Androgen deprivation therapy for prostate cancer: an update on lifestyle guidelines

Men treated with androgen deprivation therapy (ADT) for prostate cancer (PC) are susceptible to multiple treatment-induced adverse effects such as deterioration in bone health and altered body composition (decreased lean tissue mass and increased fat mass). These alterations may partially explain the marked increased risk in osteoporosis, falls, fracture and cardiometabolic risk that has been observed in such patient population.

Owen and co-authors reviewed the standard clinical guidelines for the management of ADT-induced adverse effects on bone health and body composition in men with prostate cancer.

Highlights of the review were as follows:

• Presently, standard clinical guidelines exist for the management of various bone and metabolic ADT-induced adverse effects in PC patients
• Evaluation of the effectiveness of these guidelines into routine practice: Men continued to experience increased central adiposity and unless pharmacotherapy was started, an accelerated bone loss and worsening glycaemia occurred
• This review sheds light on the current guidelines and some of the limitations and puts forward new recommendations based on emerging evidence regarding efficacy of lifestyle interventions, particularly with regard to exercise and nutritional factors, to manage ADT-related adverse effects on bone health and body composition in men with prostate cancer

Reference: Owen PJ, et al. Lifestyle guidelines for managing adverse effects on bone health and body composition in men treated with androgen deprivation therapy for prostate cancer: an update. Prostate Cancer Prostatic Dis. 2017 Jan 24.