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ADT Metabolic Syndrome — SCE Medical Oncology MCQ

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ModerateUrological CancersADT Metabolic SyndromeSCE Medical Oncology

A 72-year-old man with prostate cancer on ADT for 3 years develops metabolic syndrome (central obesity, hyperglycaemia, dyslipidaemia). What is the mechanism?

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Correct answer: E — ADT causes hypogonadism leading to metabolic syndrome: increased visceral adiposity, insulin resistance/type 2 DM, dyslipidaemia (increased LDL/triglycerides) and increased cardiovascular risk — requiring metabolic monitoring and lifestyle intervention

ADT-induced hypogonadism causes a cluster of metabolic complications: increased visceral fat (~10% body fat gain in first year), insulin resistance (risk of new-onset diabetes ~16% at 5 years), dyslipidaemia (increased total cholesterol, LDL, triglycerides), reduced lean muscle mass and increased cardiovascular mortality. Monitoring includes: baseline and annual HbA1c, lipid profile, BMI/waist circumference, blood pressure. Lifestyle intervention (exercise, diet) is the primary mitigation strategy.

Reference: ESMO 2024 Prostate Cancer Survivorship; NICE NG131; Keating et al JCO 2006