Physical Function Changes in Prostate Cancer Patients on Androgen Deprivation Therapy: A 2-Year Prospective Study

Abstract

To investigate the influence of androgen deprivation therapy (ADT) in men with nonmetastatic prostate cancer. We conducted a 2-year controlled, prospective study. Twenty-three men on 6 months or longer of ADT (chronic), 12 men on less than 6 months of ADT (acute), and 13 men not on ADT (healthy controls or prostate cancer patients not on ADT) were studied. We used validated, objective tests for physical and visual-motor function and dual X-ray absorptiometry for body composition at baseline and at 24 months. We found the baseline percentage of body fat increased and baseline percentage of lean mass decreased with duration of ADT (P <0.002 across groups for both). After 24 months, men on chronic ADT had significant declines in lean body mass percentage (P = 0.058) and increases in body fat percentage (P = 0.029). Men on acute ADT had smaller but still significant differences in body composition at baseline and similar trends at 24 months. At baseline, men on chronic ADT had longer chair rise times than men on no ADT (P = 0.073) or acute ADT (P = 0.035). Four-meter walk velocities at 24 months were slower in men on acute (P = 0.006) and chronic ADT (P <0.001). Declines in lean body mass and increases in body fat percentage over 2 years are observed in men on ADT. Lower body physical function performance is reduced in men on chronic ADT. Changes in body composition and physical function should be considered in men on long-term ADT.