How does being overweight interact with ADT?

Obesity and the Odds of Weight Gain following Androgen Deprivation Therapy for Prostate Cancer. By Braunstein et al. 2014

 

Concluding summary from the paper: "Consideration should be given to avoid androgen deprivation therapy in obese men with low- or favorable-intermediate risk prostate cancer where improved cancer control has not been observed, but shortened life expectancy from weight gain is expected."

 

For the full abstract, see: http://www.hindawi.com/journals/pc/2014/230812/

 

Commentary: This paper out of Harvard comes from Dr. Anthony D’Amico group, which is famous for showing the benefits of using androgen deprivation therapy (ADT) to improve the efficiency of radiation used as a primary treatment for prostate cancer. The paper, however, has a caveat. For patients who are obese before starting radiotherapy with curative intent, they are significantly more likely to gain 10 lbs or more of weight when ADT is used in conjunction with radiotherapy. The more obese they are, the more weight they are likely to gain.

Since obesity itself increases the risk of mortality, the authors state that “ADT used should be discouraged in obese men with low – or favourable – intermediate risk prostate cancer”. Their sample size is quite small, but their warning is well taken. For obese patients who have prostate cancer, their obesity may be more life-threatening than the prostate cancer itself. 

 

Braunstein LZ, Chen M-H, Loffredo M, Kantoff PW, D'Amico AV. 2014. Obesity and the Odds of Weight Gain following Androgen Deprivation Therapy for Prostate Cancer. Prostate Cancer 2014: Article ID 230812, 6 pages.