The urology faculty of Johns-Hopkins publishes a quarterly Prostate
Cancer Bulletin containing articles summarizing current PC topics. The
current winter issue included an article on ADT and Metabolic Syndrome,
 from which the following excerpts are taken FYI.

Hot flashes occur in 2/3 of men on chemical ADT but only half of men
castrated for PC. [This implies to me that the drugs add their own hot
flash risk above and beyond that of androgen suppression alone], and hot
flashes may abate over time or continue for years. Those address two
questions we’ve often raised here.

To the long lost of ADT SEs, the metabolic syndrome, which significantly
increases the risks of heart disease deaths and diabetes, should now be
added, according to the JNCI.

The female hormone estrogen is regaining hormone-blocking favor in low
doses because it is as effective as much more costly ADT drugs but
doesn’t cause bone loss as the others do (and don’t forget that Fosamax
is threatened with total recall).

Total androgen blockade with antiandrogens is not thought to improve
over ordinary LHRH adonists such as  Lupron or Zoladex because adrenal
androgens have little effect on the prostate.

ADT very often leads to increases in abdominal fat, blood sugar, and
triglycerides … components of metabolic syndrome, aka Syndrome X or
insulin resistance. All this very significantly and directly contributes
to heart disease, diabetes, and many other threats [which could become
bigger problems than PC.] If your waist circumference exceeds your hip
circumference, or if your waist exceeds 40 inches, congratulations;
you’re officially obese. The extra belly fat is often both an indicator
and a cause of insulin resistance or full-blown metabolic syndrome.

While no studies prove that ADT causes metabolic syndrome, the
connection looks and walks like a duck and recent evidence quacks.

The next 14 pages are titled, “In-Depth Report: The Artificial Urinary
Sphincter for Post-Prostatectomy Incontinence.”

After that, some Q&A. Snippets include:

SRT has only a 15% chance of helping after a G-7 case returns, because
it’s likely to be distant. The ProtoScint Scan isn’t helping much in
determining met location. [Walsh says seminal vesicle involvement and
negative margins  render SRT even less likely to help.]

The admission criteria for J-H  WW/AS/EM program includes Gleason < 7, <
3 of 12 positive biopsy cores, < 50% involvement in any core, PSA
Density  no more than 0.1, and no palpable DRE (T1C only).

I.P.