Could hormone therapy increase the risk of respiratory infections?

This study investigated a possible relationship between respiratory infections and androgen deprivation therapy (ADT) used to treat prostate cancer.

Researchers concluded that the risk of developing respiratory infections increases with hormonal therapy.

Androgen deprivation therapy (ADT) is commonly used to treat prostate cancer. By reducing the levels of androgens (male sex hormones such as testosterone), cancer progression can be delayed and survival increased.

Recent reports have suggested an increased risk of respiratory infections (such as nasal congestion, bronchitis, and pneumonia) among men undergoing ADT. This study aimed to further examine a possible relationship between between ADT and respiratory infections.

This study included 52,905 men with localized prostate cancer. Men were divided according to ADT received, no ADT received, or undergoing orchiectomy (surgical removal of the testes, or testicles, a form of ADT). The rates of respiratory infections were compared between patients undergoing different treatments.

Analysis showed that ADT with hormonal therapy significantly increased the risk of respiratory infections. Within the first 14 months after cancer diagnosis, 62% of men undergoing ADT experienced some form of respiratory infection, compared with 55% of men that did not undergo ADT. Among men undergoing ADT, 18% reported nasal congestion (compared to 17% of men not receiving ADT), 40% experienced bronchitis (compared to 34% of men not receiving ADT), 26% developed pneumonia (compared to 21% of men not receiving ADT), and 4% experienced severe pneumonia (compared to 3% of men not receiving ADT). The risk of developing respiratory infections increased with the combined ADT dose received.

Treatment with orchiectomy as a means of ADT was not associated with an increased risk of respiratory infections. Men undergoing orchiectomy were about 34% less likely to experience a respiratory infection (including nasal congestion and bronchitis), and 20% less likely to experience pneumonia, compared to men receiving ADT using hormonal therapy.

The researchers concluded that ADT with hormonal therapies is associated with an increased risk of developing respiratory infections. Researchers advise that patients should be properly informed about possible side-effects before treatment.

This study did not account for additional factors which may be associated with the risk of respiratory infections, such as smoking and additional medical conditions.