Androgen-deprivation therapy and metabolic syndrome in men with prostate cancer.

PURPOSE/OBJECTIVES: To examine the trajectory of changes in body composition and metabolic profile in men who receive androgen-deprivation therapy (ADT) for prostate cancer. DESIGN: Prospective longitudinal design with repeated measures. SETTING: Urban medical center in the southwestern United States. SAMPLE: 55 men starting radiation therapy for prostate cancer. METHODS: Changes in the parameters of metabolic syndrome were estimated with ADT (n=31) and non-ADT (n=24) groups by repeated-measures analysis of variance implemented by general linear mixed-effects models. Models included interactions between groups and follow-up time to test differences between the groups. MAIN RESEARCH VARIABLES: Body composition and metabolic variables. FINDINGS: The ADT group demonstrated a transient increase in waist circumference at the nine-month time point and significant changes in measures of insulin resistance were noted at the three month point. Values for diastolic and systolic blood pressure, plasma glucose, high-density lipoprotein, and triglycerides were not altered for either group. Differences in metabolic variables or measures of body composition did not differ significantly between the groups. CONCLUSIONS: The findings demonstrate the development of insulin resistance in men receiving ADT as early as three months after starting ADT. IMPLICATIONS FOR NURSING: Addressing survivorship concerns can lead to the development of nursing interventions designed to reduce adverse effects associated with ADT.

Relationship between severity of symptoms and quality of life in patients with breast cancer receiving adjuvant hormonal therapy.

PURPOSE/OBJECTIVES: To describe symptoms and quality of life (QOL) of patients with breast cancer receiving adjuvant hormonal therapy and to examine possible relationships between the two measurements. DESIGN: Descriptive, correlational study. SETTING: An oncology clinic within a tertiary medical center in Israel. SAMPLE: Convenience sample of 132 patients diagnosed with primary breast cancer receiving hormonal therapy. METHODS: Data collection was conducted through the self-administered Functional Assessment of Cancer Therapy endocrine subscale and a sociodemographic and medical information questionnaire. MAIN RESEARCH VARIABLES: QOL and symptoms of hormonal therapy. FINDINGS: Ten symptoms were categorized by more than 20% of the participants as "very much" or "quite a bit." The mean QOL score for the participants was higher than that for a healthy population, although a correlation was found between fewer symptoms and higher QOL. Mood swings and irritability were the symptoms most strongly associated with a decrease in QOL. Patients who exercised had higher QOL scores. CONCLUSIONS: Adjuvant hormonal therapy did not affect the QOL of a majority of patients with primary breast cancer. A reduced number of symptoms indicated a higher QOL. Mood swings and irritability have a negative impact on QOL. IMPLICATIONS FOR NURSING: A need exists to design a program to follow up on hormonal symptoms and the QOL of patients receiving hormonal therapy and to encourage patients to engage in regular exercise.

Supportive care in the patient with hormone refractory prostate cancer.

Despite the advances being made in prostate cancer screening and early detection, a large percentage of patients will eventually be classified as "hormone refractory." Patients entering this phase are no longer curable, and therapies instituted in this setting are primarily palliative in nature. As a result, the onus on those working in the field of urologic oncology becomes managing the plethora of symptoms these patients experience as a result of both their disease and the treatment modalities used at this stage. The intent of this article is to provide an overview of some of these symptoms with guidelines for their management. Principles of pain management and additional manifestations requiring supportive care such as anorexia, constipation, anemia, urinary obstruction, and psychological concerns are discussed.