Androgen deprivation therapy in prostate cancer. Indication and systemic consequences

Androgen deprivation therapy (ADT) is effective in prolonging the progression free survival of patients with symptomatic/metastatic prostate cancer (PC). The reduction of clinical symptoms of tumour disease and the reduction of tumour growth and metastatic dissemination is accompanied by systemic consequences of testosterone deficiency. These are hot flushes, fatigue due to reduction of muscular strength and muscle mass as well as anaemia. Moreover, patients develop cognitive impairment und depressive mood. Weight gain with insulin resistance, disturbances of lipid metabolism and gynecomastia are other effects of androgen deficiency. A decrease in bone mineral density may lead to an increased susceptibility to bone fractures. There are several options to reduce these side effects of ADT, e.g. physical activity, dietary supplementation, tailored pharmacological therapy and psychotherapy. The knowledge of these adjuvant treatment options, despite their palliative character, is relevant to optimize the quality of life of these patients.