Exercise and metabolic disease/prostate/Medical and Clinical Considerations
Androgen deprivation therapy (ADT) has proven to be very effective in treating prostate cancer. This is why so many prostate cancer patients undergo this type of treatment. But ADT has been shown to cause a number of side-effects, all of which need to be taken into consideration when dealing with someone undergoing ADT. Some of the more common side effects are listed below:
- Muscular endurance decreased
- Muscular strength decreased(1)
- Decreased bone mineral density, leading to significantly increased risk of osteoporosis. This then also leads to an increased risk of bone fractures
- Sexual dysfunction(2)
- Increased fat mass(2)(3)(6)
- Decreased skeletal muscle(6)
- Reduced gait speed
- Decreased insulin sensitivity
- Acute coronary syndrome
- Increased risk of falls
- There is also thought that ADT may be associated with a higher incidence of cardiovascular disease and diabetes(6).
As a result of these side-effects quality of life tends to be significantly decreased(1)(2).
The majority of these-side effects are due to decreased testosterone levels(7).
All of these factors need to be considered when determining appropriate exercise programs.
References[edit | edit source]
- Alibhai, AMH, Breunis, H, Timilshina, N, Johnston, C, Tomlinson, G, Tannock, I, Krahn, M, Fleshner, NE, Warde, P, Canning, SD, Klotz, L, and Naglie, G. Impact of androgen-deprivation therapy on physical function and quality of life in men with nonmetastatic prostate cancer. Journal of Clinical Oncology 28(34): 5038-5045, 2010
- Basaria, S, Lieb, J, Tang, AM, DeWeese, T, Carducci, M, Eisenberger, M, and Dobs, AS. Long-term effects of androgen deprivation therapy in prostate cancer patients. Clinical Endocrinology 56(6): 779-786, 2002
- Preston, DM, Torrens, JI, Harding, P, Howard, RS, Duncan, WE, and Mcleod, DG. Androgen deprivation in men with prostate cancer is associated with an increased rate of bone loss. Prostate Cancer and Prostatic Diseases 5: 304-310, 2002
- Shahinian, VB, Kuo, YF, Freeman, JL, and Goodwin, JS. Risk of fracture after androgen deprivation for prostate cancer. The New England Journal of Medicine 352: 154-164, 2005
- Boxer, RS, Kenny, AM, Dowsett, R, and Taxel, P. The effect of 6 months of androgen deprivation therapy on muscle and fat mass in older men with localized prostate cancer. Aging Male 8(3): 207-212, 2005
- Clay, CA, Perera, S, Wagner, JM, Miller, ME, Nelson, JB, and Greenspan, SL. Physical function in men with prostate cancer on androgen deprivation therapy. Physical Therapy 87(10): 1325-1333, 2007
- Saylor, PJ, and Smith MR. Metabolic complications of androgen deprivation therapy for prostate cancer. The Journal of Urology 181(5): 1998-2008, 2009
- Kintzel, PE, Chase, SL, Schultz, LM, and O'Rourke, TJ. Increased risk of metabolic syndrome, diabeties mellitus, and cardiovascular disease in men receiving androgen deprivation therapy for prostate cancer. The Journal of Human Pharmacology and Drug Therapy 28(12): 1511-1522, 2008
- Bylow, K, Dale, W, Mustain, K, Stadler, WM, Rodin, M, Hall, W, Lachs, M, and Mohile, SG. Falls and physical performance deficits in older patients with prostate cancer undergoing androgen deprivation therapy. Urology 72(2): 422-427, 2008
- Anita, S, and Jorge, AC. Complications of androgen deprivation therapy in prostate cancer. Current opinion in urology 19(3): 322-326, 2009
- Schmitz, KH, Courneya, KS, Matthews, C, Demark-Wahnefried, W, Galvao, DA, Pinto, BM, Irwin, ML, Wolin, KY, Segal, RJ, Lucia, A, Schneider, CM, Von Gruenigen, VE, and Schwartz, AL. American college of sports medicine roundtable on exercise guidelines for cancer survivors. Medicine and Science in Sports and Exercise 42(7): 1409-1426, 2010