Metabolic Syndrome in Patients on Androgen Deprivation Therapy for Prostate Cancer as seen at Kilimanjaro Christian Medical Center, Moshi, Tanzania

Abstract

Background: Prostate cancer is a frequently diagnosed malignancy in elderly men worldwide. Previously displayed as rare in Africa, but now a common diagnosis and a cause of mortality. Androgen deprivation therapy (ADT) is the main stay of treatment in Africa due to men presenting with advanced or metastatic disease. Men on androgen deprivation therapy will either develop androgen resistant prostate cancer and die of it or die of other causes. Men with prostate cancer on ADT have been found to have increased non cancer mortality and most of the excess mortality have been attributed to treatment. This study was aimed at evaluating the metabolic risk factors in men undergoing short term androgen deprivation therapy at Kilimanjaro Christian Medical Center (KCMC), Tanzania.

Methods: This was a prospective cohort study, we evaluated 83 prostate cancer patients; 48 on surgical castration, 9 medical castration (zoladex) and 26 were followed up with no treatment. Data analysis was done using stat version 12. Student 2 sided t tests was used to compare mean of the various variables between ADT group and none ADT group.

Results: The mean age at diagnosis was 75±6.7 (55-95). The group of patients on ADT compared to the group of patients not on ADT had a statistically significant increase in all the lipid fractions i.e. low density lipoprotein(LDL), high density lipoprotein (HDL), cholesterol (CHOL), triglyceride (TGA) P=<0.001 at three and six month, fasting plasma glucose (P=<0.001) at three and six month, waist circumference P=0.02 and p=0.001 at three and six month respectively, compared to prostate cancer patients not on treatment. No patient in the six month had increments in serum and anthropometric parameter to meet the definition of a metabolic syndrome.

Conclusion: Six month of androgen deprivation therapy is associated with a statistically significant increase in the fasting plasma glucose, lipid fractions, and waist circumference.

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