Androgen deprivation affects memory in prostate cancer patients

Sex steroid loss and replacement affects specific cognitive processes in older men, according to the results of a study published in the January issue of the Journal of Urology.

“Little is known about the effect of androgen deprivation therapy on the brain despite the fact that sex steroid receptors are abundant in cortical brain regions that mediate memory and other cognitive functions,” Dr. Tomasz M. Beer, of Oregon Health and Science University, Portland, and colleagues write.The study included 18 androgen-independent prostate cancer patients starting second-line hormonal treatment with transdermal estradiol and two age-matched control groups (18 prostate cancer patients undergoing androgen deprivation and 17 healthy controls). Dr. Beer’s group assessed long-term memory, working memory, and Profile of Mood States at baseline and 4 weeks.Men with prostate cancer on androgen deprivation had significantly worse immediate and delayed verbal memory than healthy controls. Prostate cancer patients also took more time to complete the Trails A task, which indicated slower processing speed, but no significant differences were observed between men with prostate cancer and healthy controls in working memory tasks.Prostate cancer patients undergoing androgen deprivation also exhibited significantly more fatigue and confusion, and less vigor. No differences were observed on other affective measures.In individual repeated measures analyses, men treated with estradiol therapy showed improved verbal memory performance, but verbal memory performance did not change in the two control groups.”There is a critical need to rapidly expand our understanding of the effects of androgen deprivation therapy on the human brain,” Dr. Beer’s team concludes. “While it is premature to recommend parenteral estradiol as an alternative to conventional androgen deprivation therapy, these data support the further study of this novel method of prostate cancer hormonal therapy.”(Source: J Urol 2006;175:130-135: Reuters Health: Oncolink: January 2005.)