Effect of ADT in Chinese Male With Prostate Cancer
Effect of ADT in Chinese Male With Prostate Cancer
Many prostate cancer patients required the use of androgen deprivation therapy (ADT) for the
 control of disease.

 In this study, the investigators aim at assessing the different in various parameters between
 PCa patients received ADT and those without ADT.

 60 patients diagnosed with PCa and planned for hormonal therapy will be recruited for study
 (active arm) and 30 PCa patients that do not planned to receive hormonal therapy (based on
 the clinical assessment by the investigators) will be recruited as control arm.

 After written consent obtained from study subject, a series of investigation will be arranged
 to assess the following aspect of the subjects before the commenced of ADT:

 -  General condition - symptoms, general health,

 -  Body composition - BMI and body composition

 -  Mental state assessment by Mini-Mental State Examination (MMSE)

 -  Blood for fasting lipid, sugar, hsCRP and other hormones (about 15cc)

 -  Cardiovascular status - BP, Ankle-brachial index (ABI), Arterial stiffness, ECG,

 -  Bone status - bone mineral density by dual-energy X-ray absorptiometry (DEXA) scan

 The assessment of general condition, body composition, blood parameter and cardiovascular
 status will be performed every 26weeks +/- 1 weeks for two years. Bone density measurement
 will be performed every 52 weeks +/- 2 weeks.

 Appropriate medical referral will be made if subject was found to have abnormal metabolic or
 cardiovascular parameters.
The prostate gland is a clinically important male accessory sex gland and vital for its
 production of semen. Prostate cancer (PCa) is now ranked 4th in annual incidence of male
 cancer and ranked 8th for cancer-related death in men in Hong Kong which accounts for about
 6.2 deaths per 100,000 persons. Its incidence is rising rapidly, almost tripled in the past
 10 years. As the elderly population continues to increase, the impact of PCa on the men's
 health and also the burden on health care system will continue to rise.

 Despite the improvement in awareness of the disease and also increasing use of serum prostate
 specific antigen, many patients still presented at a late stage that beyond cure by local
 therapy. Together with those patients suffered recurrent disease after local therapy, many
 PCa patients required the use of androgen deprivation therapy (ADT) for the control of
 disease.

 However, unlike other malignancy, PCa is characterized by its slow progression nature and
 even for metastatic disease the 5-year survival is upto 20%. Therefore, while ADT can provide
 effective control of disease, there are increasing evidences suggesting that it can also
 result in many adverse effects in the patients, and these effects are particular important
 due to the long survival of these patients. From the western literature, the adverse effects
 can be quite diverse. Classical side effects after ADT include mood changes, hot flushes,
 change in cognitive function, loss of libido, erectile dysfunction, osteoporosis and
 pathological fracture. Also there are more and more evidences showed ADT will also altered
 the metabolic and cardiovascular status of the patients and resulted in increase in insulin
 resistance and increase in risk of cardiovascular related mortality.

 Traditionally, in order to achieve a complete control of PCa, ADT is given in a continue
 manner, either in the form of bilateral orchidectomy or regular luteinizing hormone releasing
 hormone injection. However, in order to balance the benefit and potential of long-term
 complication, intermittent hormonal therapy (IHT) become increasing common to be used in
 patients suffered PCa, in particular those with low tumour volume and low-grade disease.
 However, formal comparison of the benefit, in term of side effect reduction, for IHT compare
 to traditional continue-hormonal suppression is still lacking.

 Unfortunately information regarding the side effects of ADT in Chinese population is lacking.
 However, there are some evidences from female menopause related studies that there may be
 some differences in the presentation and prevalence of sex hormone deprivation in difference
 racial groups. Therefore, there is a need to have more information on the adverse effect
 profiles related to ADT (both complete and IHT) in Chinese population.
For those received hormonal therapy will be recruited for study (active arm) Study subject
 inclusion criteria

 1. Male patients 18 years or older

 2. Adenocarcinoma of the prostate either histologically or cytologically confirmed

 3. Decided to be put on ADT -bilateral orchidectomy or LHRH agonist or LHRH antagonist,
 with or without additional antiandrogen

 4. After ADT performed, serum testosterone level should reach castrated level, i.e. < 50
 ng/dL after 6 weeks of treatment

 5. Able to consent for the participate in the study

 For those do not plan to receive hormonal therapy (based on the clinical assessment by the
 investigators) will be recruited as control arm

 Control subject:

 1. Male patients 18 years or older

 2. Adenocarcinoma of the prostate either histologically or cytologically confirmed

 3. Able to consent for the participate in the study

 Exclusion Criteria:

 1. Patient did not able to provide consent or comply with the follow-up arrangement

 2. Patient with life expectancy of less than 2 years - based on clinical judgement