Side Effects and Complications of Androgen Deprivation Therapy in the Treatment of Metastatic Prostate Cancer

Abstract

Introduction: Androgen deprivation therapy is the standard treatment for metastatic prostate cancer. Its palliative action aims to improve patients’ quality of life through better control of the disease. Androgen deprivation therapy causes side effects that are often overlooked in light of the expected benefits in terms of cancer control. Side effects can be cardiovascular, metabolic, sexual, skeletal and neurophysiological. Patients and methods: Retrospective study collecting the records of patients who underwent androgen deprivation therapy for the management of metastatic prostate cancer between January 2022 and December 2024 at the Urology-Andrology Department of the Ouakam Military Hospital. Results: 82 patients were included in the study. The average age of patients was 68.6 years. Androgen suppression was surgical in 76.8% of cases and medical in 23.2%. Hot flushes were reported by 91.4% of patients. Sexual disorders consisted of erectile dysfunction (64.6%), decreased libido (79.2%) and decreased penis size (20.7%). Metabolic complications included obesity (10.9%) and type 2 diabetes (3.6%). Femoral neck fractures were observed in 6.09%. Thirty-two percent of patients had severe anemia requiring blood transfusion. Nineteen percent of patients reported concentration problems. Mortality was 15.8% (n = 13). Conclusion : Pre-treatment assessment is a necessary step in screening for cardiovascular risk factors and osteopenia in order to optimise the management of the side effects of androgen suppression.