Androgen Deprivation Therapy for Prostate Cancer

Recently, a patient asked what I know about Androgen Deprivation Therapy (ADT) for prostate cancer as she is concerned about her aging father. As an evidence informed doctor, I told her I that I would consult available research and would let her know what I discovered...additionally, I have decided to share findings with everyone...here you go...

The prevalence of prostate cancer in American men is about 14 %; almost 3,000,000 US men are living with prostate cancer. According to the CDC, prostate cancer is the most commonly diagnosed cancer among men. The incidence of prostate cancer increases with age. While the incidence of prostate cancer is high in the US and other western nations, it is very low in China, Japan, India and African nations. While it would take a large and ongoing clinical trial to confirm, there is a correlation that cultures that squat to have a bowel movement, as opposed to sit, are at a much lower risk of suffering prostate cancer. If this is a preventative measure you are interested in pursuing with our modern toilets and plumbing there is a product available called the Squatty Potty (if nothing else, the linked video is pretty comical). 

Treatment for prostate cancer includes regular monitoring, radiation, cryotherapy, hormone therapy (ADT), chemotherapy, surgery and/or other treatments. ADT is a hormone therapy that reduces or eliminates testosterone. It is thought that prostate cancer growth is inhibited by removing testosterone. ADT is commonly prescribed for patients that are unable to receive radiation or as a co-treatment along with radiation for prostate cancer.  It may be an intermittent treatment or ongoing; risks associated with this treatment are increased with ongoing use without statistically significant effects compared to intermittent treatment. So what are the risks of ADT?

Reported side effects of ADT include:

- reduced bone density leading to osteoporosis
- reduced muscle mass
- increased BMI (overweight and obesity)
- increased free fat in blood (increased cholesterol)
- anemia and fatigue
- increased risk for diabetes
- increased risk for cardiovascular disease
- increased risk of death from cardiovascular disease if a person has had a previous cardiac event or prostate surgery
- decreased sex drive (libido)
- increased breast size (men)
- depression
- cognitive impairment 
- Alzheimer's disease 

There are some important concerns here to elucidate. First, prostate cancer risk increases with age...cognitive decline and Alzheimer's disease rates are relatively high in senior populations even without ADT. Cognitive decline and Alzheimer's have significant impact on an individuals' quality of life; the effects of Alzheimer's include: problems with memory, thinking, judgement and dementia. So, when we mention risk, really how significant is the risk of cognitive impairment or Alzheimer's as a result of ADT?

- Research (2015) showed that men taking ADT for a 6 month period were 70% more likely than control groups to experience cognitive decline and over 12 months, men more than 2 times more likely to experience cognitive decline.
- Another 2015 study reported results showing men taking ADT were 88% more likely to develop Alzheimer's within 2 years compared to the control group.

While it is not within the scope of practice for your chiropractor to make recommendations regarding pharmaceutical care, it is appropriate that research and information be shared so that patients can make informed decisions. 

If you would like objective information regarding research about chiropractic care or anything else health related, feel free to make an appointment and have a discussion with your doctor at Gallatin Valley Chiropractic.  

406-551-2177