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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 RSSTeam finds breast cancer gene linked to disease spread
A team of researchers at Princeton University and The Cancer Institute of New Jersey has identified a long-sought gene that is fatefully switched on in 30 to 40 percent of all breast cancer patients, spreading the disease, resisting traditional chemotherapies and eventually leading to death.
New hope for cancer comes straight from the heart
Digitalis-based drugs like digoxin have been used for centuries to treat patients with irregular heart rhythms and heart failure and are still in use today. In the Dec. 16 issue of the Proceedings of the National Academy of Sciences, researchers at the Johns Hopkins University School of Medicine now report that this same class of drugs may hold new promise as a treatment for cancer.
Why prostate cancer patients fail hormone deprivation therapy
The hormone deprivation therapy that prostate cancer patients often take gives them only a temporary fix, with tumors usually regaining their hold within a couple of years.
Family history of prostate cancer does not affect some treatment outcomes
In a first of its kind study, a first-degree family history of prostate cancer has no impact on the treatment outcomes of prostate cancer patients treated with brachytherapy (also called seed implants), and patients with this type of family history have clinical and pathologic characteristics similar to men with no family history at all, according to a January 1 study in the International Journal of Radiation Oncology*Biology*Physics, the official journal of the American Society for Radiation Oncology.
New study shows that a cough medicine ingredient could effectively treat prostate cancer
A study published today in the December issue of the European medical journal Anticancer Research demonstrates that an ingredient used in a common cough suppressant may be useful in treating advanced prostate cancer.
Key to regulation of puberty discovered
A team of scientists from the University of Cambridge and the University of Cukurova in Turkey have taken a major step to understanding how the brain controls the onset of puberty.
Stowers Institute's Workman Lab discovers novel histone demethylase protein complex
The Stowers Institute's Workman Lab has discovered a novel histone demethylase protein complex characterized in work published today in Molecular Cell.
Men with wives, significant others more likely to be screened for prostate cancer
Although the link between early screening and prostate cancer survival is well established, men are less likely to go for early screening unless they have a wife or significant other living with them.
Drop in cancer deaths tied primarily to gains in behavior and screening
Improvements in behavior and screening have contributed greatly to the 13 percent decline in cancer mortality since 1990, with better cancer treatments playing a supporting role, according to new research from David Cutler of Harvard University.
Prostate cancer spurs new nerves
Prostate cancer - and perhaps other cancers - promotes the growth of new nerves and the branching axons that carry their messages, a finding associated with more aggressive tumors, said researchers from Baylor College of Medicine in the first report of the phenomenon that appears today in the journal Clinical Cancer Research.
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