Hormonal regulation of appetite and body mass in patients with advanced prostate cancer treated with combined androgen blockade

Cachexia is rarely observed in patients with advanced prostate cancer treat ed with combined androgen blockade. Androgens play an important role in the regulation of body mass composition and influence the secretion of leptin, the appetite regulating hormone. The aim of the study was to assess the in fluence of a combined treatment with nonsteroidal antiandrogen and LH-RH an alogue on the hormonal regulation of appetite and changes in body mass in p atients with advanced prostate cancer (Whitmore-Jewett stage D1 or D2). Eig hteen patients with prostate cancer and 17 healthy subjects matched for age and body mass index were included. In all patients serum concentrations of leptin, neuropeptide Y (NPY), insulin, testosterone and estradiol were mea sured before and after four and twelve weeks of androgen blockade. Pretreat ment serum leptin levels were similar in patients with prostate cancer and in the controls. In a multiple regression analysis only body mass index and testosterone significantly contributed to the variation of plasma leptin. During the treatment body mass and plasma leptin significantly increased wh ile NPY decreased. The change of plasma NPY was significant only after 4 we eks of therapy. This study shows that the afferent regulation of leptin sec retion is unchanged in advanced prostate cancer. Androgen ablation signific antly increases body mass and influences secretion of appetite regulating h ormones. Testosterone appears to play a significant role in the regulation of leptin secretion. (C) 2001, Editrice Kurtis.