Prostate-Specific Antigen and Testosterone Levels as Biochemical Indicators of Cognitive Function in Prostate Cancer Survivors and the Role of Diabetes

Abstract

Prostate cancer (PC) is one of the most common malignancies in men. The increase in the number of PC survivors is associated with many problems including cognitive impairment. Early detection of such problems facilitates timely protective intervention. This study examined the association between prostate-specific antigen (PSA) or testosterone (T) levels and cognitive function in patients undergoing radical prostatectomy. Such a correlation could help identify patient groups at risk of cognitive impairment. Participants underwent clinical (demographic data, medical history, physical examination, and blood analyses) and neuropsychological assessment (cognitive test battery). Preoperative PSA or T levels were not associated with cognitive function. However, long-term follow-up after prostatectomy showed a strong correlation between PSA levels and the results of verbal memory and executive function tests. A trend toward significance was also observed for visuospatial memory. The levels of free T and total T were not correlated with cognitive function. Only the levels of free T after hormonal treatment were significantly correlated with executive functions. Comorbid diabetes affected these correlations. In conclusion, PSA levels at a distant postoperative time and free T level after hormonal treatment may be biomarkers of cognitive function.

Androgen Deprivation Therapy for Prostate Cancer: Focus on Cognitive Function and Mood

“…A study from Japan of older men found that higher salivary testosterone concentration measured by immunoassay was associated with better global cognitive function [75]. In a study of prostate cancer patients from Poland, higher testosterone levels in those who had received ADT were associated with better cognitive function based on neuropsychological assessment [76]. These findings support the influence of androgens such as testosterone on cognitive function and the potential of cognitive disruption with anti-androgen treatment.…”

A genome-wide association study with tissue transcriptomics identifies genetic drivers for classic bladder exstrophy

“…Markers in the region of EFNA1, DPM3, SLC50A1 have previously been associated with prostate cancer risk 16 . Prostate cancer risk on the other side correlates with serum testosterone levels 17 . All of these observations suggest a possible gene-environmental interaction for this region.…”