"First, do no harm": Managing the metabolic impacts of androgen deprivation in men with advanced prostate cancer. By Lomax et al. 2015
Key sentence from the paper: “We believe that all patients at commencement of ADT for metastatic prostate cancer should have baseline bone and metabolic investigations.”
For the full abstract, see: http://www.ncbi.nlm.nih.gov/pubmed/25732203
Commentary: This review article comes out of Australia and is yet another paper on managing the side effects of ADT. The authors rationalize their review by pointing out that most of the papers on this topic deal with patients who are largely or wholly non-metastatic whereas they focus on patients with metastatic disease. The recommendations they make for managing ADT side effects, however, are essentially the same ones made in many other papers summarized in this blog and the ADT book. The authors recognize, for example, that even patients with metastatic disease may benefit from exercise, although they feel that more research is necessary in that regard.
One small variant in the paper from the recommendations made in Canada concerns vitamin D. Consistent with a higher insolation and generally warmer climate of Australia versus Canada (where most of the members of the ADT Working Group reside), the daily recommended dose of vitamin D is slightly lower in Australia than in Canada.
Lomax AJ, Parente P, Gilfillan C, Livingston PM, Davis ID, Pezaro C. 2015. "First, do no harm": Managing the metabolic impacts of androgen deprivation in men with advanced prostate cancer. Intern Med J. 2 March 2015 [Epub ahead of print]