Effects of androgen deprivation therapy on cognitive functions in patients with metastatic prostate cancer: A multicentric, prospective study of the Society of Urological Surgery Andrology group

Abstract

Aims of the study The aim of this study was to investigate the impact of testosterone deficiency on cognitive functions in metastatic prostate cancer patients receiving androgen deprivation therapy (ADT). Methods In this multicentric prospective study, 65 metastatic prostate cancer patients were evaluated. Demographic and clinical data were recorded. Cognitive functions were assessed using the Symbol Digit Modalities Test, the California Verbal Learning Test Second Edition, the Brief Visuospatial Memory Test—Revised, and the Trail Making Test. Depressive symptoms were assessed using the Beck Depression Inventory. Cognitive functions and depressive symptoms were recorded before the androgen deprivation therapy and at the 3‐ and 6‐month follow‐ups. Results At the basal cognitive assessment, the mean Symbol Digit Modalities Test, the California Verbal Learning Test Second Edition, the Brief Visuospatial Memory Test—Revised scores were 25.84 ± 17.54, 32.68 ± 10.60, and 17.63 ± 11.23, respectively, and the mean time for the Trail Making Test was 221.56 ± 92.44 seconds, and were similar at the 3‐month, and 6‐month controls (P > .05). The mean pretreatment, third and sixth month testosterone levels were 381.40 ± 157.53 ng/dL, 21.61 ± 9.09 ng/dL and 12.25 ± 6.45 ng/dL (P < .05), and the total PSA levels were 46.46 ± 37.83 ng/mL, 1.41 ± 3.31 ng/mL and 0.08 ± 0.14 ng/mL (P < .05), respectively. Conclusion The ADT in patients with metastatic prostate cancer does not affect patients’ cognitive functions and depressive symptoms. However, further prospective randomised studies with higher cohorts and longer follow‐up periods are needed.

Does hormone therapy impact cognition in patients with prostate cancer? A systematic review and meta‐analysis

“…The database search provided 685 records. After the removal of duplicates, screening, and full‐text assessment, 30 reports 28–57 from 20 studies were selected for the systematic review (Figure 1). Among these 20 studies, eight did not provide sufficient data to be included in the meta‐analysis.…”

“…Among these 20 studies, eight did not provide sufficient data to be included in the meta‐analysis. Data from three studies were retrieved after contacting the authors, and the meta‐analysis finally included 22 reports 30–45,50–52,54,55,57 from 15 studies.…”

A review of the objective cognitive function measurements in males receiving hormonal therapy for prostate cancer

“…Several studies concluded no influence of ADT on cognitive function [ 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 ], and these are listed in the table below ( Table 3 ) [ 27 32 34 36 37 39 40 42 43 44 45 50 52 53 54 56 ].…”

The Roles of Androgens in Humans: Biology, Metabolic Regulation and Health

“…The high occurrence of prostate cancer and the implication of the AR signaling in its growth [ 124 , 138 ] resulted in the need to find drugs able to sustain most of the anabolic and protein-protective functions of T because of the limited (or counterproductive) benefits of T deprivation [ 139 , 140 , 141 , 142 ]. These efforts resulted in the development of a large number of selective AR modulators (SARM) [ 143 , 144 ].…”