Androgen deprivation therapy (ADT) with Luteinizing hormone releasing hormone analogues or bilateral subcapsular orchiectomy is the mainstay of treatment in high risk localized and metastatic prostate cancer along with other modalities. ADT is associated with increased fat mass and insulin resistance, but the risk of incident diabetes and non-cancer mortality during this treatment has not been well studied. We conducted a meta-analysis to see whether androgen deprivation therapy is associated with an increased incidence of diabetes and cardiovascular diseases. The MEDLINE, CANCERLIT, COCHRANE library database, and the search engines, were searched to identify, prospective, randomized, controlled studies in prostate cancer patients receiving short, long term or no ADT and risk of incident diabetes and non cancer mortality. Comprehensive Meta-analysis software version 2.0 was used for the analysis. Four prospective trials with a total patient population of 1, 15,119 were identified. Pooled results from these trials showed an increased risk of diabetes in patients treated with long term ADT (p= 0.0001) as well as increased non-cancer mortality (Odds ratio 1.69; p < 0.001. Main cause of non-cancer death was sudden cardiac death (SCD). The resultant funnel plot of metaanalysis showed lack of publication bias. This meta-analysis shows increased risk of diabetes and cardiovascular diseases in prostate cancer patient on long term androgen deprivation therapy; already existing diabetes also deteriorated. The results of this study warrants active surveillance of patients on androgen deprivation therapy.

Androgen deprivation therapy, Prostate cancer, Risk of diabetes, Cardiovascular diseases, Meta-analysis