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Prostate cancer hormonal therapy may increase sexual and physical problems

A new study suggests that men with early-stage prostate cancer who are treated with androgen deprivation therapy (ADT) may experience more physical discomfort and be twice as likely to experience sexual impairment compared with men who forgo such therapy.

In the March 20 issue of the Journal of the National Cancer Institute, Arnold L. Potosky, Ph.D., of the National Cancer Institute, and his coworkers estimate that roughly 20,000 men in the United States are treated initially with ADT each year for localized prostate cancer. While ADT was associated with increased complications, the authors note that men treated with ADT were generally more satisfied with their treatment decision than men who received no treatment.

Approximately 160,000 men are diagnosed with localized prostate cancer each year, and more than half of these men are treated with either surgery or radiation. About 40% of patients with early stages of the disease are treated more conservatively, with either ADT or a watch-and-wait approach.

The use of ADT alone, however, has not been proven to increase the life of prostate cancer patients. Earlier studies of ADT in men with advanced prostate cancer, for whom such therapy is considered the standard of care, have suggested that ADT may be associated with fatigue and decreased sexual functioning.

To compare the quality-of-life of treatment-free people with those receiving ADT, Potosky and his coworkers analyzed data from 661 men who were diagnosed with localized prostate cancer but did not undergo surgery or radiotherapy. The authors found that 245, or 37%, of these patients received ADT. These men tended to have a higher risk of having their cancers progress than untreated men.

After one year, 80% of the treated men reported having become impotent, compared with 30% of the untreated men. Men who received ADT were also five times more likely to report breast swelling and hot flashes. Moreover, men treated
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Contact: Linda Wang
jncinews@oup-usa.org
301-841-1287
Journal of the National Cancer Institute
19-Mar-2002


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