Toxicity with Androgen-Deprivation Therapy: The Plot Thickens

Evidence supports the benefits of androgen-deprivation therapy (ADT) for men with prostate cancer; thus, in the metastatic setting, ADT has been the standard of care for more than 6 decades. In addition, ADT improves survival in men with node-positive disease, and, when combined with external-beam radiotherapy, ADT improves survival in men who have locally advanced disease. However, ADT also is frequently used as primary therapy in patients with localized disease — and in patients whose levels of prostate-specific antigen (PSA) rise following surgery or radiotherapy — despite the lack of long-term evidence supporting ADT in these settings. ADT often causes hot flushes and other adverse effects (JW Oncol Hematol Jan 19 2010), and emerging da…