Reversing the effects of androgen-deprivation therapy in men with metastatic castration-resistant prostate cancer

Catherine H. Marshall, Jessa Tunacao, Varun Danda, Hua Ling Tsai, John Barber, Rakhee Gawande, Clifford R. Weiss, Samuel R. Denmeade, Corinne Joshu

Research output: Contribution to journalArticlepeer-review


Objective: To investigate whether bipolar androgen therapy (BAT), involving rapid cyclic administration of high-dose testosterone, as a novel treatment for metastatic castration-resistant prostate cancer (mCRPC) promotes improvements in body composition and associated improvements in lipid profiles and quality of life. Patients and Methods: Men from two completed trials with computed tomography imaging at baseline and after three cycles of BAT were included. Cross-sectional areas of psoas muscle, visceral and subcutaneous fat were measured at the L3 vertebral level. Functional Assessment of Chronic Illness Therapy – Fatigue questionnaire and 36-item short-form health survey were used to assess quality of life. Results: The 60 included patients lost a mean (sd) of 7.8 (8.2)% of subcutaneous fat, 9.8 (18.2)% of visceral fat, and gained 12.2 (6.7)% muscle mass. Changes in subcutaneous and visceral fat were positively correlated with each other (Spearman’s correlation coefficient 0.58, 95% confidence interval 0.35–0.71) independent of the effects of age, body mass index, and duration of androgen-deprivation therapy. Energy, physical function, and measures of limitations due to physical health were all significantly improved at 3 months. The improvements in body composition were not correlated with decreases in lipid levels or observed improvements in quality of life. Conclusions: In the present study, BAT was associated with significant improvements in body composition, lipid parameters, and quality of life. This has promising implications for the long-term health of men with mCRPC.

Original languageEnglish (US)
Pages (from-to)366-373
Number of pages8
JournalBJU International
Issue number3
StatePublished - Sep 2021


  • #PCSM
  • #ProstateCancer
  • #uroonc
  • androgen-deprivation therapy
  • bipolar androgen therapy
  • body composition
  • cancer survivorship
  • metastatic castration-resistant prostate cancer
  • prostate cancer

ASJC Scopus subject areas

  • Urology


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