One occasionally hears reference to prostate cancer as a “metabolic disease”. This is particularly in reference to ADT, which can lead to “metabolic syndrome” with its classic signs of loss of muscle mass and weight gained as fat.
Metabolism, as a general term, relates to how the body converts the nutrients we eat into energy. Whether we gain or lose weight is primarily regulated by thyroid hormones produced by the thyroid gland, which lies at the front of our neck. Since those hormones regulate metabolic function, one might wonder if there’s any relationship between ADT and thyroid diseases. Finally, a group of researchers in Taiwan have taken on that question.
In their retrospective study of over 17,000 patients, the authors showed a significant decrease in the risk of thyroid diseases with increasing amount of time prostate cancer patients are on ADT.
The most common sign of thyroid disease is an increase in the size of the thyroid gland. This can be seen in one’s neck and is known as a goiter. As this paper documents, the risk of goiter showing up in a prostate cancer patient clearly goes down with ADT, at least for prostate cancer patients in Taiwan. Whether the association is the same for other ethnic groups remains to be investigated.
The mechanism for the relation of “more ADT = less thyroid disease” is not definitively resolved in this paper, but the authors discuss various ways that a lower risk of thyroid disease might be associated with long term ADT.
To read the study abstract, see: https://pubmed.ncbi.nlm.nih.gov/35226371/
Reference:
Liu JM, Chen YT, Wu CT, Hsu WL, Hsu RJ. Androgen deprivation therapy for prostate cancer and the risk of thyroid diseases. Prostate. 2022 Feb 28. doi: 10.1002/pros.24323. Epub ahead of print. PMID: 35226371.