We all know that LHRH agonists are used for androgen deprivation therapy (ADT) cause a tremendous number of side effects, but it is not uncommon for our doctors to never discuss these potential side effects with us prior to starting therapy. Additionally, doctors neglect to offer alternative therapies that might accomplish the same results (like estrogen therapy).
The reality is simple; ADT has many side effects that reduce of the quality of life of prostate cancer patients and their partners. We are poorly informed about these side effects of these drugs and how to manage them.
A recent study verified this claim. The researchers set out to test the hypothesis that there is bias in the peer-reviewed literature on ADT that correlates with an association between authors and the luteinising hormone-releasing hormone (LHRH) agonists pharmaceutical industry.
The researchers assessed 155 articles on ADT published in English-language peer-reviewed journals in terms of how comprehensive they were in acknowledging LHRH agonists’ side effects. They found that the literature regarding ADT is substantial, however the vast majority of articles failed to acknowledge many of the more stressful side effects of ADT for patients and their partners.
They also found that the articles most likely to acknowledge the psychosocial impact of ADT were significantly less likely to have had industrial support than those articles that did not mention those side effects.
They also found that alternative treatments to the LHRH agonists were rarely mentioned. Authors who indicated some association with a pharmaceutical company tended to minimize the side effects of LHRH agonists and not acknowledge alternatives to the LHRH agonists for ADT.
Pharmaceutical support is associated with a proliferation of articles published in the peer-reviewed literature. It is possible that this barrage of literature may limit our physicians’ knowledge of the side effects of these drugs. This issue may account for the poor knowledge that many patients on LHRH agonists have about the drugs they are taking and ways to manage the side effects.
Reference: Int J Clin Pract. 2012 Dec;66(12):1189-96 ?doi: doi: 10.1111/ijcp.12025; Phillips JL, Wassersug RJ, McLeod DL Are you the author? ?Department of Anatomy and Neurobiology, Dalhousie University, Halifax, NS, Canada Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada Dalhousie University, School of Nursing and Capital Health/QEII Cancer Care Program, Halifax, NS, Canada.
?PubMed Abstract?PMID: 23163498
Joel T. Nowak, M.A., M.S.W.
What are the alternative treatments to LHRH? My own ADT treatment is a Japanese product called Trenantone (generic Leuprorelin) for the last 6 years. But it now has to be augmented with Bicalutamide.
Estrogens are the most common alternatives used in the United States – Joel