Prostate Cancer 360 Findings

Comprehensive care is critical in ADT management

ADT is a foundational treatment in prostate cancer care but can be associated with a broad range of negative consequences due to suppressed T, which can affect overall health and quality of life1-9

To address these issues, the PC360 team developed overarching recommendations based on existing key guidelines, risk assessment tools, and clinician resources.7

These specific recommendations have been categorized into 5 health domains, including cardiometabolic, bone, sexual, and psychological health, and lifestyle management.7

Focusing on lifestyle and behavioral changes can help enhance quality of life and minimize ADT complications1
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Doctor and a patient conversing.

ADT prescribers should ensure a few key steps are taken before treatment, at initiation, and during treatment7

These include:

  • Identify clinical leads necessary for each step of treatment
  • Be prepared to provide patient education, oversight, counseling, monitoring, and referrals
  • Manage patient medication
  • Ensure patient has the right care team available for specific adverse events that may occur
  • Periodically measure weight, perform routine blood tests, and check in on lifestyle changes

Implementing ADT in a busy practice setting is possible. Consider building your professional network to include providers you can refer patients to should side effects arise and staff that can delegate patient counseling and follow-up steps with appropriate team members.

Other providers can also help standardize an approach to patient counseling, initial assessments, and follow-up monitoring. Resources such as comprehensive care roadmaps are available for both healthcare providers and patients and can help navigate the ADT journey.

Optimal ADT management involves a collaborative approach to share the responsibility of treatment

ADT, androgen deprivation therapy; PC360, Prostate Cancer 360; T, testosterone.

What does comprehensive care in ADT management look like?

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References: 1. Kokorovic A, So AI, Serag H, et al. Canadian Urological Association guideline on androgen deprivation therapy: Adverse events and management strategies. Can Urol Assoc J. 2021;15(6):E307-E322. 2. Edmunds K, Tuffaha H, Galvão DA, Scuffham P, Newton RU. Incidence of the adverse effects of androgen deprivation therapy for prostate cancer: a systematic literature review. Support Care Cancer. 2020;28(5):2079-2093. 3. Gandaglia G, Sun M, Hu JC, et al. Gonadotropin-releasing hormone agonists and acute kidney injury in patients with prostate cancer. Eur Urol. 2014;66(6):1125-1132. 4. Yang DD, Krasnova A, Nead KT, et al. Androgen deprivation therapy and risk of rheumatoid arthritis in patients with localized prostate cancer. Ann Oncol. 2018;29(2):386-391. 5. Drevinskaite M, Dadoniene J, Miltiniene D, Patasius A, Smailyte G. Association between androgen deprivation therapy and the risk of inflammatory rheumatic diseases in men with prostate cancer: nationwide cohort study in Lithuania. J Clin Med. 2022;11(7):2039. 6. Gild P, Cole AP, Krasnova A, et al. Liver disease in men undergoing androgen deprivation therapy for prostate cancer. J Urol. 2018;200(3):573-581. 7. Crawford ED, Garnick MB, Eckel RH, et al. A proposal for the comprehensive care of men on androgen deprivation therapy: recommendations from the Multidisciplinary Prostate Cancer 360 Working Group. Urol Pract. 2024;11(1):18-29. 8. Fradin J, Kim FJ, Lu-Yao GL, Storozynsky E, Kelly WK. Review of cardiovascular risk of androgen deprivation therapy and the influence of race in men with prostate cancer. Cancers (Basel). 2023;15(8):2316. 9. Narayan V, Ross AE, Parikh RB, Nohria A, Morgans AK. How to treat prostate cancer with androgen deprivation and minimize cardiovascular risk: a therapeutic tightrope. JACC CardioOncol. 2021;3(5):737-741.
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