Matthew R Smith1. 1. Massachusetts General Hospital Cancer Center, Boston, Massachusetts 02114, USA. smith.matthew@mgh.harvard.edu
Abstract
PURPOSE: A presentation on osteoporosis, obesity and obesity related disease at the Conference on Innovations and Challenges in Prostate Cancer: Prevention, Detection and Treatment is summarized. MATERIALS AND METHODS: A focused literature review was done. RESULTS: Gonadotropin-releasing hormone (GnRH) agonists decrease bone mineral density and increase fracture risk. GnRH agonists also increase weight and fat mass, and decrease lean body mass. Treatment related changes in body composition may contribute to fatigue and fracture risk. The phenotype of men with GnRH agonist shares some features with the insulin resistance syndrome, raising the possibility that GnRH may also increase the risk of diabetes mellitus and cardiovascular disease. CONCLUSIONS: The routine use of GnRH agonists in men with long life expectancy increases the importance of understanding and preventing the unintended adverse effects of treatment. Some adverse effects have the potential to impact not only quality of life, but also noncancer mortality. Additional research is needed to characterize better the unintended effects of androgen deprivation therapy and develop optimal strategies to prevent osteoporosis, obesity and obesity related disease.
PURPOSE: A presentation on osteoporosis, obesity and obesity related disease at the Conference on Innovations and Challenges in Prostate Cancer: Prevention, Detection and Treatment is summarized. MATERIALS AND METHODS: A focused literature review was done. RESULTS:Gonadotropin-releasing hormone (GnRH) agonists decrease bone mineral density and increase fracture risk. GnRH agonists also increase weight and fat mass, and decrease lean body mass. Treatment related changes in body composition may contribute to fatigue and fracture risk. The phenotype of men with GnRH agonist shares some features with the insulin resistance syndrome, raising the possibility that GnRH may also increase the risk of diabetes mellitus and cardiovascular disease. CONCLUSIONS: The routine use of GnRH agonists in men with long life expectancy increases the importance of understanding and preventing the unintended adverse effects of treatment. Some adverse effects have the potential to impact not only quality of life, but also noncancer mortality. Additional research is needed to characterize better the unintended effects of androgen deprivation therapy and develop optimal strategies to prevent osteoporosis, obesity and obesity related disease.
Authors: Lan-Juan Zhao; Hui Jiang; Christopher J Papasian; Dev Maulik; Betty Drees; James Hamilton; Hong-Wen Deng Journal: J Bone Miner Res Date: 2008-01 Impact factor: 6.741
Authors: Hendrik Isbarn; Laurent Boccon-Gibod; Peter R Carroll; Francesco Montorsi; Claude Schulman; Matthew R Smith; Cora N Sternberg; Urs E Studer Journal: Eur Urol Date: 2008-10-14 Impact factor: 20.096