[Androgen deprivation therapy of prostate cancer from a geriatric perspective].

Androgen deprivation therapy (ADT) for prostate cancer is carried out in a palliative approach in symptomatic geriatric patients. Testosterone synthesis is suppressed using a dual therapy principle with luteinising hormone-releasing hormone (LH-RH) analogues or antagonists of LH-RH, in addition to modern antiandrogens. Additional administration of taxanes is initially possible in cases of high tumor burden and aggressive tumor biology, which is otherwise reserved for castration-resistant prostate cancer. The ADT is a systemic therapy for all testosterone-dependent processes and can lead to hot flushes, gynecomastia, osteoporosis, sarcopenia, anemia, falls, cognitive decline, depression, metabolic syndrome, increased cardiovascular events and many drug interactions. In patients identified as geriatric, ADT should therefore only be used after a thorough risk-benefit analysis.