Management of the side effects of androgen deprivation therapy in men with prostate cancer

Background: Androgen deprivation therapy is the foundation of the medical management of prostate cancer. Androgen deprivation therapy offers improved efficacy when used with local therapy such as external beam radiation therapy and substantial palliation in the metastatic setting. Objective: The adverse events of androgen deprivation therapy include hot flashes, decreased bone mineral density, metabolic changes and gynecomastia. Each of these is described as well as their individual management. Method: The medical literature pertaining to androgen deprivation therapy and its adverse events was reviewed with pertinent publications highlighted. Results: Despite the long history of androgen deprivation therapy use in prostate cancer, ongoing work continues to identify and define the adverse events better. For each complication and particularly with regard to metabolic syndrome, recent efforts continue to characterize the problem and its rational management.