期刊
CLINICAL & TRANSLATIONAL ONCOLOGY
卷 24, 期 5, 页码 733-741出版社
SPRINGER INT PUBL AG
DOI: 10.1007/s12094-021-02727-1
关键词
Androgen deprivation therapy; Cognitive function; Prostate cancer; Hormonal therapies; Management strategies; Testosterone
类别
资金
- Alzheimer's Foundation of America [AWD00004772]
- Evelyn Abrams Family Amyloid Research Fund
ADT is a preferred treatment for advanced prostate cancer, but it can lead to cognitive dysfunction possibly due to reduced testosterone support. While the direct causal relationship is not established, there is controversy surrounding the connection between ADT and neurocognitive deterioration. Studies on the protective mechanisms of androgens on neuronal integrity are discussed, along with lifestyle modifications to minimize cognitive issues in prostate cancer patients.
Prostate cancer is the second most common form of cancer in men. For advanced, high risk prostate cancer, androgen deprivation therapy (ADT) is the preferred treatment and can induce remission, but resistance to ADT brings biochemical recurrence and progression of cancer. ADT brings adverse effects such as erectile dysfunction, decreased libido, and diminished physical strength. It is estimated that between 25 and 50% of men on ADT manifest some form of cognitive dysfunction that may be self-reported or reported by a family member. There is concern that impaired cognitive function with ADT is due to loss of testosterone support. Testosterone and its metabolites are known to possess neuroprotective properties. While a direct causal relationship between ADT and cognitive decline in prostate cancer patients has not been established, this review describes the controversy surrounding the possible connection between ADT and neurocognitive deterioration. The cellular and molecular mechanisms believed to underlie the protection of neuronal integrity by androgens are discussed. Results from animal models and human clinical studies are presented. Finally, we call attention to lifestyle modifications that may minimize cognitive issues in prostate cancer patients.
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