Androgen Deprivation Linked to Diabetes in Prostate Cancer
Related study shows that prostate specific antigen dynamics are not predictive of outcomes
WEDNESDAY, June 10 (HealthDay News) -- Researchers have found that androgen deprivation therapy (ADT) is associated with a higher risk of diabetes and fragility fractures in men with prostate cancer, according to a study published online June 8 in the Journal of Clinical Oncology. In a related study in the same issue, pretreatment prostate specific antigen (PSA) dynamics do not add predictive value for prostate cancer outcomes.
In the first study, Shabbir M.H. Alibhai, M.D., from the University Health Network in Toronto, and colleagues examined whether ADT was associated with adverse outcomes in 19,079 men with prostate cancer and the same number of matched men who did not receive ADT. After a mean follow-up of 6.47 years, they found that ADT was associated with a higher risk of diabetes mellitus (hazard ratio, 1.16) and fragility fracture (hazard ratio, 1.65), but not acute myocardial infarction or sudden cardiac death.
In the second study, Matthew Frank O'Brien and colleagues from Memorial Sloan-Kettering Cancer Center in New York City investigated whether pretreatment PSA dynamics were associated with outcomes among 2,938 men undergoing prostate cancer treatment. They found that neither pretreatment PSA velocity or doubling time had much predictive accuracy for recurrence or metastasis over PSA alone, stage, and grade.
"The most novel finding is the increase in well-characterized incident diabetes in those men undergoing ADT," William Dale, M.D., from the University of Chicago, writes in an accompanying editorial. "This convincingly supports the conclusion that ADT contributes to the development of diabetes mellitus and that providers should test for underlying hyperglycemia in men being considered for ADT or in men currently receiving ADT who have not been diagnosed with diabetes mellitus."