Saylor and Smith of the Massachusetts General Hospital Cancer Center in Boston, Massachusetts have an article that is coming out in the Journal of Urology in January 2013 which discusses adverse effects of androgen deprivation therapy (ADT). Their review focuses on the more recently described metabolic complications of ADT including obesity, insulin resistance and lipid alterations as well as the association of androgen deprivation therapy with diabetes and cardiovascular disease.They found that ADT causes a decrease in lean mass (muscle) and an increase in the mass of fat. This was associated with a decrease in insulin sensitivity and increase in LDL, HDL and triglycerides. This is associated with an increase in the incidence of diabetes and cardiovascular disease.
The benefit versus the risk of ADT must be considered when considering treatment, and it is recommended to screen for risk factors associated with diabetes and cardiovascular disease and treat as indicated, thus mitigating the adverse effects that can be associated with ADT.
