Researchers found that the therapy exposed them to more adverse side effects and was associated with increased risk of death and deprived the men of the opportunity for a cure by other methods.
ADT or androgen deprivation therapy involves injecting or implanting medication that disrupts the bodies ability to make testosterone and has significant side effects such as heart disease, diabetes, increased weight gain and impotence and potential earlier death.
According to the authors the treatment has become a mainstay for prostate cancer that has metastasized or spread beyond the prostate gland and others used it with radiation therapy. The authors say there is no evidence for use of ADT for low risk or localized prostate cancer despite its use in these patients.
This misuse of ADT therapy lead to changes in Medicare reimbursement policies for ADT in 2004 with a resulting 40 per cent drop in reimbursement and a reduction in inappropriate use of ADT from 38.7 percent to 25.7 percent for newly diagnosed localized prostate cancers. The current study hypothesized that adverse effects of ADT might be more pronounced in men with longer life expectancies since they would likely be treated with ADT for a longer period and be exposed to more treatment-related side effects.”
Of a population of 46,376 men diagnosed with localized prostate cancer who did not undergo radical prostectomy or radiation therapy for prostate cancer, diagnosed between 1992 and 2009, thirty eight and a half percent were treated with ADT and the hypothesis was confirmed. Findings showed that primary ADT was associated with decreased survival in men with localized prostate cancer relative to men who received no active treatment.
Thus, ADT should not be used as a primary treatment for men with prostate cancer that has not spread beyond the prostate or men with moderate or high disease undergoing radiation therapy.