Nav: Home

Is androgen deprivation therapy for prostate cancer associated with dementia?

October 13, 2016

Androgen deprivation therapy (ADT) is a mainstay of prostate cancer treatment. ADT has shown survival benefit in some patients but it also has been associated with some adverse health effects and a possible link to neurocognitive dysfunction.

A new study published online by JAMA Oncology uses an informatics approach with a text-processing method to analyze electronic medical records data to examine ADT and the subsequent development of dementia (senile dementia, vascular dementia, frontotemporal dementia and Alzheimer dementia).

Kevin T. Nead, M.D., M.Phil., formerly of the Stanford University School of Medicine, California, and now the University of Pennsylvania Perelman School of Medicine, Philadelphia, and coauthors used data from an academic medical center from 1994 to 2013. The final study group included 9,272 men with prostate cancer, including 1,862 (19.7 percent) who received ADT.

The authors report there were 314 new cases of dementia during a media follow-up of 3.4 years with a median time to dementia of four years.

The absolute increased risk of developing dementia among those men who received ADT was 4.4 percent at five years, according to the results. Further analysis suggests men who received ADT at least 12 months had the greatest absolute increased risk of dementia. Men 70 or older who received ADT were the least likely to remain dementia free.

The report suggests several plausible mechanisms to explain an association between ADT and dementia in general, including that androgens have a demonstrated role in neuron health and growth.

Study limitations include using clinical text documentation and billing codes to determine a diagnosis of dementia. Because of its design, the study also cannot determine a causal association between the use of ADT and the risk of dementia.

"Our study extends previous work supporting an association between use of ADT and Alzheimer disease and suggests that ADT may more broadly affect neurocognitive function. This finding should be investigated in prospective studies given significant individual patient and health system implications if there are higher rates of dementia among the large groups of patients undergoing ADT," the study concludes.
-end-
(JAMA Oncol. Published online October 13, 2016. doi:10.1001/jamaoncol.2016.3662. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: The article includes conflicts of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

The JAMA Network Journals

Related Prostate Cancer Articles:

ASCO and Cancer Care Ontario update guideline on radiation therapy for prostate cancer
The American Society of Clinical Oncology (ASCO) and Cancer Care Ontario today issued a joint clinical practice guideline update on brachytherapy (internal radiation) for patients with prostate cancer.
Patient prostate tissue used to create unique model of prostate cancer biology
For the first time, researchers have been able to grow, in a lab, both normal and primary cancerous prostate cells from a patient, and then implant a million of the cancer cells into a mouse to track how the tumor progresses.
Moffitt Cancer Center awarded $3.2 million grant to study bone metastasis in prostate cancer
Moffitt researchers David Basanta, Ph.D., and Conor Lynch, Ph.D., have been awarded a U01 grant to investigate prostate cancer metastasis.
New findings concerning hereditary prostate cancer
For the first time ever, researchers have differentiated the risks of developing indolent or aggressive prostate cancer in men with a family history of the disease.
Prostate cancer discovery may make it easier to kill cancer cells
A newly discovered connection between two common prostate cancer treatments may soon make prostate cancer cells easier to destroy.
More Prostate Cancer News and Prostate Cancer Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Anthropomorphic
Do animals grieve? Do they have language or consciousness? For a long time, scientists resisted the urge to look for human qualities in animals. This hour, TED speakers explore how that is changing. Guests include biological anthropologist Barbara King, dolphin researcher Denise Herzing, primatologist Frans de Waal, and ecologist Carl Safina.
Now Playing: Science for the People

#534 Bacteria are Coming for Your OJ
What makes breakfast, breakfast? Well, according to every movie and TV show we've ever seen, a big glass of orange juice is basically required. But our morning grapefruit might be in danger. Why? Citrus greening, a bacteria carried by a bug, has infected 90% of the citrus groves in Florida. It's coming for your OJ. We'll talk with University of Maryland plant virologist Anne Simon about ways to stop the citrus killer, and with science writer and journalist Maryn McKenna about why throwing antibiotics at the problem is probably not the solution. Related links: A Review of the Citrus Greening...