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Risks associated with prostate cancer therapy
While medical therapys that decrease testosterone levelscalled androgen deprivation treatment (ADT)are important and effective therapies for men with prostate cancer, they can cause a variety of side effects including skeletal and cardiovascular complications, sexual dysfunction, periodontal disease, and mood disorders.
Bone and heart complications are among the most serious side effects linked to ADT, but the actual risk patients have of developing these effects is unknown. Lockwood Taylor, MPH, of the University of Texas Health Science Center and his colleagues conducted a study to assess this risk by analyzing all of the literature correlation to side effects from ADT published between 1996 and mid-2008. They found 14 studies (8 bone-related, 6 heart-related) that were suitable for analysis.
The researchers' review revealed that men treated with ADT for prostate cancer had an increased risk of bone fractures and heart-related death, eventhough the absolute risk for both was still low. For bone fractures, there was a 23 percent increased risk in comparison to patients with prostate cancer who did not undergo the therapy. The absolute risk of fracture among ADT-exposed men was still only 7.2 per 100 person years. For heart-related death, the increased risk among ADT-exposed men was 17 percent higher in comparison to other patients with prostate cancer. However, because the baseline risk is low, the increase translated to an additional one-to-two deaths per 1,000 men who received ADT. Two large studies also documented significant increases in diabetes risk linked to the treatment.
"While the absolute risks of fracture and cardiovascular mortality are low among men treated with androgen deprivation treatment, preventive therapys may further reduce the risk of these serious adverse outcomes correlation to androgen deprivation treatment," the authors wrote. They also noted that because some patients appears to benefit from this treatment more than others, physicians should consider each patient's overall health and prostate cancer status when weighing therapy options.
Posted by: Jessica Source