Androgen Deprivation Therapy and Mental Health: Impact on Depression and Cognition

Izard, Jason

doi:10.1016/j.euf.2019.11.010

Cited by 24 publications

(20 citation statements)

References 15 publications

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“…Another population‐based study have found the risk of depression to be associated with the prognosis of the disease, concurring with our results of an increased cumulative incidence of depression among those with metastases or high‐risk profile of the disease at diagnosis 5 . This may be related to the significant association between the risk of depression and treatment with androgen deprivation therapy 32,33 …”

Section: Discussionsupporting

confidence: 90%

Risk of depression after diagnostic prostate cancer workup – A nationwide, registry‐based study

et al. 2021

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Objective To compare the risk of depression after diagnostic workup for prostate cancer (PCa), regardless of the histopathologic outcome, with that of a cancer‐free population. Methods A nationwide cohort of Danish men who had a prostatic biopsy sample in 1998–2011 was identified from the Danish Prostate Cancer Registry and compared to an age‐matched cohort from the background population. Men with other cancers, major psychiatric disorder, or prior use of antidepressants were excluded. The risk of depression defined as hospital contact for depression or prescription for antidepressants was determined from cumulative incidence functions and multivariate Cox regression models. Results Of 54,766 men who underwent diagnostic workup for PCa, benign results were found for 21,418 and PCa was diagnosed in 33,347. During up to 18 years of follow‐up, the adjusted hazard of depression was higher in men with PCa than in the background population, with the highest risk in the two years after diagnosis (hazard ratio (HR) 2.77, 95% CI 2.66–2.87). Comorbidity and lowest or highest income were significant risk factors for depression and the cumulative incidence was substantially higher in men with metastatic or high‐risk disease. In men with benign histopathology the HR for depression was 1.22 (95% CI 1.14–1.31) in the first two years but no different from the background population after that. Conclusions Diagnostic workup for PCa is associated with an increased risk of depression, mainly among men with a diagnosis of PCa. Clinicians should be aware of depressive symptoms in prostate cancer patients.

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Section: Discussionsupporting

confidence: 90%

Risk of depression after diagnostic prostate cancer workup – A nationwide, registry‐based study

et al. 2021

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“…Another study revealed a beneficial effect of testosterone supplementation on cognition in a placebo-controlled comparative study using 57 healthy men with normal testosterone levels [ 17 ]. However, unfortunately not all patients' testosterone levels and hypogonadal states were reversible with testosterone supplementation even after the cessation of ADT [ 18 ]. Some clinical studies also reported negative results of testosterone supplementation for the prevention of early cognitive dysfunction [ 19 ].…”

Section: Main Bodymentioning

confidence: 99%

“…Some clinical studies also reported negative results of testosterone supplementation for the prevention of early cognitive dysfunction [ 19 ]. Thereby, the direct effects of ADT on mental health in patients with PC are challenging to determine because of the multiple factors influencing cognitive function, such as age, marital status, retirement status, number of comorbidities, previous history of depression, and the disease state of PC [ 18 20 ].…”

Section: Main Bodymentioning

confidence: 99%

How Does Androgen Deprivation Therapy Affect Mental Health including Cognitive Dysfunction in Patients with Prostate Cancer?

Lee

Park

Joung

et al. 2021

World J Mens Health

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Androgen deprivation therapy (ADT) is used to block the release of androgen in prostate cancer to promote the regression of cancer cells, and hence, disease progression. Its indication has been widened from the metastatic setting to the localized setting in prostate cancer. Long-term ADT for suppressing androgen release leads to a rapid decrease in androgen, termed as andropause, resulting in several dose and duration dependent adverse effects, including cognitive dysfunction such as dementia. Many retrospective and prospective studies, as well as meta-analyses, have attempted to confirm the crucial relationship between ADT and cognitive dysfunction, but pro and contrary opinions regarding this issue are ongoing owing to the absence of randomized controlled trials. Additionally, several recent studies have suggested the negative effects of dose-and duration-dependent ADT on cognitive dysfunction, especially in 40-65-year-old patients with prostate cancer, who are currently active workers in the society. This review article discusses several studies examining the influence of ADT on mental health based on diverse significant perspectives, especially cognitive dysfunction.

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“…Multiple recent clinical trials have demonstrated life-prolonging benefits of abiraterone acetate, enzalutamide, apalutamide, and docetaxel when added to ADT for patients with hormone-sensitive and castration-resistant metastatic prostate cancer ( 23 – 25 ). The toxicities of ADT and novel hormonal agents—decreased bone density, increased risk of cardiovascular events, sexual dysfunction and neuropsychiatric symptoms—support the need for integrating metastasis-directed therapies into the treatment paradigm ( 26 , 27 ). The success of SBRT in palliating painful metastatic bone lesions and its favorable toxicity profile led to increasing interest in SBRT for patients with limited metastatic disease with the goal of either sparing patients the toxicity from systemic therapies or augmenting the effects of existing systemic therapy without leading to undue toxicity (see Table 1 ).…”

Section: Sbrt For Metastatic Prostate Cancermentioning

confidence: 99%

Translating the Immunobiology of SBRT to Novel Therapeutic Combinations for Advanced Prostate Cancer

et al. 2020

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Stereotactic body radiotherapy (SBRT) is an increasingly used radiation modality for the treatment of both localized and metastatic prostate cancer. Substantial data suggests that prostate cancer may be more sensitive to higher doses of radiation per fraction due to its low α/β ratio. This increased sensitivity raises important questions as to how SBRT should be combined with systemic therapy for clinically significant prostate cancer, including whether androgen deprivation therapy retains its beneficial effects when combined with SBRT. Furthermore, pre-clinical and clinical data suggest pronounced immunomodulatory effects of SBRT, including observed improvements in T cell priming and trafficking. These data support investigational strategies combining SBRT with immunotherapy. Here we aim to review the data for the use of SBRT in both the local and metastatic disease settings as well as ongoing translational and clinical research examining combinations with ADT, immunotherapy and other targeted agents.

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Androgen Deprivation Therapy and Mental Health: Impact on Depression and Cognition

Cited by 24 publications

References 15 publications

Risk of depression after diagnostic prostate cancer workup – A nationwide, registry‐based study

Risk of depression after diagnostic prostate cancer workup – A nationwide, registry‐based study

How Does Androgen Deprivation Therapy Affect Mental Health including Cognitive Dysfunction in Patients with Prostate Cancer?

Translating the Immunobiology of SBRT to Novel Therapeutic Combinations for Advanced Prostate Cancer

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