Association Between Androgen Deprivation Therapy and Risk of Dementia

Nead, Kevin T.; Gaskin, Greg; Chester, Cariad; Swisher‐McClure, Samuel; Leeper, Nicholas J.; Shah, Nigam H.

doi:10.1001/jamaoncol.2016.3662

Cited by 139 publications

(146 citation statements)

References 42 publications

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“…One caveat of the study is that a higher percentage of fatigued subjects received concomitant ADT (85%) compared to SF subjects (62.5%). Concomitant ADT use has been linked to impaired cognitive performance in prostate cancer patients [52, 53]. In addition, we have shown previously that ADT was a reliable clinical predictor of fatigue during radiation therapy for prostate cancer [5].…”

Section: Discussionmentioning

confidence: 99%

Association of Fatigue Intensification with Cognitive Impairment during Radiation Therapy for Prostate Cancer

Feng

Espina

Saligan³

2018

Oncology

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Purpose: Cancer-related fatigue is a common complaint during cancer treatment and is often associated with cognitive impairment. This study examined cognitive deficits that were associated with fatigue symptoms during external-beam radiation therapy (EBRT) in men with localized prostate cancer. Methods: A total of 36 participants were enrolled and followed up at baseline, 24 h, 7 days, 14 days after EBRT initiation, at midpoint, and at completion of EBRT. Fatigue was measured by self-report using the Functional Assessment of Cancer Therapy – Fatigue (FACT-F), and cognitive impairment by the Computer Assessment of Mild Cognitive Impairment (CAMCI®). Results: Subjects with increased fatigue during EBRT reported a significant decline in cognitive function and had difficulties with CAMCI®’s route finding and item recall tasks during EBRT. Increased fatigue during EBRT was associated with perceived cognitive difficulties in executive function and recognition memory, but not with attention or verbal memory. Conclusions: Our results suggest that there might be specific cognitive domains that are associated with increased fatigue during EBRT. These findings will provide important information for targeting specific cognitive domains using pharmacotherapy or behavioral interventions. CAMCI® is a valuable tool for psycho social providers to detect subtle cognitive impairment in fatigued cancer patients in a clinical setting.

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Section: Discussionmentioning

confidence: 99%

Association of Fatigue Intensification with Cognitive Impairment during Radiation Therapy for Prostate Cancer

Feng

Espina

Saligan³

2018

Oncology

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“…93 Studies examining the effects of ADT on cognitive functioning have yielded inconclusive results, 94–97 however a meta-analysis of 14 studies concluded ADT in patients with prostate cancer had a significant impact on visuomotor ability, 98 and ADT has been associated with increased risk for dementia. 99 …”

Section: Risk Factors For Crcimentioning

confidence: 99%

Cognitive Effects of Chemotherapy and Cancer-Related Treatments in Older Adults

Vega

Dumas

Newhouse

2017

The American Journal of Geriatric Psychiatry

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Advances in cancer treatment are producing a growing number of cancer survivors; therefore, issues surrounding quality of life during and following cancer treatment have become increasingly important. Chemotherapy-related cognitive impairment (CRCI) is a problem that is commonly reported following the administration of chemotherapy treatment in patients with cancer. Research suggests that CRCI can persist for months to years after completing treatment, which has implications for the trajectory of normal and pathologic cognitive aging for the growing number of long-term cancer survivors. These problems are particularly relevant for older individuals given that cancer is largely a disease of older age, and the number of patients with cancer who are age 65 years or older will increase dramatically over the coming decades. This review will briefly summarize empirical findings related to CRCI, discuss CRCI in older patients with cancer, potential causative hypotheses, and provide a canonical patient case to illustrate how CRCI presents clinically. Finally, potential intervention strategies for CRCI will be highlighted and issues to consider when evaluating older patients with a history of cancer will be discussed.

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“…Depression is common in patients with cancer, and men who are taking ADT may have a higher risk of depression 91 . The data suggesting that exposure to ADT is associated with an increased risk of cognitive decline are inconsistent 92–95 . While effective treatments for depression are available, there are no standardized interventions to reverse cognitive decline for this patient population.…”

Section: Resultsmentioning

confidence: 99%

Optimizing the role of androgen deprivation therapy in advanced prostate cancer: Challenges beyond the guidelines

et al. 2020

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Background For specific clinical indications, androgen deprivation therapy (ADT) will induce disease prostate cancer (PC) regression, relieve symptoms and prolong survival; however, ADT has a well‐described range of side effects, which may have a detrimental effect on the patient's quality of life, necessitating additional interventions or changes in PC treatment. The risk‐benefit analysis for initiating ADT in PC patients throughout the PC disease continuum warrants review. Methods A 14‐member panel comprised of urologic and medical oncologists were chosen for an expert review panel, to provide guidance on a more judicious use of ADT in advanced PC patients. Panel members were chosen based upon their academic and community experience and expertise in the management of PC patients. Four academic members of the panel served as group leaders; the remaining eight panel members were from Large Urology Group Practice Association practices with proven experience in leading their advanced PC clinics. The panel members were assigned to four separate working groups, and were tasked with addressing the role of ADT in specific PC settings. Results This article describes the practical recommendations of an expert panel for the use of ADT throughout the PC disease continuum, as well as an algorithm summarizing the key recommendations. The target for this publication is all providers (urologists, medical oncologists, radiation oncologists, or advanced practice providers) who evaluate and manage advanced PC patients, regardless of their practice setting. Conclusion The panel has provided recommendations for monitoring PC patients while on ADT, recognizing that PC patients will progress despite testosterone suppression and, therefore, early identification of conversion from castrate‐sensitive to castration resistance is critical. Also, the requirement to both identify and mitigate side effects of ADT as well as the importance of quality of life maintenance are essential to the optimization of patient care, especially as more combinatorial therapeutic strategies with ADT continue to emerge.

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Association Between Androgen Deprivation Therapy and Risk of Dementia

Abstract: Androgen deprivation therapy in the treatment of prostate cancer may be associated with an increased risk of dementia. This finding should be further evaluated in prospective studies.

Cited by 139 publications

References 42 publications

Association of Fatigue Intensification with Cognitive Impairment during Radiation Therapy for Prostate Cancer

Association of Fatigue Intensification with Cognitive Impairment during Radiation Therapy for Prostate Cancer

Cognitive Effects of Chemotherapy and Cancer-Related Treatments in Older Adults

Optimizing the role of androgen deprivation therapy in advanced prostate cancer: Challenges beyond the guidelines

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