Managing Side Effects of Androgen Deprivation Therapy

If you’ve been diagnosed with advanced prostate cancer, there’s a good chance you’ll receive androgen deprivation therapy (ADT) at some point, as ADT is a mainstay of prostate cancer treatment. It works by lowering levels of testosterone, a type of androgen (a hormone) in the body that fuels prostate cancer growth. Starving the cancer of its fuel helps shrink prostate cancer tumors and prevent new ones from growing.

“Depleting testosterone creates a lot of systemic side effects,” says Joseph Renzulli, MD, an associate professor of urology at Yale School of Medicine in New Haven, Connecticut. “ADT does have a large impact on men, especially those who are on it long term.”

Here are some common side effects of ADT, plus tips on managing them and boosting your quality of life during prostate cancer treatment.

1. Fatigue

How to Manage Fatigue

Exercise can help increase your energy levels. Go for resistance workouts, which can help boost energy levels while maintaining bone and muscle mass, says Renzulli. Aim for about 30 minutes of exercise each day, he says.

2. High Blood Sugar

How to Manage High Blood Sugar

3. High Blood Pressure and Cholesterol

ADT can increase blood pressure and cholesterol, so your oncologist will likely work with your primary care doctor — and possibly a cardiologist — to monitor your levels. “It should be a team approach,” says Renzulli.

How to Manage High Blood Pressure and Cholesterol

4. Weak Bones

How to Manage Weak Bones

“We often encourage men … to start vitamin D and calcium supplementation [to help shore up bone health],” says Ramkishen Narayanan, MD, a urologic oncologist and the director of the Center for Urologic Health at the Disney Family Cancer Center at Providence Saint Joseph Medical Center in Burbank, California.

5. Sexual Dysfunction

How to Manage Sexual Dysfunction

Psychological treatment may help you counter a loss of libido related to ADT. Some research has found that cognitive behavioral therapy (CBT) can help prostate cancer survivors treated with ADT improve their sexual desire, functioning, and satisfaction, possibly by improving body image and relationship issues that can take a toll.

Discuss Side Effects at Each Checkup

Many of the side effects of ADT go away after treatment is finished, but some men have to stay on the therapy for life, says Renzulli. Additionally, some men may never regain normal levels of testosterone production. That’s a good thing for helping prevent prostate cancer from coming back, but you may continue to experience the effects of ADT for years to come as a result.

Keep in close touch with your doctors. “We strongly encourage people to maintain follow-ups with the physician prescribing the ADT to make sure any side effects are noted,” says Dr. Narayanan. “We also encourage engaging with a psychiatrist, neurologist, or psychiatric-oncologist as part of a multidisciplinary team to make sure any emotional or cognitive issues are dealt with, either with or without medication.”

The Takeaway

• Androgen deprivation therapy (ADT) lowers levels of testosterone, a type of androgen, in the body, which helps shrink prostate cancer and prevent tumors from growing.
• Suppressing testosterone levels, can also cause side effects, though, such as bone loss, fatigue, high blood pressure and blood sugar levels, and sexual function problems.
• To help ease the side effects of ADT, try communicating openly with your doctor about any side effects you’re experiencing, eating a nutritious diet, and staying active.