***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    Input: BACKGROUND Little is known about the long-term impact of and rogen deprivation therapy ( ADT ) on body composition in men with prostate cancer . We compared body composition parameters in men with non-metastatic prostate cancer on or not on therapy with healthy , age-matched controls at baseline and monitored changes over a 2-year period . METHODS We measured body fat mass and lean body mass in 81 men with prostate cancer on no ADT , 43 men on acute ADT ( less than 6 months ) , 67 men on chronic ADT ( more than 6 months ) and 53 age-matched healthy controls . Measurements were performed every 6 months for 2 years . RESULTS Men with prostate cancer on acute ADT ( mean 3 months ) had significant gains in body fat mass [ 1499.56+/-322.28 g ( mean+/-S.E. ) after 12 months , 2167.15+/-676.45 g after 24 months , p<0.01 for both ] and losses in lean body mass ( 929.74+/-296.36 g after 12 months , 1785.81+/-501.31 g after 24 months , p<0.01 for both ) over 2 years . Men on chronic ADT ( mean 31 months ) had smaller but still significant body composition changes over 24 months . Changes in body composition in men on no ADT were small and healthy controls had no significant changes . CONCLUSIONS Men with prostate cancer on ADT have significant gains in body fat mass and losses lean body mass over 2 years . These changes are most pronounced with initiation of ADT BACKGROUND AND PURPOSE The ongoing Early Prostate Cancer ( EPC ) programme is assessing bicalutamide ( ' Casodex ' ) 150 mg , either alone or as adjuvant to treatment of curative intent , in patients with localised or locally advanced prostate cancer ( n=8113 ) . This paper presents an exploratory analysis of the subgroup of the EPC programme who received radiotherapy with curative intent ( n=1370 ) in order to determine the efficacy ( in terms of progression-free survival [ PFS ] ) and tolerability of bicalutamide 150 mg in this setting . PATIENTS AND METHODS 1370 patients with T1 - 4 , MO , any N prostate cancer received bicalutamide 150 mg or placebo adjuvant to radiotherapy of curative intent . This analysis was undertaken at median 5.3 years ' follow-up . RESULTS In patients with locally advanced disease ( n=305 ) , bicalutamide adjuvant to radiotherapy significantly increased PFS by 53 % ( event-time ratio 1.53 ; 95 % confidence intervals [ CI ] 1.16 , 2.02 ) compared with placebo and reduced the risk of disease progression by 42 % ( hazard ration [ HR ] 0.58 ; 95 % CI 0.41 , 0.84 ; P=0.00348 ) . In these patients , objective progression was experienced by 33.5 % of those r and omised to bicalutamide versus 48.6 % for those r and omised to placebo . The between-group difference in patients with localised disease ( n=1065 ) failed to reach statistical significance ( HR 0.80 ; 95 % CI 0.62 , 1.03 ; P=0.088 ) . The most common adverse events were breast pain ( 74.8 % ) and gynaecomastia ( 66.6 % ) , which were mild to moderate in > 90 % of cases . CONCLUSIONS Bicalutamide 150 mg/day given as adjuvant to radiotherapy significantly improved PFS in patients with locally advanced prostate cancer . For patients with localised disease , the results at this stage from the radiotherapy subgroup and the overall EPC programme suggest that adjuvant hormonal therapy is currently not appropriate . There were no unexpected tolerability findings CONTEXT GnRH agonists markedly increase fat mass in men with prostate cancer , but little is known about the effects of treatment on insulin sensitivity . OBJECTIVE The objective of the study was to assess the effects of short-term GnRH agonist treatment on insulin sensitivity . DESIGN This was a prospect i ve 12-wk study . SETTING The study was conducted at a general clinical research center . PATIENTS OR OTHER PARTICIPANTS We studied 25 men with locally advanced or recurrent prostate cancer , no radiographic evidence of metastases , no history of diabetes mellitus , and no evidence of diabetes mellitus at baseline visit . INTERVENTION Leuprolide depot and bicalutamide were used in the study . MAIN OUTCOME MEASURES Oral glucose tolerance tests and body composition assessment by dual-energy x-ray absorptiometry were performed at baseline and wk 12 . The primary study outcome was change in insulin sensitivity index . RESULTS Mean ( + /- se ) percentage fat body mass increased by 4.3 + /- 1.3 % from baseline to wk 12 ( P = 0.002 ) . Insulin sensitivity index decreased by 12.9 + /- 7.6 % ( P = 0.02 ) . Insulin sensitivity by homeostatic model assessment decreased by 12.8 + /- 5.9 % ( P = 0.02 ) . Fasting plasma insulin levels increased by 25.9 + /- 9.3 % ( P = 0.04 ) . Mean glycosylated hemoglobin also increased significantly ( P < 0.001 ) . CONCLUSIONS Short-term treatment with leuprolide and bicalutamide significantly increased fat mass and decreased insulin sensitivity in men with prostate cancer . These observations suggest that GnRH agonists may increase the risk of diabetes mellitus and cardiovascular disease in older men OBJECTIVE Casodex ( Zeneca ) is a new potent , long‐acting non‐steroidal anti‐ and rogen , which produces and rogen deprivation by blocking the and rogen receptor . We evaluated the endocrine effects of Casodex 150 mg daily given in monotherapy as primary treatment for patients with prostate cancer PURPOSE To examine the effect of progressive resistance training on muscle function , functional performance , balance , body composition , and muscle thickness in men receiving and rogen deprivation for prostate cancer . METHODS Ten men aged 59 - 82 yr on and rogen deprivation for localized prostate cancer undertook progressive resistance training for 20 wk at 6- to 12-repetition maximum ( RM ) for 12 upper- and lower-body exercises in a university exercise rehabilitation clinic . Outcome measures included muscle strength and muscle endurance for the upper and lower body , functional performance ( repeated chair rise , usual and fast 6-m walk , 6-m backwards walk , stair climb , and 400-m walk time ) , and balance by sensory organization test . Body composition was measured by dual-energy x-ray absorptiometry and muscle thickness at four anatomical sites by B-mode ultrasound . Blood sample s were assessed for prostate specific antigen ( PSA ) , testosterone , growth hormone ( GH ) , cortisol , and hemoglobin . RESULTS Muscle strength ( chest press , 40.5 % ; seated row , 41.9 % ; leg press , 96.3 % ; P < 0.001 ) and muscle endurance ( chest press , 114.9 % ; leg press , 167.1 % ; P < 0.001 ) increased significantly after training . Significant improvement ( P < 0.05 ) occurred in the 6-m usual walk ( 14.1 % ) , 6-m backwards walk ( 22.3 % ) , chair rise ( 26.8 % ) , stair climbing ( 10.4 % ) , 400-m walk ( 7.4 % ) , and balance ( 7.8 % ) . Muscle thickness increased ( P < 0.05 ) by 15.7 % at the quadriceps site . Whole-body lean mass was preserved with no change in fat mass . There were no significant changes in PSA , testosterone , GH , cortisol , or hemoglobin . CONCLUSIONS Progressive resistance exercise has beneficial effects on muscle strength , functional performance and balance in older men receiving and rogen deprivation for prostate cancer and should be considered to preserve body composition and reduce treatment side effects PURPOSE Gonadotropin-releasing hormone agonists decrease bone mineral density , lean mass , and muscle size and increase fat mass in men with prostate cancer . Less is known about the effects of bicalutamide monotherapy on bone mineral density and body composition . PATIENTS AND METHODS In a 12-month , open-label study , we r and omly assigned 52 men with prostate cancer and no bone metastases to receive either leuprolide or bicalutamide ( 150 mg by mouth daily ) . Bone mineral density and body composition were measured by dual energy x-ray absorptiometry and quantitative computed tomography . RESULTS Mean ( + /- st and ard error ) bone mineral density of the posterior-anterior lumbar spine decreased by 2.5 % + /- 0.5 % in the leuprolide group and increased by 2.5 + /- 0.5 in the bicalutamide group from baseline to 12 months ( P < .001 ) . Mean changes in bone mineral density of the total body , total hip , femoral neck , and trabecular bone of the lumbar spine also differed significantly between groups ( P < or = .003 for each comparison ) . Fat mass increased by 11.1 % + /- 1.3 % in the leuprolide group and by 6.4 % + /- 1.1 % in the bicalutamide group ( P = .01 ) . Changes in lean mass , muscle size , and muscle strength were similar between the groups . Breast tenderness and enlargement were more common in the bicalutamide group than in the leuprolide group . Fatigue , loss of sexual interest , and vasomotor flushing were less common in the bicalutamide group than in the leuprolide group . CONCLUSION In men with prostate cancer , bicalutamide monotherapy increases bone mineral density , lessens fat accumulation , and has fewer bothersome side effects than treatment with a gonadotropin-releasing hormone agonist PURPOSE We evaluated changes in bone mineral density ( BMD ) , fat-free mass ( FFM ) and serum lipid levels during bicalutamide 150 mg monotherapy compared with medical castration for 2 years . MATERIAL S AND METHODS A total of 103 men with localized or locally advanced prostate cancer ( T1-T4 , Nx , M0 ) for whom immediate and rogen deprivation was indicated were enrolled in this prospect i ve , multicenter , open-label , parallel group study . Patients were r and omized to bicalutamide 150 mg once daily ( 51 ) or medical castration with a luteinizing hormone releasing hormone analogue ( 52 ) for 96 weeks . Primary end points were mean percent change from baseline in lumbar spine BMD , hip BMD and FFM at 96 weeks . Mean changes in lipid parameters with time were also evaluated . RESULTS BMD was maintained during bicalutamide 150 mg monotherapy ( + 2.42 % for lumbar spine BMD and + 1.13 % for hip BMD at week 96 ) , while castration was associated with a progressive loss in BMD ( -5.40 % and -4.39 % at week 96 , respectively , both p < 0.0001 at week 96 ) . There was no significant difference between bicalutamide 150 mg and castration in mean percent change from baseline in FFM ( -1.56 % and -3.86 % , respectively , at week 96 , p = 0.31 ) , although there was a trend for greater progressive loss over time with castration . Mean changes in lipid parameters were small and similar in the 2 groups . CONCLUSIONS Bicalutamide 150 mg monotherapy may offer an important advantage compared to castration in terms of bone loss and body composition for patients who require long-term and rogen deprivation for localized or locally advanced prostate cancer PURPOSE Radiation Therapy Oncology Group protocol 85 - 31 was design ed to evaluate the effectiveness of adjuvant and rogen suppression , using goserelin , in unfavorable prognosis carcinoma of the prostate treated with definitive radiotherapy ( RT ) . METHODS AND MATERIAL S Eligible patients were those with palpable primary tumor extending beyond the prostate ( clinical Stage T3 ) or those with regional lymphatic involvement . Patients who had undergone prostatectomy were eligible if penetration through the prostatic capsule to the margin of resection and /or seminal vesicle involvement was documented histologically . Stratification was based on histologic differentiation , nodal status , acid phosphatase status , and prior prostatectomy . The patients were r and omized to either RT and adjuvant goserelin ( Arm I ) or RT alone followed by observation and application of goserelin at relapse ( Arm II ) . In Arm I , the drug was to be started during the last week of RT and was to be continued indefinitely or until signs of progression . RESULTS Between 1987 and 1992 , when the study was closed , 977 patients were entered : 488 to Arm I and 489 to Arm II . As of July 2003 , the median follow 
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More extensive changes were seen with longer duration of treatment .
Conclusions Substantial increases in fat and declines in lean mass were observed in prostate cancer patients treated with ADT .
Implication s for cancer survivorsProstate cancer survivors should be made aware of the side effect of treatment on body composition and further work is required to determine what interventions can minimize the impact of ADT on body composition and therefore what evidence based advice they should be provided with .
In general , though recommendation of a healthy diet and moderate exercise is reasonable