The risk of several adverse events is higher in patients who receive gonadotropin-releasing hormone agonist (GnRHa) therapy for prostate cancer than in those who undergo orchiectomy, according to a new paper. In their population-based study of 3,295 men with metastatic prostate cancer, Sun et al. found that men who received GnRHa therapy had significantly increased risks of fracture, peripheral arterial disease and cardiac-related complications compared with patients who underwent bilateral orchiectomy. Patients on GnRHa therapy for ≥35 months were also at increased risk of venous thromboembolism and diabetes mellitus.