Assessment of men before androgen deprivation therapy.

摘要

The discussion involved in initiating androgen deprivation therapy (ADT) for advanced prostate cancer has changed notably during the last decade. In the 1990s a brief discussion about hot flushes and changes in energy level and libido might have sufficed for risk counseling. The sophisticated physician might mention cognitive changes. A simple laboratory evaluation would be all that was necessary to initiate therapy and monitor patients. Beginning in the early part of this century our understanding changed from appreciating only the early, common and symptomatic effects of the hypogonadal state to identifying several other clinically significant complications of a common therapy such as heart disease, diabetes mellitus and osteoporosis with fracture. The contemporary discussion and evaluation are much more involved, and patients might walk out of the office with a number of new medications or supplements.