Prostate news article, April 2006
| INTERMITTANT
ANDROGEN SUPPRESSION CAN IMPROVE QUALITY OF LIFE.
Article published in Eur J Cancer 2006. Reported by: Mr Tom Swallow BSc MBBS MRCS (Ed) |
Androgen suppression is a common treatment for men with locally-advanced and metastatic prostate cancer. It is normally a continuous course with tablets or depot injections being given regularly. Unfortunately the blockade of testosterone is not without side effects. The most significant effects are the loss of libido and erectile dysfunction. Obviously this impacts on the patients’ quality of life.
A recent longitudinal study has been carried out in Australia. This study investigated the dynamic change to quality of life and testosterone dependant physiology in men starting an intermittent maximal androgen blockade program. 250 men were recruited, and if their PSA stayed at below 4 ng/ml for nine months, they were allowed to stop their treatment. Therapy was restarted when the PSA went over 20 ng/ml.
Quality of life was assessed every 3 months for 30 months using two standard modules. As expected the quality of life scores significantly deteriorated with the onset of the androgen suppression. However during the off period an improvement was seen in the quality of life scores, but the recovery was seen to be at a slower rate than seen in the rate of deterioration. Recovery was normally complete between 9 and 12 months. The rate of testosterone recovery was slower and less complete in older men, and paralleled their quality of life scores.
This interesting study has scope to be expanded. Most men would probably welcome a “drug holiday” and a rest from the adverse effects of androgen suppression. Further, larger trials are indicated to ensure that the benefits of an improved quality of life during an “off period” are not to the detriment of the patients’ long term health.
Reference:
Eur J Cancer 2006: Adverse effects to quality
of life arising from treatment can recover with intermittent
androgen suppression in men with prostate cancer.
Spry NA, Kristjanson L, Hooton B, Hayden L, Neerhut G, Gurney
H, Corica T, Korbel E, Weinstein S, McCaul K.