Advanced

Cardiovascular risk with androgen deprivation therapy for prostate cancer: Potential mechanisms.

Tivesten, Åsa; Pinthus, Jehonathan H; Clarke, Noel; Duivenvoorden, Wilhelmina and Nilsson, Jan LU (2015) In Urologic Oncology 33(11). p.464-475
Abstract
Androgen deprivation therapy (ADT) is frequently used for the treatment of advanced prostate cancer. ADT is associated with numerous side effects related to its mode of action, namely the suppression of testosterone to castrate levels. Recently, several large retrospective studies have also reported an increased risk of diabetes and cardiovascular disease in men receiving ADT, although these risks have not been confirmed by prospective randomized trials. We review the literature to consider the risk of cardiovascular disease with different forms of ADT and examine in detail potential mechanisms by which any such risk could be mediated. Mechanisms discussed include the metabolic syndrome resulting from low testosterone level and the... (More)
Androgen deprivation therapy (ADT) is frequently used for the treatment of advanced prostate cancer. ADT is associated with numerous side effects related to its mode of action, namely the suppression of testosterone to castrate levels. Recently, several large retrospective studies have also reported an increased risk of diabetes and cardiovascular disease in men receiving ADT, although these risks have not been confirmed by prospective randomized trials. We review the literature to consider the risk of cardiovascular disease with different forms of ADT and examine in detail potential mechanisms by which any such risk could be mediated. Mechanisms discussed include the metabolic syndrome resulting from low testosterone level and the potential roles of testosterone flare, gonadotropin-releasing hormone receptors outside the pituitary gland, and altered levels of follicle-stimulating hormone. Finally, the clinical implications for men prescribed ADT for the treatment of advanced prostate cancer are considered. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Urologic Oncology
volume
33
issue
11
pages
464 - 475
publisher
Elsevier
external identifiers
  • pmid:26141678
  • wos:000364404400003
  • scopus:84945457222
ISSN
1873-2496
DOI
10.1016/j.urolonc.2015.05.030
language
English
LU publication?
yes
id
85907033-1504-4c28-8c63-fc17cf8d257a (old id 7750767)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/26141678?dopt=Abstract
date added to LUP
2015-08-06 22:18:13
date last changed
2017-05-28 03:00:28
@article{85907033-1504-4c28-8c63-fc17cf8d257a,
  abstract     = {Androgen deprivation therapy (ADT) is frequently used for the treatment of advanced prostate cancer. ADT is associated with numerous side effects related to its mode of action, namely the suppression of testosterone to castrate levels. Recently, several large retrospective studies have also reported an increased risk of diabetes and cardiovascular disease in men receiving ADT, although these risks have not been confirmed by prospective randomized trials. We review the literature to consider the risk of cardiovascular disease with different forms of ADT and examine in detail potential mechanisms by which any such risk could be mediated. Mechanisms discussed include the metabolic syndrome resulting from low testosterone level and the potential roles of testosterone flare, gonadotropin-releasing hormone receptors outside the pituitary gland, and altered levels of follicle-stimulating hormone. Finally, the clinical implications for men prescribed ADT for the treatment of advanced prostate cancer are considered.},
  author       = {Tivesten, Åsa and Pinthus, Jehonathan H and Clarke, Noel and Duivenvoorden, Wilhelmina and Nilsson, Jan},
  issn         = {1873-2496},
  language     = {eng},
  number       = {11},
  pages        = {464--475},
  publisher    = {Elsevier},
  series       = {Urologic Oncology},
  title        = {Cardiovascular risk with androgen deprivation therapy for prostate cancer: Potential mechanisms.},
  url          = {http://dx.doi.org/10.1016/j.urolonc.2015.05.030},
  volume       = {33},
  year         = {2015},
}