospital (JHL), Washington, D.C., and Department of Urologic Surgery and Medicine, Vanderbilt University Medical Center and Geriatric Research Education and Clinical Center, Veterans Affairs Tennessee Valley Healthcare System, Nashville (DP), Tennessee
| | - David Penson
- Departments of Oncology (HTT, YZ, ALP) and Biostatistics, Bioinformatics and Biomathematics (GL), Georgetown University Medical Center and Department of Urology, MedStar Georgetown University Hospital (JHL), Washington, D.C., and Department of Urologic Surgery and Medicine, Vanderbilt University Medical Center and Geriatric Research Education and Clinical Center, Veterans Affairs Tennessee Valley Healthcare System, Nashville (DP), Tennessee
| | - George Luta
- Departments of Oncology (HTT, YZ, ALP) and Biostatistics, Bioinformatics and Biomathematics (GL), Georgetown University Medical Center and Department of Urology, MedStar Georgetown University Hospital (JHL), Washington, D.C., and Department of Urologic Surgery and Medicine, Vanderbilt University Medical Center and Geriatric Research Education and Clinical Center, Veterans Affairs Tennessee Valley Healthcare System, Nashville (DP), Tennessee
| | - John H Lynch
- Departments of Oncology (HTT, YZ, ALP) and Biostatistics, Bioinformatics and Biomathematics (GL), Georgetown University Medical Center and Department of Urology, MedStar Georgetown University Hospital (JHL), Washington, D.C., and Department of Urologic Surgery and Medicine, Vanderbilt University Medical Center and Geriatric Research Education and Clinical Center, Veterans Affairs Tennessee Valley Healthcare System, Nashville (DP), Tennessee
| | - Yingjun Zhou
- Departments of Oncology (HTT, YZ, ALP) and Biostatistics, Bioinformatics and Biomathematics (GL), Georgetown University Medical Center and Department of Urology, MedStar Georgetown University Hospital (JHL), Washington, D.C., and Department of Urologic Surgery and Medicine, Vanderbilt University Medical Center and Geriatric Research Education and Clinical Center, Veterans Affairs Tennessee Valley Healthcare System, Nashville (DP), Tennessee
| | - Arnold L Potosky
- Departments of Oncology (HTT, YZ, ALP) and Biostatistics, Bioinformatics and Biomathematics (GL), Georgetown University Medical Center and Department of Urology, MedStar Georgetown University Hospital (JHL), Washington, D.C., and Department of Urologic Surgery and Medicine, Vanderbilt University Medical Center and Geriatric Research Education and Clinical Center, Veterans Affairs Tennessee Valley Healthcare System, Nashville (DP), Tennessee
| |
Collapse
|
27
|
Morgans AK, Fan KH, Koyama T, Albertsen PC, Goodman M, Hamilton AS, Hoffman RM, Stanford JL, Stroup AM, Resnick MJ, Barocas DA, Penson DF. Influence of age on incident diabetes and cardiovascular disease in prostate cancer survivors receiving androgen deprivation therapy. J Urol 2015; 193:1226-31. [PMID: 25451829 PMCID: PMC4542148 DOI: 10.1016/j.juro.2014.11.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Observational data suggest that androgen deprivation therapy increases the risk of diabetes and cardiovascular disease. Using data from the population based PCOS we evaluated whether age at diagnosis and comorbidity impact the association of androgen deprivation therapy with incident diabetes and cardiovascular disease. MATERIALS AND METHODS We identified men with nonmetastatic prostate cancer diagnosed from 1994 to 1995 who were followed through 2009 to 2010. We used multivariable logistic regression models to assess the relationship of androgen deprivation therapy exposure (2 or fewer years, greater than 2 years or none) with incident diabetes and cardiovascular disease, adjusting for age at diagnosis, race, stage and comorbidity. RESULTS Of 3,526 eligible study participants 2,985 without diabetes and 3,112 without cardiovascular disease comprised the cohorts at risk. Androgen deprivation therapy was not associated with an increased risk of diabetes or cardiovascular disease in men diagnosed with prostate cancer before age 70 years. Prolonged androgen deprivation therapy and increasing age at diagnosis in older men was associated with an increased risk of diabetes (at age 76 years OR 2.1, 95% CI 1.0-4.4) and cardiovascular disease (at age 74 years OR 1.9, 95% CI 1.0-3.5). Men with comorbidities were at greater risk for diabetes (OR 4.3, 95% CI 2.3-7.9) and cardiovascular disease (OR 8.1, 95% CI 4.3-15.5) than men without comorbidities. CONCLUSIONS Prolonged androgen deprivation therapy exposure increases the risk of cardiovascular disease and diabetes in men diagnosed with prostate cancer who are older than approximately 75 years, especially those with other comorbidities. Older men who receive prolonged androgen deprivation therapy should be closely monitored for diabetes and cardiovascular disease.
Collapse
Affiliation(s)
- Alicia K Morgans
- School of Medicine, Vanderbilt University, Nashville, Tennessee.
| | - Kang-Hsien Fan
- School of Medicine, Vanderbilt University, Nashville, Tennessee; Center for Quantitative Sciences and Department of Biostatistics, Vanderbilt University, Nashville, Tennessee
| | - Tatsuki Koyama
- School of Medicine, Vanderbilt University, Nashville, Tennessee; Center for Quantitative Sciences and Department of Biostatistics, Vanderbilt University, Nashville, Tennessee
| | | | | | - Ann S Hamilton
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | | | | | | | | | | | - David F Penson
- School of Medicine, Vanderbilt University, Nashville, Tennessee; Geriatric Research, Education and Clinical Center, Tennessee Valley Veterans Administration Healthcare System, Nashville, Tennessee
| |
Collapse
|
28
|
Morgans AK, Fan KH, Koyama T, Albertsen PC, Goodman M, Hamilton AS, Hoffman RM, Stanford JL, Stroup AM, Penson DF. Bone complications among prostate cancer survivors: long-term follow-up from the prostate cancer outcomes study. Prostate Cancer Prostatic Dis 2014; 17:338-42. [PMID: 25134939 PMCID: PMC4227957 DOI: 10.1038/pcan.2014.31] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 06/27/2014] [Accepted: 07/15/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND To assess the relationship between androgen deprivation therapy (ADT) exposure and self-reported bone complications among men in a population-based cohort of prostate cancer survivors followed for 15 years after diagnosis. METHODS The Prostate Cancer Outcomes Study enrolled 3533 patients diagnosed with prostate cancer between 1994 and 1995. This analysis included participants with non-metastatic disease at the time of diagnosis who completed 15-year follow-up surveys to report development of fracture, and use of bone-related medications. The relationship between ADT duration and bone complications was assessed using multivariable logistic regression models. RESULTS Among 961 surviving men, 157 (16.3%) received prolonged ADT (>1 year), 120 (12.5%) received short-term ADT (⩽ 1 year) and 684 (71.2%) did not receive ADT. Men receiving prolonged ADT had higher odds of fracture (OR 2.5; 95% confidence interval (CI): 1.1-5.7), bone mineral density testing (OR 5.9; 95% CI: 3.0-12) and bone medication use (OR 4.3; 95% CI: 2.3-8.0) than untreated men. Men receiving short-term ADT reported rates of fracture similar to untreated men. Half of men treated with prolonged ADT reported bone medication use. CONCLUSIONS In this population-based cohort study with long-term follow-up, prolonged ADT use was associated with substantial risks of fracture, whereas short-term use was not. This information should be considered when weighing the advantages and disadvantages of ADT in men with prostate cancer.
Collapse
Affiliation(s)
- A K Morgans
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - K-H Fan
- 1] Division of Hematology/Oncology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA [2] Vanderbilt University Center for Quantitative Sciences and Department of Biostatistics, Nashville, TN, USA
| | - T Koyama
- 1] Division of Hematology/Oncology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA [2] Vanderbilt University Center for Quantitative Sciences and Department of Biostatistics, Nashville, TN, USA
| | - P C Albertsen
- University of Connecticut Health Center, Farmington, CT, USA
| | | | - A S Hamilton
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - R M Hoffman
- University of New Mexico, Albuquerque, NM, USA
| | - J L Stanford
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - A M Stroup
- University of Utah, Salt Lake City, UT, USA
| | - D F Penson
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| |
Collapse
|
29
|
Bolam KA, Beck BR, Adlard KN, Skinner TL, Cormie P, Galvão DA, Spry N, Newton RU, Taaffe DR. The relationship between BPAQ-derived physical activity and bone density of middle-aged and older men. Osteoporos Int 2014; 25:2663-8. [PMID: 24993816 DOI: 10.1007/s00198-014-2797-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 06/26/2014] [Indexed: 10/25/2022]
Abstract
UNLABELLED The bone-specific physical activity questionnaire (BPAQ) accounts for activities that affect bone but has not been used in studies with older adults. Relationships exist between the BPAQ-derived physical activity and bone density in healthy middle-aged and older men but not men with prostate cancer. Disease-related treatments detrimental to bone should be considered when administering the BPAQ. INTRODUCTION The bone-specific physical activity questionnaire (BPAQ) was developed to account for bone-specific loading. In this retrospective study, we examined the relationship between BPAQ-derived physical activity and bone mineral density (BMD) in middle-aged and older men with and without prostate cancer. METHODS Two groups, 36 healthy men and 69 men with prostate cancer receiving androgen suppression therapy (AST), completed the BPAQ and had whole body, total hip, femoral (FN) and lumbar spine BMD assessed by dual-energy X-ray absorptiometry. RESULTS Past (pBPAQ), current (cBPAQ) and total BPAQ (tBPAQ) scores for the healthy men were related to FN BMD (pBPAQ r = 0.36, p = 0.030; cBPAQ r s = 0.35, p = 0.034; tBPAQ r = 0.41, p = 0.014), and pBPAQ and tBPAQ were related to total hip (r s = 0.35, p = 0.035 and r s = 0.36, p = 0.029, respectively) and whole body BMD (r s = 0.44, p = 0.007 and r s = 0.45, p = 0.006, respectively). In men with prostate cancer, the BPAQ was not significantly associated with BMD. In stepwise regression analyses, body mass and tBPAQ predicted 30 % of the variance in total hip BMD (p = 0.003), cBPAQ predicted 14 % of the variance in FN BMD (p = 0.002), and body mass, age and tBPAQ predicted 47% of the variance in whole body BMD (p < 0.001) in healthy men. In men with prostate cancer, the BPAQ was not an independent predictor of BMD. CONCLUSIONS Although BPAQ-derived estimates of physical activity are related to bone status in healthy middle-aged and older men, the adverse effect of AST on bone appears to obscure this relationship in men with prostate cancer.
Collapse
Affiliation(s)
- K A Bolam
- School of Human Movement Studies, The University of Queensland, Brisbane, QLD, Australia,
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Cheung AS, Zajac JD, Grossmann M. Muscle and bone effects of androgen deprivation therapy: current and emerging therapies. Endocr Relat Cancer 2014; 21:R371-94. [PMID: 25056176 DOI: 10.1530/erc-14-0172] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Prostate cancer and treatment with androgen deprivation therapy (ADT) affect significant numbers of the male population. Endocrine effects of ADT are a critical consideration in balancing the benefits and risks of treatment on long-term survival and quality of life. This review highlights the latest advances in androgen manipulation in prostate cancer with an emphasis on the effects of ADT on muscle and bone, which universally affects the health and well-being of men undergoing ADT for prostate cancer. Muscle mass declines with ADT; however, the evidence that this correlates with a decrease in muscle strength or a decrease in physical performance is discordant. Cortical bone decay also occurs in association with an increase in fracture risk, hence optimization of musculoskeletal health in men undergoing ADT is crucial. The role of exercise, and current and emerging anabolic therapies for muscle as well as various new strategies to prevent loss of bone mass in men undergoing ADT are discussed. Future well-designed, prospective, controlled studies are required to elucidate the effects of ADT on physical performance, which are currently lacking, and larger randomized controlled trials are required to test the efficacy of medical therapies and exercise interventions to target proven deficits and to ensure safety in men with prostate cancer.
Collapse
Affiliation(s)
- Ada S Cheung
- Department of EndocrinologyAustin Health, Heidelberg, Victoria, AustraliaDepartment of Medicine (Austin Health)The University of Melbourne, 300 Waterdale Road, Heidelberg West, Victoria 3081, Australia Department of EndocrinologyAustin Health, Heidelberg, Victoria, AustraliaDepartment of Medicine (Austin Health)The University of Melbourne, 300 Waterdale Road, Heidelberg West, Victoria 3081, Australia
| | - Jeffrey D Zajac
- Department of EndocrinologyAustin Health, Heidelberg, Victoria, AustraliaDepartment of Medicine (Austin Health)The University of Melbourne, 300 Waterdale Road, Heidelberg West, Victoria 3081, Australia Department of EndocrinologyAustin Health, Heidelberg, Victoria, AustraliaDepartment of Medicine (Austin Health)The University of Melbourne, 300 Waterdale Road, Heidelberg West, Victoria 3081, Australia
| | - Mathis Grossmann
- Department of EndocrinologyAustin Health, Heidelberg, Victoria, AustraliaDepartment of Medicine (Austin Health)The University of Melbourne, 300 Waterdale Road, Heidelberg West, Victoria 3081, Australia Department of EndocrinologyAustin Health, Heidelberg, Victoria, AustraliaDepartment of Medicine (Austin Health)The University of Melbourne, 300 Waterdale Road, Heidelberg West, Victoria 3081, Australia
| |
Collapse
|
31
|
Zhao J, Zhu S, Sun L, Meng F, Zhao L, Zhao Y, Tian H, Li P, Niu Y. Androgen deprivation therapy for prostate cancer is associated with cardiovascular morbidity and mortality: a meta-analysis of population-based observational studies. PLoS One 2014; 9:e107516. [PMID: 25264674 PMCID: PMC4180271 DOI: 10.1371/journal.pone.0107516] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 08/12/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There is no consensus regarding whether androgen deprivation therapy (ADT) is associated with cardiovascular disease (CVD) and cardiovascular mortality (CVM). The objective of this study was to determine the role of ADT for prostate cancer (PCa) in development of cardiovascular events (CVD and CVM). METHODS AND FINDINGS We performed a meta-analysis from population-based observational studies comparing ADT vs control aimed at treating PCa in patients with PCa, reporting either CVD or CVM as outcome. Publications were searched using Medline, Embase, Cochrane Library Central Register of observational studies database up to May 31th 2014, and supplementary searches in publications from potentially relevant journals. 6 studies were identified with a total of 129,802 ADT users and 165,605 controls investigating the relationship between ADT and CVD. The incidence of CVD was 10% higher in ADT groups, although no significant association was observed (HR = 1.10, 95%CIs: 1.00-1.21; P = 0.06). For different types of ADT, CVD was related with gonadotropin-releasing hormone (GnRH) (HR = 1.19, 95%CIs: 1.04-1.36; P<0.001) and GnRH plus oral antiandrogen (AA) (HR = 1.46, 95%CIs: 1.03-2.08; P = 0.04), but not with AA alone or orchiectomy. For CVM, 119,625 ADT users and 150,974 controls from 6 eligible studies were included, pooled results suggested that ADT was associated with CVM (HR = 1.17, 95%CIs: 1.04-1.32; P = 0.01). Significantly increased CVM was also detected in GnRH and GnRH plus AA groups. When patients received other treatments (e.g. prostatectomy and radiotherapy) were ruled out of consideration, more increased CVD (HR = 1.19, 95%CIs: 1.08-1.30; P<0.001) and CVM (HR = 1.30, 95%CIs: 1.13-1.50; P<0.001) were found in men treated with ADT monotherapy. CONCLUSIONS ADT is associated with both CVD and CVM. Particularly, GnRH alone and GnRH plus AA can significantly increase the incidence of cardiovascular events in patients with PCa.
Collapse
Affiliation(s)
- Jinsheng Zhao
- Tianjin Medical University, Tianjin, China
- Department of Neurology, Tianjin Nankai Hospital, Tianjin, China
- Department of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical Unversity, Tianjin, China
| | - Shimiao Zhu
- Tianjin Medical University, Tianjin, China
- Department of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical Unversity, Tianjin, China
| | - Libin Sun
- Tianjin Medical University, Tianjin, China
- Department of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical Unversity, Tianjin, China
| | - Fanzheng Meng
- Department of Neurology, Tianjin Nankai Hospital, Tianjin, China
| | - Lin Zhao
- Tianjin Medical University, Tianjin, China
| | - Yusheng Zhao
- First teaching hospital of Tianjin University of TCM, Tianjin, China
| | - Hao Tian
- Tianjin Medical University, Tianjin, China
- Department of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical Unversity, Tianjin, China
| | - Ping Li
- Tianjin Third Central Hospital, Tianjin, China
| | - Yuanjie Niu
- Tianjin Medical University, Tianjin, China
- Department of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical Unversity, Tianjin, China
| |
Collapse
|
32
|
Harrington JM, Schwenke DC, Epstein DR, Bailey DE. Androgen-deprivation therapy and metabolic syndrome in men with prostate cancer. Oncol Nurs Forum 2014; 41:21-9. [PMID: 24368236 DOI: 10.1188/14.onf.21-29] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To examine the trajectory of changes in body composition and metabolic profile in men who receive androgen-deprivation therapy (ADT) for prostate cancer. DESIGN Prospective longitudinal design with repeated measures. SETTING Urban medical center in the southwestern United States. SAMPLE 55 men starting radiation therapy for prostate cancer. METHODS Changes in the parameters of metabolic syndrome were estimated with ADT (n=31) and non-ADT (n=24) groups by repeated-measures analysis of variance implemented by general linear mixed-effects models. Models included interactions between groups and follow-up time to test differences between the groups. MAIN RESEARCH VARIABLES Body composition and metabolic variables. FINDINGS The ADT group demonstrated a transient increase in waist circumference at the nine-month time point and significant changes in measures of insulin resistance were noted at the three month point. Values for diastolic and systolic blood pressure, plasma glucose, high-density lipoprotein, and triglycerides were not altered for either group. Differences in metabolic variables or measures of body composition did not differ significantly between the groups. CONCLUSIONS The findings demonstrate the development of insulin resistance in men receiving ADT as early as three months after starting ADT. IMPLICATIONS FOR NURSING Addressing survivorship concerns can lead to the development of nursing interventions designed to reduce adverse effects associated with ADT.
Collapse
Affiliation(s)
| | | | - Dana R Epstein
- College of Nursing and Health Innovation, Arizona State University
| | | |
Collapse
|
33
|
Lee M, Jim HS, Fishman M, Zachariah B, Heysek R, Biagioli M, Jacobsen PB. Depressive symptomatology in men receiving androgen deprivation therapy for prostate cancer: a controlled comparison. Psychooncology 2014; 24:472-7. [PMID: 24924331 DOI: 10.1002/pon.3608] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Revised: 05/22/2014] [Accepted: 05/28/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Prostate cancer patients who receive androgen deprivation therapy (ADT) often experience many physical and psychological side effects. ADT may be associated with increased risk for depression, but the relationship between ADT and depression is not fully understood. This study used a longitudinal design to assess depressive symptomatology in patients receiving ADT compared with two groups of matched controls. METHODS Participants were men initiating ADT treatment (ADT+ group; n = 61) and their matched controls: prostate cancer patients treated with radical prostatectomy (ADT- group; n = 61), and no-cancer controls (CA- group; n = 61). Depressive symptomatology was assessed using the Center for Epidemiological Studies Depression Scale at ADT initiation and again 6 months later. Differences in depressive symptomatology and rates of clinically significant depressive symptomatology were analyzed between groups at each time point and within groups over time. RESULTS Between baseline and follow-up, ADT+ participants demonstrated increased depressive symptomatology and increased rates of clinically significant depressive symptomatology (ps < 0.05). ADT+ participants also reported greater depressive symptomatology than both control groups at follow-up (ps < 0.001). Rates of clinically significant depressive symptomatology were higher in the ADT+ group than the ADT- and CA- groups at both time points (baseline: 28%, 5%, 12%; follow-up: 39%, 9%, 11%). CONCLUSIONS Findings support the hypothesis that ADT administration yields increases in depression and suggest that the mechanism behind ADT's association with depression should be explored and that prostate cancer patients treated with ADT should receive particular focus in depression screening and intervention.
Collapse
Affiliation(s)
- Morgan Lee
- Department of Psychology, University of South Florida, Tampa, FL, USA; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | | | | | | | | | | | | |
Collapse
|
34
|
Ziouziou I, Karmouni T, Khader KE, Koutani A, Andaloussi AIA. [Not Available]. Can Urol Assoc J 2014; 8:E159-E162. [PMID: 24678355 PMCID: PMC3956835 DOI: 10.5489/cuaj.1608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Les effets indésirables de l’hormonothérapie anti-androgénique (HAA) dans le traitement du cancer de la prostate sont attribuables à la carence d’androgènes. L’HAA entraîne le syndrome de castration, qui se caractérise par une diminution de la libido, la dysfonction érectile, l’asthénie, des bouffées de chaleur, la diminution des capacités intellectuelles et la dépression. Il en résulte également une augmentation de la graisse abdominale, ce qui favorise l’insulinorésistance et le diabète. La perte de la densité minérale osseuse secondaire à l’HAA entraîne un risque fracturaire accru. Il existe de plus un risque cardiovasculaire important dû aux facteurs métaboliques. L’effet thérapeutique de l’HAA doit donc être soupesé en regard de la toxicité liée à l’hypogonadisme.
Collapse
|
35
|
Gardner JR, Livingston PM, Fraser SF. Effects of Exercise on Treatment-Related Adverse Effects for Patients With Prostate Cancer Receiving Androgen-Deprivation Therapy: A Systematic Review. J Clin Oncol 2014; 32:335-46. [DOI: 10.1200/jco.2013.49.5523] [Citation(s) in RCA: 187] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Androgen-deprivation therapy is a commonly used treatment for men with prostate cancer; however, the adverse effects can be detrimental to patient health and quality of life. Exercise has been proposed as a strategy for ameliorating a range of these treatment-related adverse effects. We conducted a systematic review of the literature regarding the effects of exercise on treatment-related adverse effects in men receiving androgen-deprivation therapy for prostate cancer. Methods An online electronic search of the Cochrane Library, EMBASE, MEDLINE, CINAHL, SPORTDiscus, and Health Source databases was performed to identify relevant peer-reviewed articles published between January 1980 and June 2013. Eligible study designs included randomized controlled trials as well as uncontrolled trials with pre- and postintervention data. Information was extracted regarding participant and exercise intervention characteristics as well as the effects of exercise on bone health, body composition, physical performance, cardiometabolic risk, fatigue, and quality of life. Results Ten studies were included, with exercise interventions involving aerobic and/or resistance training. Exercise training demonstrated benefits in muscular strength, cardiorespiratory fitness, functional task performance, lean body mass, and fatigue, with inconsistent effects observed for adiposity. The impact of exercise on bone health, cardiometabolic risk markers, and quality of life are currently unclear. Conclusion Among patients with prostate cancer treated with androgen-deprivation therapy, appropriately prescribed exercise is safe and may ameliorate a range of treatment-induced adverse effects. Ongoing research of high methodologic quality is required to consolidate and expand on current knowledge and to allow the development of specific evidence-based exercise prescription recommendations.
Collapse
Affiliation(s)
| | | | - Steve F. Fraser
- All authors: Deakin University, Melbourne, Victoria, Australia
| |
Collapse
|
36
|
Murphy R, Wassersug R, Dechman G. The role of exercise in managing the adverse effects of androgen deprivation therapy in men with prostate cancer. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/1743288x11y.0000000029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
37
|
Zolochevska O, Ellis J, Parelkar S, Chan-Seng D, Emrick T, Wei J, Patrikeev I, Motamedi M, Figueiredo ML. Interleukin-27 gene delivery for modifying malignant interactions between prostate tumor and bone. Hum Gene Ther 2013; 24:970-81. [PMID: 24028178 DOI: 10.1089/hum.2013.091] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
We have examined the role of a novel cytokine, interleukin-27 (IL-27), in mediating interactions between prostate cancer and bone. IL-27 is the most recently characterized member of the family of heterodimeric IL-12-related cytokines and has shown promise in halting tumor growth and mediating tumor regression in several cancer models, including prostate cancer. Prostate cancer is frequently associated with metastases to the bone, where the tumor induces a vicious cycle of communication with osteoblasts and osteoclasts to induce bone lesions, which are a significant cause of pain and skeletal-related events for patients, including a high fracture risk. We describe our findings in the effects of IL-27 gene delivery on prostate cancer cells, osteoblasts, and osteoclasts at different stages of differentiation. We applied the IL-27 gene delivery protocol in vivo utilizing sonoporation (sonodelivery) with the goal of treating and reducing the growth of prostate cancer at a bone metastatic site in vivo. We used a new model of immune-competent prostate adenocarcinoma and characterized the tumor growth reduction, gene expression, and effector cellular profiles. Our results suggest that IL-27 can be effective in reducing tumor growth, can help normalize bone structure, and can promote enhanced accumulation of effector cells in prostate tumors. These results are promising, because they are relevant to developing a novel IL-27-based strategy that can treat both the tumor and the bone, by using this simple and effective sonodelivery method for treating prostate tumor bone metastases.
Collapse
Affiliation(s)
- Olga Zolochevska
- 1 Department of Pharmacology and Toxicology, The University of Texas Medical Branch , Galveston, TX 77555
| | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Abstract
Osteoporotic fractures in older men (>50 years of age) are common and associated with considerable mortality and morbidity, but osteoporosis in men is under-recognized and undertreated. Secondary osteoporosis is also common in men, and causes include androgen deprivation therapy for prostate cancer, glucocorticoid treatment and alcohol excess. Clinical trials have demonstrated the efficacy of pharmacological osteoporosis treatments in men in terms of increasing BMD and decreasing levels of bone turnover markers; however, few trials have included fracture reduction end points. This Review will consider the pathophysiology of osteoporosis in men and the evidence for testing and treatment. The aims of the Review are to inform clinical practice, to discuss the current evidence base and to highlight the 2012 Endocrine Society clinical practice guidelines on osteoporosis in men.
Collapse
Affiliation(s)
- Jennifer S Walsh
- Academic Unit of Bone Metabolism, Sorby Wing, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK
| | | |
Collapse
|
39
|
How reliable are “reputable sources” for medical information on the Internet? The case of hormonal therapy to treat prostate cancer. Urol Oncol 2013; 31:1546-52. [DOI: 10.1016/j.urolonc.2012.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 07/16/2012] [Accepted: 08/07/2012] [Indexed: 11/21/2022]
|
40
|
Tran S, Walker LM, Wassersug RJ, Matthew AG, McLeod DL, Robinson JW. What do Canadian uro-oncologists believe patients should know about androgen deprivation therapy? J Oncol Pharm Pract 2013; 20:199-209. [DOI: 10.1177/1078155213495285] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Patients prescribed luteinizing hormone-releasing hormone agonists for androgen deprivation therapy (ADT) have significant misconceptions about treatment side effects and how to manage them. We surveyed a subset of Canadian physicians about what they think is important information to tell patients starting on ADT to determine the degree to which there is consensus of opinion. Method A questionnaire about ADT side effects and management strategies was distributed to physicians–urologists, radiation oncologists, and medical oncologists – actively practicing within cancer and urology centers in the Canadian provinces of British Columbia, Alberta, Ontario, and the Maritime Provinces. Result A total of 75 physicians filled out the survey. Physicians agreed that osteoporosis, erectile dysfunction, hot flashes, loss of libido, and loss of muscle mass were drug responses that were essential or important to warn patients about. However, for six commonly reported side effects (i.e. depression, diabetes, elevated cholesterol, anemia, delayed or absent orgasm, and genital shrinkage), physicians showed great variance, with less than 60% agreeing on whether to discuss these topics or not. Conclusion There is little consensus among physicians regarding what to tell patients when prescribing this treatment. The lack of agreement among physicians may partially explain the lack of awareness of ADT side effects by patients and partners. The current findings may help guide strategies for the design, evaluation, and implementation of educational interventions for both physicians and patients that will better prepare patients to recognize, adapt to, and overcome ADT side effects.
Collapse
Affiliation(s)
- Susan Tran
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Alberta, Canada; Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Lauren M Walker
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Alberta, Canada; Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Richard J Wassersug
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada; Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
| | - Andrew G Matthew
- Department of Psychosocial Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Deborah L McLeod
- Nova Scotia Capital Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - John W Robinson
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Alberta, Canada; Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
41
|
Walker LM, Tran S, Wassersug RJ, Thomas B, Robinson JW. Patients and partners lack knowledge of androgen deprivation therapy side effects. Urol Oncol 2013; 31:1098-105. [DOI: 10.1016/j.urolonc.2011.12.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 11/23/2011] [Accepted: 12/20/2011] [Indexed: 10/14/2022]
|
42
|
Trost LW, Serefoglu E, Gokce A, Linder BJ, Sartor AO, Hellstrom WJG. Androgen deprivation therapy impact on quality of life and cardiovascular health, monitoring therapeutic replacement. J Sex Med 2013; 10 Suppl 1:84-101. [PMID: 23387914 DOI: 10.1111/jsm.12036] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Androgen deprivation therapy (ADT) is commonly utilized in the management of both localized and advanced adenocarcinoma of the prostate. The use of ADT is associated with several adverse events, physical changes, and development of medical comorbidities/mortality. AIM The current article reviews known adverse events associated with ADT as well as treatment options, where available. Current recommendations and guidelines are cited for ongoing monitoring of patients receiving ADT. METHODS A PubMed search of topics relating to ADT and adverse outcomes was performed, with select articles highlighted and reviewed based on level of evidence and overall contribution. MAIN OUTCOME MEASURES Reported outcomes of studies detailing adverse effects of ADT were reviewed and discussed. Where available, randomized trials and meta-analyses were reported. RESULTS ADT may result in several adverse events including decreased libido, erectile dysfunction, vasomotor symptoms, cognitive, psychological and quality of life impairments, weight gain, sarcopenia, increased adiposity, gynecomastia, reduced penile/testicular size, hair changes, periodontal disease, osteoporosis, increased fracture risk, diabetes and insulin resistance, hyperlipidemia, and anemia. The definitive impact of ADT on lipid profiles, cardiovascular morbidity/mortality, and all-cause mortality is currently unknown with available data. Treatment options to reduce ADT-related adverse events include changing to an intermittent treatment schedule, biophysical therapy, counseling, and pharmacotherapy. CONCLUSIONS Patients treated with ADT are at increased risk of several adverse events and should be routinely monitored for the development of potentially significant morbidity/mortality. Where appropriate, physicians should reduce known risk factors and counsel patients as to known risks and benefits of therapy.
Collapse
|
43
|
Treleaven MM, Jackowich RA, Roberts L, Wassersug RJ, Johnson T. Castration and personality: Correlation of androgen deprivation and estrogen supplementation with the Big Five factor personality traits of adult males. JOURNAL OF RESEARCH IN PERSONALITY 2013. [DOI: 10.1016/j.jrp.2013.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
44
|
Walker LM, Tran S, Robinson JW. Luteinizing hormone--releasing hormone agonists: a quick reference for prevalence rates of potential adverse effects. Clin Genitourin Cancer 2013; 11:375-84. [PMID: 23891497 DOI: 10.1016/j.clgc.2013.05.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 05/01/2013] [Accepted: 05/14/2013] [Indexed: 10/26/2022]
Abstract
Men with prostate cancer (PCa) frequently undergo androgen deprivation therapy (ADT), typically in the form of a depot injection of luteinizing hormone-releasing hormone agonists (LHRHa). LHRHa are associated with many adverse effects (eg, hot flashes, sexual dysfunction, loss of muscle mass, osteopenia, metabolic syndrome), which drastically impact patient quality of life. This literature review, which includes a comprehensive table documenting prevalence rates, provides a quick reference for health care professionals involved in the care of men undergoing ADT with LHRHa. Primary sources were acquired from PubMed using the search terms "androgen deprivation therapy" and each potentially adverse effect (eg, "androgen deprivation therapy and hot flashes"). Commonly cited review articles were also examined for citations of original studies containing prevalence rates. More than 270 articles were reviewed. In contrast to many existing reviews, rates are cited exclusively from original sources. The prevalence rates, obtained from original sources, suggest that more than half of documented adverse effects are experienced by as many as 40% or more of patients. A critique of the literature is also provided. Although there is a vast literature of both original and review articles on specific adverse effects of LHRHa, the quality of research on prevalence rates for some adverse effects is subpar. Many review articles contain inaccuracies and do not cite original sources. The table of prevalence rates will serve as a quick reference for health care providers when counseling patients and will aid in the development of evidence-based patient education materials.
Collapse
Affiliation(s)
- Lauren M Walker
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
| | | | | |
Collapse
|
45
|
Androgen Deprivation Therapy and maintenance of intimacy: A randomized controlled pilot study of an educational intervention for patients and their partners. Contemp Clin Trials 2013; 34:227-31. [DOI: 10.1016/j.cct.2012.11.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Revised: 11/24/2012] [Accepted: 11/27/2012] [Indexed: 11/18/2022]
|
46
|
Kaufman JM, Reginster JY, Boonen S, Brandi ML, Cooper C, Dere W, Devogelaer JP, Diez-Perez A, Kanis JA, McCloskey E, Mitlak B, Orwoll E, Ringe JD, Weryha G, Rizzoli R. Treatment of osteoporosis in men. Bone 2013; 53. [PMID: 23201268 PMCID: PMC3662207 DOI: 10.1016/j.bone.2012.11.018] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
SUMMARY Aspects of osteoporosis in men, such as screening and identification strategies, definitions of diagnosis and intervention thresholds, and treatment options (both approved and in the pipeline) are discussed. INTRODUCTION Awareness of osteoporosis in men is improving, although it remains under-diagnosed and under-treated. A European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) workshop was convened to discuss osteoporosis in men and to provide a report by a panel of experts (the authors). METHODS A debate with an expert panel on preselected topics was conducted. RESULTS AND CONCLUSIONS Although additional fracture data are needed to endorse the clinical care of osteoporosis in men, consensus views were reached on diagnostic criteria and intervention thresholds. Empirical data in men display similarities with data acquired in women, despite pathophysiological differences, which may not be clinically relevant. Men should receive treatment at a similar 10-year fracture probability as in women. The design of mixed studies may reduce the lag between comparable treatments for osteoporosis in women becoming available in men.
Collapse
Affiliation(s)
- J-M Kaufman
- Department of Endocrinology and Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, De pintelaan 185, B9000 Gent, Belgium.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Morgans AK, Smith MR, O'Malley AJ, Keating NL. Bone density testing among prostate cancer survivors treated with androgen-deprivation therapy. Cancer 2013; 119:863-70. [PMID: 23065626 PMCID: PMC3671351 DOI: 10.1002/cncr.27830] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 08/17/2012] [Accepted: 08/20/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND Androgen-deprivation therapy (ADT) causes bone loss and fractures. Guidelines recommend bone density testing before and during ADT to characterize fracture risk. The authors of the current report assessed bone density testing among men who received ADT for ≥ 1 year. METHODS Surveillance, Epidemiology, and End Results/Medicare data were used to identify 28,960 men aged > 65 years with local/regional prostate cancer diagnosed from 2001 to 2007 who were followed through 2009 and who received ≥ 1 year of continuous ADT. Bone density testing was documented in the 18-month period beginning 6 months before ADT initiation. Logistic regression was used to identify the factors associated with bone density testing. RESULTS Among men who received ≥ 1 year of ADT, 10.2% had a bone density assessment from 6 months before starting ADT through 1 year after. Bone density testing increased over time (14.5% of men who initiated ADT in 2007-2008 vs 6% of men who initiated ADT in 2001-2002; odds ratio for 2007-2008 vs 2001-2002, 2.29; 95% confidence interval, 1.83-2.85). Less bone density testing was observed among men aged ≥ 85 years versus men ages 66 to 69 years (odds ratio, 0.76; 95% confidence interval, 0.65-0.89), among black men versus white men (odds ratio, 0.72; 95% confidence interval, 0.61-0.86), and among men in areas with lower educational attainment (P < .001). Men who visited a medical oncologist and/or a primary care provider in addition to a urologist had higher odds of testing than men who only consulted a urologist (P < .001). CONCLUSIONS Few men who received ADT for prostate cancer underwent bone density testing, particularly older men, black men, and those living in areas with low educational attainment. Visiting a medical oncologist was associated with increased odds of testing. Interventions are needed to increase bone density testing among men who receive long-term ADT. Data on bone density testing for nonmilitary populations of prostate cancer survivors in the United States who have received long-term androgen-deprivation therapy (ADT) have not been published. The current analysis of Surveillance, Epidemiology, and End Results/Medicare data suggests that few prostate cancer survivors who receive long-term ADT undergo bone density testing; and several key populations, including African Americans and older men, have considerably lower rates of bone density screening.
Collapse
Affiliation(s)
- Alicia K Morgans
- Division of Hematology and Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | | | | |
Collapse
|
48
|
Does the timing of estrogen administration after castration affect its ability to preserve sexual interest in male rats? — Exploring the critical period hypothesis. Physiol Behav 2013; 110-111:63-72. [DOI: 10.1016/j.physbeh.2012.12.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 09/12/2012] [Accepted: 12/20/2012] [Indexed: 01/20/2023]
|
49
|
Herrera A, Lobo-Escolar A, Mateo J, Gil J, Ibarz E, Gracia L. Male osteoporosis: A review. World J Orthop 2012; 3:223-34. [PMID: 23362466 PMCID: PMC3557324 DOI: 10.5312/wjo.v3.i12.223] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 11/19/2012] [Accepted: 12/06/2012] [Indexed: 02/06/2023] Open
Abstract
Osteoporosis in men is a heterogeneous disease that has received little attention. However, one third of worldwide hip fractures occur in the male population. This problem is more prevalent in people over 70 years of age. The etiology can be idiopathic or secondary to hypogonadism, vitamin D deficiency and inadequate calcium intake, hormonal treatments for prostate cancer, use of toxic and every disease or drug use that alters bone metabolism.Risk factors such as a previous history of fragility fracture should be assessed for the diagnosis. However, risk factors in men are very heterogeneous. There are significant differences in the pharmacological treatment of osteoporosis between men and women fundamentally due to the level of evidence in published trials supporting each treatment. New treatments will offer new therapeutic prospects. The goal of this work is a revision of the present status knowledge about male osteoporosis.
Collapse
|
50
|
Phillips JL, Wassersug RJ, McLeod DL. Systemic bias in the medical literature on androgen deprivation therapy and its implication to clinical practice. Int J Clin Pract 2012; 66:1189-96. [PMID: 23163498 DOI: 10.1111/ijcp.12025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND LHRH agonists are used for androgen deprivation therapy (ADT) to treat prostate cancer, but have many side effects that reduce of the quality of life of prostate cancer patients and their partners. Patients are poorly informed about the side effects of these drugs and how to manage them. AIM To test the hypothesis that there is bias in the peer-reviewed literature on ADT that correlates with an association between authors and the luteinising hormone-releasing hormone (LHRH) agonists pharmaceutical industry. METHODS We assessed 155 articles on ADT published in English-language peer-reviewed journals in terms of how comprehensive they were in acknowledging LHRH agonists' side effects. RESULTS Although the literature regarding ADT is substantial, the vast majority of articles failed to acknowledge many of the more stressful side effects of ADT for patients and their partners. Articles most likely to acknowledge the psychosocial impact of ADT were significantly less likely to have had industrial support than those articles that did not mention those side effects. Alternative treatments to the LHRH agonists were rarely mentioned. Authors who indicated some association with a pharmaceutical company tended to minimise the side effects of LHRH agonists and not acknowledge alternatives to the LHRH agonists for ADT. CONCLUSION Industrial support is associated with a proliferation of articles published in the peer-reviewed literature directed at practising physicians. Such flooding of the literature may, in part, limit physicians' knowledge of the side effects of these drugs and, in turn, account for the poor knowledge that patients on LHRH agonists have about the drugs they are taking and ways to manage their side effects.
Collapse
Affiliation(s)
- J L Phillips
- Department of Anatomy and Neurobiology, Dalhousie University, Halifax, NS, Canada
| | | | | |
Collapse
|