Does ADT increase the risk of developing a stroke?

Risk of ischemic stroke after androgen deprivation therapy for prostate cancer in the Chinese population living in Hong Kong. By Teoh et al 2015 

 

Key sentence from the paper: “ADT may predispose the development of ischemic stroke through changes in glucose and lipid metabolism.”

 

For the full abstract, see: http://www.ncbi.nlm.nih.gov/pubmed/25724216

 

Commentary: Data from North America and Europe have established the fact that ADT increases the risk of diabetes, skeletal fractures, and acute myocardial infarction (i.e., heart attacks). But, as the authors here point out, those studies have been based on Caucasian populations. Similar data have not been collected for Chinese man. This study, which included a sample of 452 Chinese patients, of which 200 were not on ADT in 252 were on ADT, concludes that "the incidence of machine stroke in the ADT group is much higher than that in the non-ADT group and also in the general population."

 

One interesting aspect of this study is that it considered the possibility of racial differences in the risk of serious side effects from ADT. On one hand, Chinese men can feel lucky that their chances of getting prostate cancer are lower than that of Caucasians. However the authors suggest that Chinese men may have overall lower testosterone levels and as a result poor insulin sensitivity when challenged with androgen suppression. They go on to say that this "may result in increased risk of diabetes, metabolic syndrome and eventually thromboembolic events, and in particular ischemic stroke [for Chinese men on ADT].” 

 

Teoh JY, Chiu PK, Chan SY, Poon DM, Cheung HY, Hou SS, et al. Risk of ischemic stroke after androgen deprivation therapy for prostate cancer in the Chinese population living in Hong Kong. Jpn J Clin Oncol. 2015.