Cognitive effects of hormone therapy in men with prostate cancer

Nelson, Christian J.; Lee, Jennifer S.; Gamboa, María Cecilia; Roth, Andrew

doi:10.1002/cncr.23658

Cited by 205 publications

(189 citation statements)

References 56 publications

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“…Section summary. Overall, consistent with findings from a previous review, 12 these three rather small studies indicate an appreciably reliable finding of impaired spatial memory and spatial abilities in men receiving ADT for prostate cancer compared to healthy controls. These deficits appeared during the third month of treatment with ADT but were not found again at 9 months regardless of whether the patient was still receiving ADT.…”

Section: Adt and Cognitionsupporting

confidence: 90%

“…11 A thorough review of the clinical literature was published in 2008 and indicated that although studies suffered from small sample sizes, there was a strong argument that ADT is linked to subtle but significant cognitive declines in men with prostate cancer. 12 Since that publication, new high-quality evidence has emerged, 13 warranting a reexamination of the data.…”

Section: According To the World Health Organization (Who) Internationalmentioning

confidence: 99%

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Cognitive changes associated with ADT: a review of the literature

Jamadar¹,

Winters²,

Maki³

2012

Asian J Androl

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The use of androgen deprivation therapy (ADT) has increased since the early 1990s after early detection efforts and greater use of the prostate-specific antigen (PSA) test. Although ADT is associated with favorable clinical outcomes, ADT has been associated with an increased risk for cardiovascular disease, increased serum cholesterol, triglycerides, insulin resistance, body mass index and fat body mass. Here we review findings from 11 clinical studies examining the effects of ADT on cognition as measured by standardized tests in cognitive domains such as verbal and spatial memory. Most of these studies have important limitations, including small sample sizes, suboptimal control groups and baseline group differences in confounding factors. Despite these limitations, the best designed studies, those comparing patients on ADT to healthy controls, generally suggest that spatial memory might be especially sensitive to the effects of ADT. Critically, to date there is only one study involving random assignment of ADT versus close clinical observation. That study revealed a decrease in verbal memory with ADT, but was limited in sample size and did not include a measure of spatial memory. A recent observational study revealed no substantial evidence of cognitive impairment with ADT, even in the domain of verbal memory. Like the randomized study, however, this large observational study lacked a measure of spatial memory. Overall, the studies with the best controls suggest a potential negative impact of ADT on spatial memory, and perhaps verbal memory, and a need for continued investigation of the impact of ADT on cognition, particularly in these two cognitive domains.

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Section: Adt and Cognitionsupporting

confidence: 90%

Section: According To the World Health Organization (Who) Internationalmentioning

confidence: 99%

Cognitive changes associated with ADT: a review of the literature

Jamadar¹,

Winters²,

Maki³

2012

Asian J Androl

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show abstract

“…73 Although there appear to be specific mechanisms for testosterone to directly impact cognition, it is possible that the side effects of androgen ablation therapy (e.g., hot flashes, fatigue and anaemia) may contribute indirectly to impaired cognition. Clearly, some findings have been inconsistent because of low sample size and inadequate controls.…”

Section: Cognitive and Affective Symptomsmentioning

confidence: 99%

“…73,75 Fatigue, sleep disturbance and depression PCa patients commonly state that fatigue, insomnia and depression are the most troublesome side effects of ADT. 76 Hot flashes have been specifically linked to insomnia and disrupted sleep patterns and have been shown to contribute to depression in the elderly patients on ADT.…”

Section: Cognitive and Affective Symptomsmentioning

confidence: 99%

Quality of life issues in men undergoing androgen deprivation therapy: a review

Casey¹,

Corcoran²,

Goldenberg³

2012

Asian J Androl

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Androgen deprivation therapy (ADT) has been an essential treatment option for treating prostate cancer (PCa). The role for hormonal treatment initially was restricted to men with metastatic and inoperable, locally advanced disease. Now it has been extended to neoadjuvant or adjuvant therapy for surgery and radiotherapy, for biochemical relapse after surgery or radiation, and even as primary therapy for non-metastatic disease. Fifty percent of PCa patients treated will receive ADT at some point. There is growing concern about the adverse effects and costs associated with more widespread ADT use. The adverse effects on quality of life (QoL), including physical, social and psychological well-being when men are androgen-deprived, may be considerable. This review examines the QoL issues in the following areas: body feminisation, sexual changes, relationship changes, cognitive and affective symptoms, fatigue, sleep disturbance, depression and physical effects. Further suggestions for therapeutic approaches to reduce these alterations are suggested.

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“…Several prior studies had shown declines due to ADT in executive functions and visuospatial abilities; however, previous studies have been inconsistent in their findings often suffering from low sample size and inadequate controls. 6 The effect of therapy on cognitive function has been a pertinent topic recently, with terms like 'chemo fog' and 'chemo brain' now routinely used to describe the cognitive effects of systemic chemotherapy. In their report, the authors presented a prospective matched cohort study to more conclusively answer this question.…”

mentioning

confidence: 99%