Androgen deprivation therapy for prostate cancer

Nima Sharifi, James L. Gulley, William L. Dahut

Research output: Contribution to journalArticle

650 Citations (Scopus)

Abstract

Context: Prostate cancer is the most common nonskin cancer and second most common cause of cancer mortality in US men. Androgen deprivation therapy (ADT), specifically surgical or medical castration, is the first line of treatment against advanced prostate cancer and is also used as an adjuvant to local treatment of high-risk disease. Objective: To review systematically the evidence on the risks and benefits of ADT for prostate cancer as well as clinical management of its adverse effects. Evidence Acquisition: We performed MEDLINE searches of English-language literature (1966 to March 2005) using the terms androgen deprivation therapy, hormone treatment, and prostate cancer. We reviewed bibliographies of literature to extract other relevant articles. Studies were selected based on clinical pertinence, with an emphasis on controlled study design. Evidence Synthesis: Androgen deprivation therapy is effective for palliation in many patients with advanced prostate cancer and improves outcomes for high-risk patients treated with radiation therapy for localized disease. Although patients with increasing prostate-specific antigen levels after local treatment without metastatic disease frequently undergo ADT, the benefits of this strategy are not clear. Adverse effects of ADT include decreased libido, impotence, hot flashes, osteopenia with increased fracture risk, metabolic alterations, and changes in cognition and mood. Conclusions: Androgen deprivation therapy has clear roles in the management of advanced prostate cancer and high-risk localized disease. The benefits of ADT in other settings need to be weighed carefully against substantial risks and adverse effects on quality of life.

Original languageEnglish (US)
Pages (from-to)238-244
Number of pages7
JournalJournal of the American Medical Association
Volume294
Issue number2
DOIs
StatePublished - Jul 13 2005

Fingerprint

Androgens
Prostatic Neoplasms
Therapeutics
Hot Flashes
Libido
Second Primary Neoplasms
Metabolic Bone Diseases
Castration
Bibliography
Erectile Dysfunction
Prostate-Specific Antigen
MEDLINE
Cognition
Language
Radiotherapy
Quality of Life
Hormones
Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Androgen deprivation therapy for prostate cancer. / Sharifi, Nima; Gulley, James L.; Dahut, William L.

In: Journal of the American Medical Association, Vol. 294, No. 2, 13.07.2005, p. 238-244.

Research output: Contribution to journalArticle

Sharifi, Nima ; Gulley, James L. ; Dahut, William L. / Androgen deprivation therapy for prostate cancer. In: Journal of the American Medical Association. 2005 ; Vol. 294, No. 2. pp. 238-244.
@article{a0df2de7517f4c7dab24440ea6561e3c,
title = "Androgen deprivation therapy for prostate cancer",
abstract = "Context: Prostate cancer is the most common nonskin cancer and second most common cause of cancer mortality in US men. Androgen deprivation therapy (ADT), specifically surgical or medical castration, is the first line of treatment against advanced prostate cancer and is also used as an adjuvant to local treatment of high-risk disease. Objective: To review systematically the evidence on the risks and benefits of ADT for prostate cancer as well as clinical management of its adverse effects. Evidence Acquisition: We performed MEDLINE searches of English-language literature (1966 to March 2005) using the terms androgen deprivation therapy, hormone treatment, and prostate cancer. We reviewed bibliographies of literature to extract other relevant articles. Studies were selected based on clinical pertinence, with an emphasis on controlled study design. Evidence Synthesis: Androgen deprivation therapy is effective for palliation in many patients with advanced prostate cancer and improves outcomes for high-risk patients treated with radiation therapy for localized disease. Although patients with increasing prostate-specific antigen levels after local treatment without metastatic disease frequently undergo ADT, the benefits of this strategy are not clear. Adverse effects of ADT include decreased libido, impotence, hot flashes, osteopenia with increased fracture risk, metabolic alterations, and changes in cognition and mood. Conclusions: Androgen deprivation therapy has clear roles in the management of advanced prostate cancer and high-risk localized disease. The benefits of ADT in other settings need to be weighed carefully against substantial risks and adverse effects on quality of life.",
author = "Nima Sharifi and Gulley, {James L.} and Dahut, {William L.}",
year = "2005",
month = "7",
day = "13",
doi = "10.1001/jama.294.2.238",
language = "English (US)",
volume = "294",
pages = "238--244",
journal = "JAMA - Journal of the American Medical Association",
issn = "0098-7484",
publisher = "American Medical Association",
number = "2",

}

TY - JOUR

T1 - Androgen deprivation therapy for prostate cancer

AU - Sharifi, Nima

AU - Gulley, James L.

AU - Dahut, William L.

PY - 2005/7/13

Y1 - 2005/7/13

N2 - Context: Prostate cancer is the most common nonskin cancer and second most common cause of cancer mortality in US men. Androgen deprivation therapy (ADT), specifically surgical or medical castration, is the first line of treatment against advanced prostate cancer and is also used as an adjuvant to local treatment of high-risk disease. Objective: To review systematically the evidence on the risks and benefits of ADT for prostate cancer as well as clinical management of its adverse effects. Evidence Acquisition: We performed MEDLINE searches of English-language literature (1966 to March 2005) using the terms androgen deprivation therapy, hormone treatment, and prostate cancer. We reviewed bibliographies of literature to extract other relevant articles. Studies were selected based on clinical pertinence, with an emphasis on controlled study design. Evidence Synthesis: Androgen deprivation therapy is effective for palliation in many patients with advanced prostate cancer and improves outcomes for high-risk patients treated with radiation therapy for localized disease. Although patients with increasing prostate-specific antigen levels after local treatment without metastatic disease frequently undergo ADT, the benefits of this strategy are not clear. Adverse effects of ADT include decreased libido, impotence, hot flashes, osteopenia with increased fracture risk, metabolic alterations, and changes in cognition and mood. Conclusions: Androgen deprivation therapy has clear roles in the management of advanced prostate cancer and high-risk localized disease. The benefits of ADT in other settings need to be weighed carefully against substantial risks and adverse effects on quality of life.

AB - Context: Prostate cancer is the most common nonskin cancer and second most common cause of cancer mortality in US men. Androgen deprivation therapy (ADT), specifically surgical or medical castration, is the first line of treatment against advanced prostate cancer and is also used as an adjuvant to local treatment of high-risk disease. Objective: To review systematically the evidence on the risks and benefits of ADT for prostate cancer as well as clinical management of its adverse effects. Evidence Acquisition: We performed MEDLINE searches of English-language literature (1966 to March 2005) using the terms androgen deprivation therapy, hormone treatment, and prostate cancer. We reviewed bibliographies of literature to extract other relevant articles. Studies were selected based on clinical pertinence, with an emphasis on controlled study design. Evidence Synthesis: Androgen deprivation therapy is effective for palliation in many patients with advanced prostate cancer and improves outcomes for high-risk patients treated with radiation therapy for localized disease. Although patients with increasing prostate-specific antigen levels after local treatment without metastatic disease frequently undergo ADT, the benefits of this strategy are not clear. Adverse effects of ADT include decreased libido, impotence, hot flashes, osteopenia with increased fracture risk, metabolic alterations, and changes in cognition and mood. Conclusions: Androgen deprivation therapy has clear roles in the management of advanced prostate cancer and high-risk localized disease. The benefits of ADT in other settings need to be weighed carefully against substantial risks and adverse effects on quality of life.

UR - http://www.scopus.com/inward/record.url?scp=22144484150&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=22144484150&partnerID=8YFLogxK

U2 - 10.1001/jama.294.2.238

DO - 10.1001/jama.294.2.238

M3 - Article

C2 - 16014598

AN - SCOPUS:22144484150

VL - 294

SP - 238

EP - 244

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0098-7484

IS - 2

ER -