Premium
Reversing the effects of androgen‐deprivation therapy in men with metastatic castration‐resistant prostate cancer
Author(s) -
Marshall Catherine H.,
Tunacao Jessa,
Danda Varun,
Tsai HuaLing,
Barber John,
Gawande Rakhee,
Weiss Clifford R.,
Denmeade Samuel R.,
Joshu Corinne
Publication year - 2021
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.15408
Subject(s) - medicine , androgen deprivation therapy , prostate cancer , quality of life (healthcare) , orchiectomy , castration , testosterone (patch) , body mass index , androgen , hormone therapy , urology , confidence interval , cancer , oncology , endocrinology , physiology , hormone , breast cancer , nursing
Objective To investigate whether bipolar androgen therapy (BAT), involving rapid cyclic administration of high‐dose testosterone, as a novel treatment for metastatic castration‐resistant prostate cancer (mCRPC) promotes improvements in body composition and associated improvements in lipid profiles and quality of life. Patients and Methods Men from two completed trials with computed tomography imaging at baseline and after three cycles of BAT were included. Cross‐sectional areas of psoas muscle, visceral and subcutaneous fat were measured at the L3 vertebral level. Functional Assessment of Chronic Illness Therapy – Fatigue questionnaire and 36‐item short‐form health survey were used to assess quality of life. Results The 60 included patients lost a mean ( sd) of 7.8 (8.2)% of subcutaneous fat, 9.8 (18.2)% of visceral fat, and gained 12.2 (6.7)% muscle mass. Changes in subcutaneous and visceral fat were positively correlated with each other (Spearman’s correlation coefficient 0.58, 95% confidence interval 0.35–0.71) independent of the effects of age, body mass index, and duration of androgen‐deprivation therapy. Energy, physical function, and measures of limitations due to physical health were all significantly improved at 3 months. The improvements in body composition were not correlated with decreases in lipid levels or observed improvements in quality of life. Conclusions In the present study, BAT was associated with significant improvements in body composition, lipid parameters, and quality of life. This has promising implications for the long‐term health of men with mCRPC.