Hormone therapy for prostate cancer may impair cognition

Washington, July 28 : New research from at Memorial Sloan-Kettering Cancer Center in New York City suggests that hormone deprivation therapy, which is commonly used to treat prostate cancer, may adversely affect cognition in patients.

The finding that hormone deprivation therapy may impair the ability to recall and concentrate in some patients results from a review of previous studies, appearing in the journal CANCER.

Dr. Christian Nelson, a psychologist behind the review, suggests clinicians and patients to be aware of such potential effects, and to watch closely for their appearance.

The Hormone deprivation therapy, also known as androgen depletion therapy, basically involves androgen depletion through chemical castration with drugs such as leuprolide and goserelin.

Prostate cancer patients who are prescribed these drugs often stay on them for the duration of their life, and the researchers have been documenting the potential adverse effects associated with their use.

Dr. Nelson and his colleagues have observed that men on such drugs may experience hot flashes, osteoporosis, anaemia, fatigue, loss of libido, erectile dysfunction, risk of diabetes, risk of cardiovascular disease, emotional distress, and other effects.

Their study also suggests that androgen depletion may impact cognitive functioning, which can affect a patient's decision-making skills and quality of life.

For their review, the researchers performed a systematic literature search of studies in animals and humans.

Dr. Nelson says that their review showed that testosterone and its derivatives might impact cognition through several mechanisms in the brain, such as modulating brain chemicals called neurotransmitters and stimulating the connections between neurons.

He says that studies that have examined the impact of androgen depletion therapy in prostate cancer patients indicate that between 47 and 69 per cent 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 researchers say that more thorough studies that include brain imaging techniques are needed to better understand the nature and extent of the cognitive effects of androgen depletion.

Besides, they are exploring the effectiveness of using androgen depletion therapy in men with rising levels of prostate specific antigen, a potential precursor to prostate cancer.

"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," the authors concluded.

ANI