It seems that there are still subtle and rare side effects of ADT that we are just learning about. The latest one relates to the meibomian glands, which are secretory glands associated with our eyelashes. These glands secrete a tiny bit of oil, which coats the surface of our eyes and keeps the water of our tears from evaporating too quickly, which can lead to dry eye syndrome.
A new study out of China suggests that ADT can reduce the secretion from these glands. The study was small, though, involving just 30 patients on ADT compared to 20 age-matched male controls.
In terms of clinical findings, ADT does not affect tear secretion itself. But it can suppress meibomian gland secretion to some extent, which, according to the authors of this study, increases the risk of dry eye syndrome.
Clearly this is not a major or common problem for most patients on ADT, at least those on ADT short term. If it were common and serious, we would have heard about it before.
If this finding holds up in a larger sample size and with other populations, it may have some clinical relevance to PSMA theranostics (i.e., the use of PSMA-specific techniques for diagnostic and therapeutic purposes). It turns out that PSMA-targeted agents, like Lutetium-177, are picked up by our tear glands and the radiation they emit can injure those glands. That can subsequently lead to dry eyes. It might therefore be worthwhile to also monitor the meibomian gland function in patients who are considering PCa treatment with PSMA-targeted radionuclide therapy, particular if they have a history of dry eye problem.
The effect of ADT on the meibomian glands may seem weird, but it really isn’t. It is known that testosterone promotes the secretion of oil from sebaceous glands in males at puberty. These are the glands that give adolescent males oily skin and contribute to their body odour. Shah et al. (2021) showed that ADT alters the secretion from sebaceous glands in PCa patients’ armpits. It is not surprising, then, that ADT alters sebaceous gland secretion whether those glands are in the armpit or on the edge of our eyelids.
This study needs to be replicated with a much larger sample size and in other populations outside of China.
To read full articles about these topics, see:
The Ocular Surface Characteristics in Prostate Cancer Patients Treated with Androgen Deprivation Therapy: https://pubmed.ncbi.nlm.nih.gov/34795806/
Gonadal suppression alters axillary steroid secretions in men, but does that affect olfactory social signaling? https://eprints.ncl.ac.uk/file_store/production/274900/6041E4E9-84FE-452A-BEFA-CD71C2F2B416.pdf
References:
Li W, Li X, Cui F, Xu Z, Dong N, Li C. The Ocular Surface Characteristics in Prostate Cancer Patients Treated with Androgen Deprivation Therapy. Disease Markers. 2021 Nov 9;2021:5390195. doi: 10.1155/2021/5390195. PMID: 34795806; PMCID: PMC8595033.
Syed Imran Ali Shah, Hannah C. P. Wilson, Paul D. Abel, Richard J. Wassersug, Vít Třebický, Jitka Třebická Fialová, Caroline Allen, Hans H. Adomat, Robert H. Bell, Emma S. Tomlinson Guns, S. Craig Roberts. Gonadal suppression alters axillary steroid secretions in men, but does that affect olfactory social signaling?. Journal of Men's Health. 2021. 17(3);69-76.