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Androgen Deprivation in Elderly Prostate Cancer Patients: Side Effects and Their Prevention

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Management of Urological Cancers in Older People

Part of the book series: Management of Cancer in Older People ((volume 1))

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Abstract

Since the early 1940s, when Huggins and Hodges first demonstrated that prostate cancer was influenced by androgens, androgen deprivation therapy (ADT) became the standard therapy for metastatic prostate cancer. Later, ADT has been shown to improve survival times when given in combination with radiotherapy for locally advanced or high-risk disease and when given after radical prostatectomy for nodal metastasis. Recently, the use of ADT has expanded beyond these justified indications to include patients with biochemical relapse where ADT may be administered for years although there are no clear benefits in terms of survival. With this increasing trend of prescribing ADT in management of prostate cancer, early and long-term complications of ADT became more frequently confronted. In addition to the well-established side effects of ADT such as hot flashes, gynecomastia, decreased libido, and erectile dysfunction, a new continuum of adverse effects has emerged on the surface including decreased bone mass density with its consequences (osteoporosis and increased risk of bone fractures), neuropsychological adverse effects, sarcopenic obesity, and a host of metabolic changes including insulin resistance, hyperglycemia, hyperlipidemia, and metabolic syndrome which are thought to increase risk for diabetes and cardiovascular morbidity and mortality. In this chapter, we will try to provide an overview on common ADT adverse effects and highlight preventive and therapeutic choices for these adverse.

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Authors and Affiliations

  1. Division of Urology, Department of Surgery, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM) and Institut du Cancer de Montréal, Montreal, Canada

    Mohamed Omar Bishr M.D., M.Sc

  2. Division of Urology, Department of Surgery, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, Canada

    Fred Saad M.D., FRCS

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  1. Mohamed Omar Bishr M.D., M.Sc
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  2. Fred Saad M.D., FRCS
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Correspondence to Fred Saad M.D., FRCS .

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Editors and Affiliations

  1. Lyon-RTH Laënnec School of Medicine, Lyon, France

    Jean-Pierre Droz

  2. University of Liverpool, St Helens Teach, Marshalls Cross Road, St Helens, WA9 3DA, United Kingdom

    Riccardo A. Audisio

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Bishr, M.O., Saad, F. (2013). Androgen Deprivation in Elderly Prostate Cancer Patients: Side Effects and Their Prevention. In: Droz, JP., Audisio, R. (eds) Management of Urological Cancers in Older People. Management of Cancer in Older People, vol 1. Springer, London. https://doi.org/10.1007/978-0-85729-999-4_6

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  • DOI: https://doi.org/10.1007/978-0-85729-999-4_6

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