Hormonal Therapy for Prostate Cancer Decreases Insulin Sensitivity

Hormonal Therapy for Prostate Cancer Decreases Insulin Sensitivity

Among men with locally advanced or recurrent prostate cancer, short-term treatment with Lupron Depot® (leuprolide) and Casodex® (bicalutamide) increased body fat and decreased insulin sensitivity. These results were published in the Journal of Clinical Endocrinology and Metabolism.

The prostate is a gland of the male reproductive system. It produces some of the fluid that transports sperm during ejaculation. After skin cancer, prostate cancer is the most common form of cancer diagnosed in men. The outlook for men diagnosed with prostate cancer is good; overall survival rates for all stages of prostate cancer have improved dramatically over the past 20 years.

Current treatment options for prostate cancer include watchful waiting, surgery, chemotherapy, radiation, or androgen deprivation therapy (also referred to as hormonal therapy). Androgen deprivation therapy is designed to block testosterone from stimulating the growth of hormone-dependent types of prostate cancer.

Adverse effects of androgen deprivation therapy include osteoporosis, hot flashes, and loss of libido, and may also include harmful metabolic changes. Metabolic changes such as insulin resistance could increase the risk of subsequent cardiovascular disease.

To explore whether androgen deprivation therapy reduces insulin sensitivity, researchers in the U.S. conducted a study among 25 men with locally advanced or recurrent prostate cancer. Average patient age was 68 years. The study excluded men who already had diabetes.

The patients were treated with Lupron Depot for three months to suppress production of testosterone. For the first four weeks of treatment, patients also received the anti-androgen medication Casodex.

  • After 12 weeks of hormonal therapy, body fat increased by an average of 4.3%.
  • Insulin sensitivity decreased by 12.9%.
  • Fasting plasma insulin levels increased by 25.9%.
  • One patient developed diabetes.

The researchers conclude that short-term treatment with Lupron and Casodex increases fat mass and decreases insulin sensitivity in men with prostate cancer. They note that these changes may increase the risk of diabetes and cardiovascular disease in older men.

Reference: Smith MR, Lee H, Nathan DM. Insulin Sensitivity During Combined Androgen Blockade for Prostate Cancer. Journal of Clinical Endocrinology and Metabolism. 2006.

Related News:Androgen Deprivation Therapy Increases Risk of Insulin Resistance and Hyperglycemia(1/14/06)

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