Androgen Deprivation Therapy (ADT) for Prostate Cancer

Introduction

Androgen Deprivation Therapy (ADT) is a common treatment used for patients with prostate cancer. You have been given this information sheet because you, or someone in your family or care, has been diagnosed with prostate cancer. This information sheet helps to explain the treatment, side effects and how to best manage these side-effects.

What is Androgen Deprivation Therapy (ADT)?

ADT is a hormone therapy used to treat people with prostate cancer. ADT lowers levels of male hormones (androgens), such as testosterone, in the body, to slow the growth of prostate cancer. High levels of androgens can fuel the growth of prostate cancer cells, so reducing their levels can help to control the disease. ADT can be given in many forms, the most common being luteinising hormone-releasing hormone (LHRH) agonists to reduce testosterone production.

Luteinising hormone plays a crucial role in the reproductive systems of men and women. In men it stimulates the production of testosterone.

What are the common side effects of ADT?

Due to the general reduction of androgens in the body, it can cause various side-effects. Importantly, many of these side-effects can be reduced with simple lifestyle changes.

Common-side effects include:

• weight gain
• loss of muscle mass and strength
• increased risk of heart disease and diabetes
• increased bone fragility (osteoporosis), increasing the risk of fractures
• reduced sex drive (libido) and erectile dysfunction
• lower energy levels
• hot flushes and sweating
• mood changes, including depression and irritability

What can I do to reduce the side-effects of ADT?

Making simple lifestyle changes can help manage the side effects of ADT and improve your overall well-being.

1. Stay physically active

• Exercise regularly, combining aerobic activities (e.g., running, hiking, cycling, swimming) and resistance training (e.g., lifting weights, bodyweight exercises, resistance bands) to maintain muscle mass, strength, and bone health.
• Aim for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous intensity activity a week.
• Exercise can also help reduce fatigue, weight gain, and improve mood.
• If you require further guidance with exercise activities and staying physically active, please contact your specialist nurse for referral to the REACT Physiotherapy team.

2. Maintain bone health

• Calcium and vitamin D supplementation should be commenced with ADT. You may also support your bone health through your diet (e.g., dairy products, leafy greens, fortified foods).
• Engage in weight-bearing exercises (e.g., walking, jogging, dancing weights and bands) to support bone strength.

3. Eat a healthy diet

• Follow a balanced diet rich in fruits, vegetables, whole grains, and lean proteins.
• Limit processed foods, sugary drinks, and excess saturated fats to reduce the risk of heart disease and diabetes.
• Maintain a healthy weight by controlling portion sizes and avoid excess calorie intake. Try using a smaller plate for your meals.

4. Stop smoking and reduce alcohol intake

• Stop smoking. Smoking increases the risk of osteoporosis, heart disease, and cancer recurrence. Seek support to quit if you are struggling.
• Limit alcohol intake, to no more than 14 units per week.

5. Tips to help manage hot flushes

• Keep a record of your flushes to identify potential triggers and help avoid them.
• Dress in layers to easily adjust your clothing when a flush occurs.
• Choose natural fabrics like cotton for clothing and bedding.
• Use layered bedding so you can remove coverings easily at night.
• Keep your environment cool with lower room temperatures or a fan.
• If you are experiencing ongoing hot flushes despite lifestyle changes, talk to your doctor or specialist nurse who may suggest medications such as sage tablets, medroxyprogesterone acetate, gabapentin or venlafaxine.
• Complementary therapies such as acupuncture, controlled breathing or yoga may also help with hot flushes.

6. Look after your mental well-being

• Stay connected with family, friends, and support groups.
• Check out Maggie’s (opens in a new tab), who offer support groups, complementary therapies, psychological support and more.
• Engage in activities that improve mood, such as mindfulness, your favourite hobbies, and stay socially active. Maybe try something new or joining clubs.
• Speak to a healthcare professional if you experience low mood or depression.

By following these steps, you can help manage the side-effects of ADT and improve your quality of life. If you have any concerns, speak to your doctor or specialist nurse.

If you would like to know more about ADT for prostate cancer and how to manage side-effects, we recommend:

• Hormonal therapy for prostate cancer by Macmillan Cancer Support (opens in a new tab)
• ‘Living with hormone therapy’ by Prostate Cancer UK (opens in a new tab)