Studies Continue to Examine Androgen-Deprivation Therapy (ADT) and Dementia Risk

Androgen deprivation therapy (ADT), also called hormonal therapy, may be used in men who have prostate cancer that has spread too far to be cured by surgery or radiation, or if their cancer comes back after treatment with surgery or radiation. Observational studies have found conflicting results on whether the use of ADT – and whether the length of ADT use – increases the risk of developing dementia.

One recent study included 30,093 patients in the UK newly diagnosed with non-metastatic prostate cancer.1 During a mean follow-up of 4.3 years, researchers compared dementia rates amongst the groups of men who used or did not use ADT. They did not find an association between ADT and an increased risk of dementia, including Alzheimer’s disease.

However, a different study found that ADT used to treat prostate cancer may be associated with an increased risk of dementia.2 The study included 9,272 men with prostate cancer, 1,826 (19.7%) of whom received ADT. The study followed the men for a median of 3.4 years. They found the absolute increased risk of developing dementia among the men who had ADT was 4.4% at 5 years (7.9% among men who received ADT compared to 3.5% in men who did not have ADT). The greatest absolute risk of dementia occurred in men with at least 12 months of ADT. Results were similar when excluding patients with Alzheimer’s disease.

The authors of both studies said that their findings should be further evaluated in prospective studies.

1. J Clin Oncol. 2017 Jan 10;35(2):201-207. Epub 2016 Nov 21.
2. JAMA Oncol. 2017 Jan 1;3(1):49-55. doi: 10.1001/jamaoncol.2016.3662.

Exercise Can Improve Fatigue for Patients on Androgen Deprivation Therapy

Physical exercise alleviates fatigue for men on androgen deprivation therapy (ADT) for prostate cancer. In a new study, 163 prostate cancer patients undergoing ADT were randomized to resistance training plus either impact loading or aerobic exercise. Resistance training impacted the patient’s muscular systems, impact loading targeted the skeletal system and aerobic exercise targeted the cardiovascular system.

Patients in both exercise programs had reduced fatigue and improved vitality, with the biggest effect seen in men who started with the highest levels of fatigue and lowest levels of vitality.

Eur Urol. 2017 Feb 26. pii: S0302-2838(17)30108-2. doi: 10.1016/j.eururo.2017.02.019. [Epub ahead of print]