Potential side-effects of endocrine treatment of long duration in prostatecancer

Endocrine treatment of prostate cancer has been established for more than 5 decades. Focusing on immediate or short-term side effects, bilateral orchi dectomy may cause psychological trauma, treatment with oral estrogens is co mbined with a high risk of severe cardiovascular complications, and the use of LH-RH agonists and antiandrogens as monotherapies or in combination may result in tumor flare, hot flashes, and gynecomastia. In recent years an i ncreasing number of reports on anemia and/or osteoporosis related to endocr ine treatment have been published. These side effects are regular and persi stant after orchidectomy, or during treatment with LH-RH agonists, and are most often expressed with maximum androgen blockade. In contrast, anemia an d/or osteoporosis are not reported with estrogen treatment or the use of no nsteroidal antiandrogens as a monotherapy regimen. Since many prostate canc er patients are treated hormonally for many years, control of Hb levels and bone mineral density before and after initiation of treatment at regular i ntervals is highly recommended as a standard of care. Prostate Supplement 1 0:38-42, 2000. (C) 2000 Wiley-Liss, Inc.