Furthermore, recent evidence suggests PE as strategy to prevent osteoporosis in men receiving ADT when associated with pharmacological therapy. As PE is recommended in healthy elderly adults to prevent these risks and also to prevent bone loss, we hypothesized that PE could be effective in preventing accidental falls and fractures even in men with PCa receiving ADT. Patients receiving ADT are more exposed to the risk of accidental falls and fractures due to the side effects of this drugs. In patients with PCa receiving ADT, exercise is beneficial to body composition, muscle strength, and physical performance, while its effects on bone health, cardiometabolic risk, quality of life, and cognitive functions remain uncertain. Initial evidence indicates that in patients with cancer, PE may produce numerous benefits on physical performance, quality of life, and cancer-related fatigue. Moderate-vigorous intensity programmes that include balance exercises seem to be particularly effective to reduce the risk of accidental falls. Recent guidelines addressing elderly adults recommend multicomponent exercise programmes, including resistance and neuromotor exercises, as a strategy to reduce the risk of accidental falls as PE can prevent osteoporosis and improves body composition, muscle strength, and cognitive function. In elderly adults, physical exercise (PE) has been proposed in different modalities as a strategy to produce several health benefits. Thus, considering the loss of BMD, altogether these side effects of ADT explain the increased risk of accidental falls and fractures in this population. It is known that both reduction in muscle strength and cognitive dysfunction are predictors of higher fall rates and hospitalization in older adults. Moreover, ADT seems responsible for cognitive dysfunction, although this finding has not been completely clarified and needs further investigation. Also, patients on ADT manifest significant loss of bone mineral density (BMD), which occurs especially within the first year of treatment and is associated with higher osteoporosis rates and risk of fractures.
Apart from the increased risk for cardiovascular events and metabolic syndrome, ADT also alters the body composition, with loss in skeletal muscle mass that leads to a decrease in muscle strength. However, ADT is responsible for many adverse effects, with negative impact on quality of life. Often, ADT is used in combination with radiotherapy for localized advanced PCa with the aim to increase survival and control disease progression.
Īndrogen deprivation therapy (ADT) is currently the standard systemic treatment in patients with metastatic or more aggressive PCa. Those questions are up to the parties involved.Prostate cancer (PCa) is the most prevalent cancer among men worldwide, with 3.724.658 cases in 2018. The Trump Administration recognized Yerushalayim as the capital of Israel in 2017, but on the State Department’s website, it states “We are not taking a position of any final status issues, including the specific boundaries of the Israeli sovereignty in Jerusalem, or the resolution of contested borders. President Barack Obama’s administration took Bush’s position, and in 2015 the Supreme Court ruled the law was a violation of the balance of federal powers. Bush defied Congress, claiming they had overstepped their boundaries in directing the State Department, which only the president has authority to do. In 2002 Congress passed a law that directed the State Department to allow “Jerusalem, Israel” on birth certificates. The State Department of the United States has announced that, effective immediately, all American citizens born in Yerushalayim will be able to list their place of birth as “Jerusalem, Israel” on official documents.įor decades, due to political tensions, if an American was born in Yerushalayaim, his or her parents could only put down “Jerusalem” on passports and consular documents.īoth Israel and the Palestinian Authority claim Yerushalayim as their capital, and the status of the city is one of the greatest sources of contention in the conflict between Israelis and Palestinians. Ambassador to Israel David Friedman stand next to the dedication plaque at the U.S.
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