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Estrogenic side effects of androgen deprivation therapy.

Authors
  • Guise, Theresa A
  • Oefelein, Michael G
  • Eastham, James A
  • Cookson, Michael S
  • Higano, Celestia S
  • Smith, Matthew Raymond
Type
Published Article
Journal
Reviews in urology
Publication Date
Jan 01, 2007
Volume
9
Issue
4
Pages
163–180
Identifiers
PMID: 18231613
Source
Medline
Keywords
License
Unknown

Abstract

Androgen deprivation therapy (ADT) is part of standard therapy for locally advanced or metastatic prostate cancer and is frequently used in men with a rising prostate-specific antigen following radical prostatectomy or radiation therapy. In some men, ADT may be administered for years or even decades. The intended therapeutic effect of ADT is testosterone deficiency. Because estrogen is a normal metabolite of testosterone, ADT also results in estrogen deficiency. ADT has a variety of adverse effects, many of which are primarily related to estrogen deficiency. Bone mineral density may decrease by 4% to 13% per year in men receiving ADT. The fracture rate for patients on ADT averages 5% to 8% per year of therapy. Hot flashes, gynecomastia, and breast tenderness are common side effects associated with ADT. In the clinic, minimum baseline testing should include weight measurement, blood pressure reading, and fasting lipid panel and serum glucose tests. Currently, there are no large outcome trials in men on ADT testing the available therapies for adverse effects. No therapies are specifically approved for treatment of adverse effects in men on ADT. Although some therapies can be used for a single indication (based upon small studies), there is currently no agent to treat the multiple estrogenic side effects of ADT.

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