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Prostate cancer patients undergoing hormone therapy may experience cognitive effects
July 28, 2008A recent review of the literature has found that hormone deprivation therapy, a commonly used treatment for prostate cancer, may have subtle adverse effects on cognition in patients-- such as in the ability to recall and concentrate. Published in the September 1, 2008 issue of CANCER, a peer-reviewed journal of the American Cancer Society, the study indicates that clinicians and patients should be aware of these potential effects and watch closely for their appearance.
For years, hormone deprivation therapy, also known as androgen depletion therapy, has been used as an effective treatment for prostate cancer because hormones such as testosterone drive the growth of prostate cancer cells. The most common way to achieve androgen depletion is through chemical castration with drugs such as leuprolide and goserelin. Androgen depletion therapy has traditionally been reserved for advanced cases of prostate cancer, but increasing numbers of men with earlier stages of the disease are also undergoing the treatment.
Prostate cancer patients who are prescribed these drugs often stay on them for the duration of their life, and researchers have been documenting the potential adverse effects associated with their use. Men may experience hot flashes, osteoporosis, anemia, fatigue, loss of libido, erectile dysfunction, risk of diabetes, risk of cardiovascular disease, emotional distress, and other effects. Research also indicates that androgen depletion may impact cognitive functioning, which can affect a patient's decision-making skills and quality of life.
Unfortunately, only a handful of relatively small studies have investigated the impact of androgen depletion on cognitive functioning, and some of these studies have reported contradictory results. Dr. Christian Nelson, a psychologist at Memorial Sloan-Kettering Cancer Center in New York City and his colleagues recently conducted the first review of these studies and summarized their overall results.
After performing a systematic literature search of studies in animals and humans, Dr. Nelson's team found that testosterone and its derivatives may impact cognition via several mechanisms in the brain. For example, testosterone can modulate brain chemicals called neurotransmitters and stimulate the connections between neurons. Also, studies that have examined the impact of androgen depletion therapy in prostate cancer patients indicate that between 47% and 69% of men being treated decline in at least one cognitive area, most commonly in processes dependent on spatial ability and in high-order capacities such as the ability to multi-task.
The findings indicate that larger, more thorough studies that include brain imaging techniques are needed to better understand the nature and extent of the cognitive effects of androgen depletion.
In addition, researchers are exploring the effectiveness of using androgen depletion therapy in men with rising levels of prostate specific antigen, a potential precursor to prostate cancer. The authors concluded that "as the use of androgen depletion therapy increases, clinicians should become aware of this relationship [with cognitive decline], and inform and monitor patients for this possible side effect of treatment."
American Cancer Society
Unfortunately, only a handful of relatively small studies have investigated the impact of androgen depletion on cognitive functioning, and some of these studies have reported contradictory results. Dr. Christian Nelson, a psychologist at Memorial Sloan-Kettering Cancer Center in New York City and his colleagues recently conducted the first review of these studies and summarized their overall results.
After performing a systematic literature search of studies in animals and humans, Dr. Nelson's team found that testosterone and its derivatives may impact cognition via several mechanisms in the brain. For example, testosterone can modulate brain chemicals called neurotransmitters and stimulate the connections between neurons. Also, studies that have examined the impact of androgen depletion therapy in prostate cancer patients indicate that between 47% and 69% of men being treated decline in at least one cognitive area, most commonly in processes dependent on spatial ability and in high-order capacities such as the ability to multi-task.
The findings indicate that larger, more thorough studies that include brain imaging techniques are needed to better understand the nature and extent of the cognitive effects of androgen depletion.
In addition, researchers are exploring the effectiveness of using androgen depletion therapy in men with rising levels of prostate specific antigen, a potential precursor to prostate cancer. The authors concluded that "as the use of androgen depletion therapy increases, clinicians should become aware of this relationship [with cognitive decline], and inform and monitor patients for this possible side effect of treatment."
American Cancer Society
Prostate Cancer Current Events and Prostate Cancer News RSSCarnegie Mellon researchers link health-care debate to risk of dying in US and Europe
The current health care debate in the United States is complicated. Trade-offs between heath care expenditures, lifestyle choices and life expectancy have been suggested but seldom clearly demonstrated.
New finding suggests prostate biopsy is not always necessary
Researchers at Wake Forest University School of Medicine and the University of Wisconsin-Madison have discovered that some elevated prostate-specific antigen (PSA) levels in men may be caused by a hormone normally occurring in the body, and are not necessarily a predictor of the need for a prostate biopsy.
Does prostate-specific antigen velocity help in early detection prostate cancer?
The November issue of European Urology, the official journal of the European Association of Urology, features an article focussing on prostate specific antigen (PSA) velocity and early cancer detection. It has been suggested that changes in PSA over time aid prostate cancer detection.
New Synthetic Molecules Trigger Immune Response to HIV and Prostate Cancer
Researchers at Yale University have developed synthetic molecules capable of enhancing the body's immune response to HIV and HIV-infected cells, as well as to prostate cancer cells. Their findings, published online in the Journal of the American Chemical Society, could lead to novel therapeutic approaches for these diseases.
Chemo-radiation before prostate removal may prevent cancer recurrence
Researchers in the Oregon Health & Science University Knight Cancer Institute and the Portland Veterans Affairs Medical Center have found a combination of radiation therapy and chemotherapy given before prostate removal is safe and may have the potential to reduce cancer recurrence and improve patient survival.
Blood vessels might predict prostate cancer behavior
A diagnosis of prostate cancer raises the question for patients and their physicians as to how the tumor will behave. Will it grow quickly and aggressively and require continuous treatment, or slowly, allowing therapy and its risks to be safely delayed?
Short-term hormone therapy and intermediate dose radiation increases survivial for early stage prostate cancer
Short-term hormone therapy given prior to and during intermediate dose radiation treatment for men with early stage prostate cancer increases their chance of living longer, compared to those who receive the same radiation alone.
Task force develops new radiation guidelines for brachytherapy
Radiation dose delivered to the prostate and nearby organs in every brachytherapy procedure should be carefully analyzed using post-implant CT or MRI and uniformly documented in every patient.
1 disease, not 1 demographic
The Asian continent has nearly four billion people living in 47 different countries, and each of these groups has their own unique set of health issues. But when they come to the United States, they're often lumped into one large demographic: "Asian/Pacific Islander."
Cancer survivors may not be getting the help they need to stop smoking
More than a quarter of cancer survivors who still smoke have not been advised to quit smoking by their health care providers in the last year, according to a study published by researchers at Fox Chase Cancer Center in the current issue of the Journal of General Internal Medicine.
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