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Androgen Deprivation Therapy (ADT) in Prostate Cancer

Hormone manipulation through medical or surgical castration as cornerstone of prostate cancer management

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is Androgen Deprivation Therapy (ADT) in Prostate Cancer?

Suppression of testicular androgen production removes hormonal stimulation that drives prostate cancer growth.

GnRH agonists (leuprolide, goserelin, triptorelin) initially cause testosterone surge requiring antiandrogen flare protection followed by suppression.

GnRH antagonists (degarelix, relugolix) provide rapid testosterone suppression without initial surge.

Surgical castration (bilateral orchiectomy) provides immediate and permanent suppression with cost-effectiveness.

Indications include metastatic disease, biochemical recurrence, neoadjuvant or adjuvant settings with radiation therapy and selected high-risk localized disease.

Symptoms

Hot flashes and vasomotor symptoms occur in majority of patients and may significantly impact quality of life.
Sexual dysfunction including erectile dysfunction and decreased libido develops in nearly all patients.
Metabolic effects include weight gain, sarcopenic obesity, insulin resistance and increased cardiovascular risk.
Bone density loss increases fracture risk requiring proactive bone health management.
Cognitive changes, fatigue, mood disturbances, gynecomastia and anemia commonly occur.

Risk Factors

Pre-existing cardiovascular disease increases risk of cardiac events during ADT.
Diabetes mellitus and metabolic syndrome may worsen with ADT-induced metabolic changes.
Osteoporosis or osteopenia increases fracture risk requiring careful baseline assessment.
Cognitive impairment or depression may worsen with ADT-related psychological effects.
Cardiovascular comorbidities require multidisciplinary management with cardiologist.

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • New cardiovascular symptoms including chest pain or dyspnea require urgent cardiology evaluation.
  • Severe hot flashes affecting quality of life may require pharmacologic intervention with non-hormonal agents.
  • Bone pain or fragility fracture requires evaluation for osteoporosis and possible bisphosphonate or denosumab therapy.
  • Significant weight gain, dyslipidemia or new diabetes mellitus require medical management and lifestyle intervention.
  • Severe depression or cognitive changes warrant psychiatric evaluation and possible intervention.

Treatment Methods

01
Comprehensive baseline evaluation including cardiovascular risk assessment, bone density measurement, lipid profile, glucose tolerance and cognitive baseline.
02
Bone protection strategies with calcium, vitamin D, weight-bearing exercise and antiresorptive therapy as indicated.
03
Cardiovascular risk modification through lifestyle measures, blood pressure and lipid management.
04
Lifestyle counseling regarding diet, exercise, smoking cessation and stress management.
05
Multidisciplinary care with urology, oncology, cardiology, endocrinology and primary care along with consideration of intermittent ADT in selected patients, addition of androgen pathway inhibitors (abiraterone, enzalutamide) in advanced disease and management of treatment-related adverse events optimizes outcomes.

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.