This fact sheet is for people who are thinking about having hormone therapy, or are already receiving hormone therapy to treat their prostate cancer.

Last updated: November 2019
To be reviewed: May 2022

References  

  1. Schmitt B, Bennett C, Seidenfeld J, Samson D, Wilt T. Maximal androgen blockade for advanced prostate cancer. Cochrane Database Syst Rev. 1999;2.
  2. Isbarn H, Pinthus JH, Marks LS, Montorsi F, Morales A, Morgentaler A, et al. Testosterone and Prostate Cancer: Revisiting Old Paradigms. Eur Urol. 2009 Jul;56(1):48–56.
  3. National Institute for Health and Care Excellence. Prostate cancer: diagnosis and management. NICE guideline 131. 2019.
  4. Mottet N, Van den Bergh RCN, Briers E, Cornford P, De Santis M, Fanti S, et al. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer. European Association of Urology; 2019.
  5. Schmidt-Hansen M, Hoskin P, Kirkbride P, Hasler E, Bromham N. Hormone and Radiotherapy versus Hormone or Radiotherapy Alone for Non-metastatic Prostate Cancer: A Systematic Review with Meta-analyses. Clin Oncol. 2014 Oct;26(10):e21–46.
  6. Crouzet S, Chapelon JY, Rouvière O, Mege-Lechevallier F, Colombel M, Tonoli-Catez H, et al. Whole-gland Ablation of Localized Prostate Cancer with High-intensity Focused Ultrasound: Oncologic Outcomes and Morbidity in 1002 Patients. Eur Urol. 2014 May;65(5):907–14.
  7. Bekelman JE, Mitra N, Handorf EA, Uzzo RG, Hahn SA, Polsky D, et al. Effectiveness of androgen-deprivation therapy and radiotherapy for older men with locally advanced prostate cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2015 Mar 1;33(7):716–22.
  8. Mason MD, Parulekar WR, Sydes MR, Brundage M, Kirkbride P, Gospodarowicz M, et al. Final Report of the Intergroup Randomized Study of Combined Androgen-Deprivation Therapy Plus Radiotherapy Versus Androgen-Deprivation Therapy Alone in Locally Advanced Prostate Cancer. J Clin Oncol [Internet]. 2015 Feb 17 [cited 2015 May 8]; Available from: http://jco.ascopubs.org/cgi/doi/10.1200/JCO.2014.57.7510
  9. Warde P, Mason M, Ding K, Kirkbride P, Brundage M, Cowan R, et al. Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer: a randomised, phase 3 trial. The Lancet. 2011 Dec;378(9809):2104–11.
  10. Artibani W, Porcaro AB, De Marco V, Cerruto MA, Siracusano S. Management of Biochemical Recurrence after Primary Curative Treatment for Prostate Cancer: A Review. Urol Int. 2018;100(3):251–62.
  11. Schröder F, Crawford ED, Axcrona K, Payne H, Keane TE. Androgen deprivation therapy: past, present and future. BJU Int. 2012 Jun;109 Suppl 6:1–12.
  12. National Institute for Health and Care Excellence. Degarelix for treating advanced hormone-dependent prostate cancer. Technology appraisal guidance 404 [Internet]. 2016. Available from: https://www.nice.org.uk/guidance/TA404/chapter/1-Recommendations
  13. Fang C, Wu C-L, Liu S-S, Ge L, Bai J-L. Efficacy, safety, and dose comparison of degarelix for the treatment of prostate cancer: A systematic review and meta-analysis. World J Meta-Anal. 2016 Jun 26;4(3):69–76.
  14. Klotz L, Boccon-Gibod L, Shore ND, Andreou C, Persson B-E, Cantor P, et al. The efficacy and safety of degarelix: a 12-month, comparative, randomized, open-label, parallel-group phase III study in patients with prostate cancer. BJU Int. 2008 Dec;102(11):1531–8.
  15. Shore ND, Abrahamsson P-A, Anderson J, Crawford ED, Lange P. New considerations for ADT in advanced prostate cancer and the emerging role of GnRH antagonists. Prostate Cancer Prostatic Dis. 2013;16(1):7–15.
  16. Nguyen PL, Alibhai SMH, Basaria S, D’Amico AV, Kantoff PW, Keating NL, et al. Adverse Effects of Androgen Deprivation Therapy and Strategies to Mitigate Them. Eur Urol. 2015 May;67(5):825–36.
  17. Kunath F, Grobe HR, Rücker G, Motschall E, Antes G, Dahm P, et al. Non-steroidal antiandrogen monotherapy compared with luteinising hormone-releasing hormone agonists or surgical castration monotherapy for advanced prostate cancer (review). Cochrane Database Syst Rev. 2014;(6).
  18. Gruca D, Bacher P, Tunn U. Safety and tolerability of intermittent androgen deprivation therapy: A literature review: IAD therapy in prostate cancer. Int J Urol. 2012 Jul;19(7):614–25.
  19. Mottet N, Prayer-Galetti T, Hammerer P, Kattan MW, Tunn U. Optimizing outcomes and quality of life in the hormonal treatment of prostate cancer. BJU Int. 2006 Jul;98(1):20–7.
  20. Eziefula CU, Grunfeld EA, Hunter MS. ‘You know I’ve joined your club… I’m the hot flush boy’: a qualitative exploration of hot flushes and night sweats in men undergoing androgen deprivation therapy for prostate cancer. Psychooncology. 2013 Dec;22(12):2823–30.
  21. Tombal B. A Holistic Approach to Androgen Deprivation Therapy: Treating the Cancer without Hurting the Patient. Urol Int. 2009;83(4):373–8.
  22. Higano CS. Side effects of androgen deprivation therapy: monitoring and minimizing toxicity. Urology. 2003;61(2):32–38.
  23. Kumar RJ. Adverse events associated with hormonal therapy for prostate cancer. Rev Urol. 2005;7(Suppl 5):S37.
  24. Sountoulides P, Rountos T. Adverse Effects of Androgen Deprivation Therapy for Prostate Cancer: Prevention and Management. ISRN Urol [Internet]. 2013 Jul 25 [cited 2015 Nov 3];2013. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747499/
  25. Langston B, Armes J, Levy A, Tidey E, Ream E. The prevalence and severity of fatigue in men with prostate cancer: a systematic review of the literature. Support Care Cancer Off J Multinatl Assoc Support Care Cancer. 2013 Jun;21(6):1761–71.
  26. Gardner JR, Livingston PM, Fraser SF. Effects of Exercise on Treatment-Related Adverse Effects for Patients With Prostate Cancer Receiving Androgen-Deprivation Therapy: A Systematic Review. J Clin Oncol. 2014 Feb 1;32(4):335–46.
  27. White ID, Wilson J, Aslet P, Baxter AB, Birtle A, Challacombe B, et al. Development of UK guidance on the management of erectile dysfunction resulting from radical radiotherapy and androgen deprivation therapy for prostate cancer. Int J Clin Pract. 2015 Jan;69(1):106–23.
  28. Haliloglu A, Baltaci S, Yaman O. Penile length changes in men treated with androgen suppression plus radiation therapy for local or locally advanced prostate cancer. J Urol. 2007 Jan;177(1):128–30.
  29. Park KK, Lee SH, Chung BH. The Effects of Long‐Term Androgen Deprivation Therapy on Penile Length in Patients with Prostate Cancer: A Single‐Center, Prospective, Open‐Label, Observational Study. J Sex Med. 2011 Nov;8(11):3214–9.
  30. Hwang TI-S, Lin Y-C, Lee MC-C, Juang G-D, Yeh C-H, Cheng Y-H, et al. The Effects of Medical Castration on Testes in Patients With Advanced Prostate Cancer. Urol Sci. 2010 Dec;21(4):169–74.
  31. Sharifi N, Gulley JL, Dahut WL. An Update on Androgen Deprivation Therapy for Prostate Cancer. Endocr Relat Cancer. 2010 Dec;17(4):R305–15.
  32. Owen PJ, Daly RM, Livingston PM, Fraser SF. Lifestyle guidelines for managing adverse effects on bone health and body composition in men treated with androgen deprivation therapy for prostate cancer: an update. Prostate Cancer Prostatic Dis. 2017 Jun;20(2):137–45.
  33. Haseen F, Murray LJ, Cardwell CR, O’Sullivan JM, Cantwell MM. The effect of androgen deprivation therapy on body composition in men with prostate cancer: Systematic review and meta-analysis. J Cancer Surviv. 2010 Jun 1;4(2):128–39.
  34. Keogh JWL, MacLeod RD. Body Composition, Physical Fitness, Functional Performance, Quality of Life, and Fatigue Benefits of Exercise for Prostate Cancer Patients: A Systematic Review. J Pain Symptom Manage. 2012 Jan;43(1):96–110.
  35. Treanor CJ, Li J, Donnelly M. Cognitive impairment among prostate cancer patients: An overview of reviews. Eur J Cancer Care (Engl). 2017 Nov 1;26(6):e12642.
  36. Wu LM, Tanenbaum ML, Dijkers MPJM, Amidi A, Hall SJ, Penedo FJ, et al. Cognitive and neurobehavioral symptoms in patients with non-metastatic prostate cancer treated with androgen deprivation therapy or observation: A mixed methods study. Soc Sci Med. 2016 May 1;156:80–9.
  37. Gunlusoy B, Ceylan Y, Koskderelioglu A, Gedizlioglu M, Degirmenci T, Ortan P, et al. Cognitive Effects of Androgen Deprivation Therapy in Men With Advanced Prostate Cancer. Urology. 2017 May 1;103:167–72.
  38. Nead KT, Sinha S, Nguyen PL. Androgen deprivation therapy for prostate cancer and dementia risk: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis. 2017 Sep;20(3):259–64.
  39. Sun M, Cole AP, Hanna N, Mucci LA, Berry DL, Basaria S, et al. Cognitive Impairment in Men with Prostate Cancer Treated with Androgen Deprivation Therapy: A Systematic Review and Meta-Analysis. J Urol. 2018 Jun 1;199(6):1417–25.
  40. Marzouk S, Naglie G, Tomlinson G, Duff Canning S, Breunis H, Timilshina N, et al. Impact of Androgen Deprivation Therapy on Self-Reported Cognitive Function in Men with Prostate Cancer. J Urol [Internet]. 2018 Mar 1 [cited 2018 Aug 10]; Available from: http://www.sciencedirect.com/science/article/pii/S0022534718393790
  41. Murad MH, Johnson, Kermott. Gynecomastia - evaluation and current treatment options. Ther Clin Risk Manag. 2011 Mar;145.
  42. Fagerlund A, Cormio L, Palangi L, Lewin R, Santanelli di Pompeo F, Elander A, et al. Gynecomastia in Patients with Prostate Cancer: A Systematic Review. PLoS ONE [Internet]. 2015 Aug 26 [cited 2018 Sep 12];10(8). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4550398/
  43. Casey RG, Corcoran NM, Larry Goldenberg S. Quality of life issues in men undergoing androgen deprivation therapy: a review. Asian J Androl. 2012 Mar;14(2):226–31.
  44. Serpa Neto A, Tobias-Machado M, Esteves MAP, Senra MD, Wroclawski ML, Fonseca FLA, et al. Bisphosphonate therapy in patients under androgen deprivation therapy for prostate cancer: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis. 2012;15(1):36–44.
  45. Alibhai SMH, Gogov S, Allibhai Z. Long-term side effects of androgen deprivation therapy in men with non-metastatic prostate cancer: A systematic literature review. Crit Rev Oncol Hematol. 2006 Dec;60(3):201–15.
  46. National Institute for Health and Clinical Excellence. Osteoporosis: assessing the risk of fragility fracture. Short clinical guideline. Clinical guideline 146 [Internet]. 2012 [cited 2015 Nov 16]. Available from: https://www.nice.org.uk/guidance/cg146/evidence/osteoporosis-fragility-fracture-full-guideline-186818365
  47. Ahmadi H, Daneshmand S. Androgen deprivation therapy: evidence-based management of side effects. BJU Int. 2013 Apr;111(4):543–8.
  48. Todenhöfer T, Stenzl A, Hofbauer LC, Rachner TD. Targeting Bone Metabolism in Patients with Advanced Prostate Cancer: Current Options and Controversies. Int J Endocrinol. 2015;2015:1–9.
  49. Cormie P, Galvão DA, Spry N, Joseph D, Chee R, Taaffe DR, et al. Can supervised exercise prevent treatment toxicity in patients with prostate cancer initiating androgen-deprivation therapy: a randomised controlled trial. BJU Int. 2015;115(2):256–66.
  50. Thorsen L, Courneya KS, Stevinson C, Fosså SD. A systematic review of physical activity in prostate cancer survivors: outcomes, prevalence, and determinants. Support Care Cancer. 2008 Feb 15;16(9):987–97.
  51. Keilani M, Hasenoehrl T, Baumann L, Ristl R, Schwarz M, Marhold M, et al. Effects of resistance exercise in prostate cancer patients: a meta-analysis. Support Care Cancer. 2017 Jun 10;
  52. Mohile SG, Mustian K, Bylow K, Hall W, Dale W. Management of complications of androgen deprivation therapy in the older man. Crit Rev Oncol Hematol. 2009 Jun;70(3):235–55.
  53. Baumann FT, Zopf EM, Bloch W. Clinical exercise interventions in prostate cancer patients: a systematic review of randomized controlled trials. Support Care Cancer. 2012;20(2):221–33.
  54. Azoulay L, Yin H, Benayoun S, Renoux C, Boivin J-F, Suissa S. Androgen-Deprivation Therapy and the Risk of Stroke in Patients With Prostate Cancer. Eur Urol. 2011 Dec;60(6):1244–50.
  55. Crawley D, Garmo H, Rudman S, Stattin P, Häggström C, Zethelius B, et al. Association between duration and type of androgen deprivation therapy and risk of diabetes in men with prostate cancer. Int J Cancer. 2016;139(12):2698–704.
  56. Jhan J-H, Yeh H-C, Chang Y-H, Guu S-J, Wu W-J, Chou Y-H, et al. New-onset diabetes after androgen-deprivation therapy for prostate cancer: A nationwide propensity score-matched four-year longitudinal cohort study. J Diabetes Complications. 2018 Jul;32(7):688–92.
  57. Nead KT, Boldbaatar N, Yang DD, Sinha S, Nguyen PL. Association of Androgen Deprivation Therapy and Thromboembolic Events: a Systematic Review and Meta-Analysis. Urology [Internet]. 2018 Jan [cited 2018 Jan 29]; Available from: http://linkinghub.elsevier.com/retrieve/pii/S0090429518300165
  58. Guo Z, Huang Y, Gong L, Gan S, Chan FL, Gu C, et al. Association of androgen deprivation therapy with thromboembolic events in patients with prostate cancer: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis. 2018 Jul 9;1.
  59. Hicks BM, Klil-Drori AJ, Yin H, Campeau L, Azoulay L. Androgen Deprivation Therapy and the Risk of Anemia in Men with Prostate Cancer: Epidemiology. 2017 Sep;28(5):712–8.
  60. Elliott S, Latini DM, Walker LM, Wassersug R, Robinson JW. Androgen Deprivation Therapy for Prostate Cancer: Recommendations to Improve Patient and Partner Quality of Life: Improving Life on ADT. J Sex Med. 2010 Sep;7(9):2996–3010.
  61. Sharpley CF, Christie DRH, Bitsika V. Do hormone treatments for prostate cancer cause anxiety and depression? Int J Clin Oncol. 2014;19(3):523–30.
  62. Nead KT, Sinha S, Yang DD, Nguyen PL. Association of androgen deprivation therapy and depression in the treatment of prostate cancer: A systematic review and meta-analysis. Urol Oncol Semin Orig Investig. 2017 Nov 1;35(11):664.e1-664.e9.
  63. Gagliano-Jucá T, Travison TG, Nguyen PL, Kantoff PW, Taplin M-E, Kibel AS, et al. Effects of Androgen Deprivation Therapy on Pain Perception, Quality of Life, and Depression in Men With Prostate Cancer. J Pain Symptom Manage. 2018 Feb 1;55(2):307-317.e1.
  64. Shahinian VB, Kuo Y-F, Freeman JL, Goodwin JS. Risk of the “androgen deprivation syndrome” in men receiving androgen deprivation for prostate cancer. Arch Intern Med. 2006;166(4):465–471.
  65. Sciarra A, Fasulo A, Ciardi A, Petrangeli E, Gentilucci A, Maggi M, et al. A meta-analysis and systematic review of randomized controlled trials with degarelix versus gonadotropin-releasing hormone agonists for advanced prostate cancer: Medicine (Baltimore). 2016 Jul;95(27):e3845.
  66. Electronic Medicines Compendium. Firmagon 80mg Injection - Summary of Product Characteristics [Internet]. 2013 [cited 2015 Oct 27]. Available from: https://www.medicines.org.uk/emc/medicine/21686/SPC/Firmagon+80mg+Injection/
  67. Abrahamsson P-A. Intermittent androgen deprivation therapy in patients with prostate cancer: Connecting the dots. Asian J Urol. 2017 Oct;4(4):208–22.
  68. Dong Z, Wang H, Xu M, Li Y, Hou M, Wei Y, et al. Intermittent hormone therapy versus continuous hormone therapy for locally advanced prostate cancer: a meta-analysis. Aging Male. 2015 Dec;18(4):233–7.
  69. Magnan S, Zarychanski R, Pilote L, Bernier L, Shemilt M, Vigneault E, et al. Intermittent vs Continuous Androgen Deprivation Therapy for Prostate Cancer: A Systematic Review and Meta-analysis. JAMA Oncol. 2015 Sep 17;1–10.
  70. Botrel TEA, Clark O, dos Reis RB, Pompeo ACL, Ferreira U, Sadi MV, et al. Intermittent versus continuous androgen deprivation for locally advanced, recurrent or metastatic prostate cancer: a systematic review and meta-analysis. BMC Urol. 2014;14:9.
  71. Husson O, Mols F, Poll-Franse LV van de. The relation between information provision and health-related quality of life, anxiety and depression among cancer survivors: a systematic review. Ann Oncol. 2010 Sep 24;mdq413.
  72. World Cancer Research Fund International. Continuous Update Project report: Diet, Nutrition, Physical Activity and Prostate Cancer [Internet]. 2014. Available from: www.wcrf.org/sites/default/files/Prostate-Cancer-2014-Report.pdf
  73. Lin P-H, Aronson W, Freedland SJ. Nutrition, dietary interventions and prostate cancer: the latest evidence. BMC Med [Internet]. 2015 Dec [cited 2017 Oct 30];13(1). Available from: http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0234-y
  74. Mohamad H, McNeill G, Haseen F, N’Dow J, Craig LCA, Heys SD. The Effect of Dietary and Exercise Interventions on Body Weight in Prostate Cancer Patients: A Systematic Review. Nutr Cancer. 2015 Jan 2;67(1):43–60.
  75. Allott EH, Masko EM, Freedland SJ. Obesity and Prostate Cancer: Weighing the Evidence. Eur Urol. 2013 May;63(5):800–9.
  76. Discacciati A, Orsini N, Wolk A. Body mass index and incidence of localized and advanced prostate cancer--a dose-response meta-analysis of prospective studies. Ann Oncol. 2012 Jan 6;23(7):1665–71.
  77. Cao Y, Ma J. Body Mass Index, Prostate Cancer-Specific Mortality, and Biochemical Recurrence: a Systematic Review and Meta-analysis. Cancer Prev Res (Phila Pa). 2011 Jan 13;4(4):486–501.
  78. Gerdtsson A, Poon JB, Thorek DL, Mucci LA, Evans MJ, Scardino P, et al. Anthropometric Measures at Multiple Times Throughout Life and Prostate Cancer Diagnosis, Metastasis, and Death. Eur Urol. 2015 Dec;68(6):1076–82.
  79. Ho T, Gerber L, Aronson WJ, Terris MK, Presti JC, Kane CJ, et al. Obesity, Prostate-Specific Antigen Nadir, and Biochemical Recurrence After Radical Prostatectomy: Biology or Technique? Results from the SEARCH Database. Eur Urol. 2012 Nov;62(5):910–6.
  80. Hu M-B, Xu H, Bai P-D, Jiang H-W, Ding Q. Obesity has multifaceted impact on biochemical recurrence of prostate cancer: a dose-response meta-analysis of 36,927 patients. Med Oncol Northwood Lond Engl. 2014 Feb;31(2):829.
  81. Wang LS, Murphy CT, Ruth K, Zaorsky NG, Smaldone MC, Sobczak ML, et al. Impact of obesity on outcomes after definitive dose-escalated intensity-modulated radiotherapy for localized prostate cancer. Cancer. 2015 Sep 1;121(17):3010–7.
  82. Keto CJ, Aronson WJ, Terris MK, Presti JC, Kane CJ, Amling CL, et al. Obesity is associated with castration-resistant disease and metastasis in men treated with androgen deprivation therapy after radical prostatectomy: results from the SEARCH database. BJU Int. 2011;110(4):492–8.
  83. Pettersson A, Johansson B, Persson C, Berglund A, Turesson I. Effects of a dietary intervention on acute gastrointestinal side effects and other aspects of health-related quality of life: A randomized controlled trial in prostate cancer patients undergoing radiotherapy. Radiother Oncol. 2012 Jun;103(3):333–40.
  84. Henson CC, Burden S, Davidson SE, Lal S. Nutritional interventions for reducing gastrointestinal toxicity in adults undergoing radical pelvic radiotherapy. Cochrane Database Syst Rev [Internet]. 2013 [cited 2014 Nov 18];(11). Available from: http://doi.wiley.com/10.1002/14651858.CD009896.pub2
  85. Wedlake LJ, Shaw C, Whelan K, Andreyev HJN. Systematic review: the efficacy of nutritional interventions to counteract acute gastrointestinal toxicity during therapeutic pelvic radiotherapy. Aliment Pharmacol Ther. 2013 Jun;37(11):1046–56.
  86. Hechtman LM. Clinical Naturopathic Medicine [Internet]. Harcourt Publishers Group (Australia); 2014 [cited 2015 Jul 21]. 1610 p. Available from: http://www.bookdepository.com/Clinical-Naturopathic-Medicine-Leah-Hechtman/9780729541923
  87. Tillisch K. Complementary and alternative medicine for functional gastrointestinal disorders. Gut. 2006 May 1;55(5):593–6.
  88. Wolin KY, Luly J, Sutcliffe S, Andriole GL, Kibel AS. Risk of Urinary Incontinence Following Prostatectomy: The Role of Physical Activity and Obesity. J Urol. 2010 Feb;183(2):629–33.
  89. Menichetti J, Villa S, Magnani T, Avuzzi B, Bosetti D, Marenghi C, et al. Lifestyle interventions to improve the quality of life of men with prostate cancer: A systematic review of randomized controlled trials. Crit Rev Oncol Hematol. 2016 Dec;108:13–22.
  90. Bourke L, Smith D, Steed L, Hooper R, Carter A, Catto J, et al. Exercise for Men with Prostate Cancer: A Systematic Review and Meta-analysis. Eur Urol. 2016 Apr;69(4):693–703.
  91. Teleni L, Chan RJ, Chan A, Isenring EA, Vela I, Inder WJ, et al. Exercise improves quality of life in androgen deprivation therapy-treated prostate cancer: systematic review of randomised controlled trials. Endocr Relat Cancer. 2016 Feb 1;23(2):101–12.
  92. Davies NJ, Batehup L, Thomas R. The role of diet and physical activity in breast, colorectal, and prostate cancer survivorship: a review of the literature. Br J Cancer. 2011 Nov 8;105:S52–73.
  93. Richman EL, Kenfield SA, Stampfer MJ, Paciorek A, Carroll PR, Chan JM. Physical Activity after Diagnosis and Risk of Prostate Cancer Progression: Data from the Cancer of the Prostate Strategic Urologic Research Endeavor. Cancer Res. 2011 May 24;71(11):3889–95.
  94. Larkin D, Lopez V, Aromataris E. Managing cancer-related fatigue in men with prostate cancer: A systematic review of non-pharmacological interventions. Int J Nurs Pract. 2014 Oct;20(5):549–60.

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