Androgen deprivation therapy: Monitoring and managing the complications

Androgen deprivation therapy (ADT), the mainstay of treatment for prostate cancer since the 1940s, was used until the 1980s mainly to treat patients who had symptomatic metastatic prostate cancer. After the serum prostate-specific antigen(PSA) test became available in the mid 1980s, a new stage of prostate cancer, biochemical relapse, was defined, marked by a rising PSA after surgery or radiation therapy and no objective evidence of metastatic disease. Although these patients had no symptoms of prostate cancer, they were often treated with ADT, which usually resulted in a PSA decline. The full scope of complications caused by ADT was appreciated only after patients were treated who had no symptoms of metastatic disease and longer life expectancies.