Does neoadjuvant hormone therapy for early prostate cancer affect cognition? Results from a pilot study.
OBJECTIVE
To examine, in a prospective study, the influence that temporary reversible medical castration for localized prostate cancer has on cognition, by assessing whether temporary 3-5 month treatment with a luteinizing-hormone releasing hormone (LHRH) agonist before radical radiotherapy had a short- or long-term affect on cognitive function.


METHODS
Thirty-two patients with localized prostate cancer had cognitive assessments at baseline (T1) before the start of drug treatment, at 3 months (T2) or on completing drug treatment but before radiotherapy, and 9 months later (T3). Eighteen men with no prostate cancer (controls subjects) completed the cognitive tests at the same times. In addition, psychological functioning and quality of life were assessed at the same times, together with serum free and bound testosterone, beta-oestradiol and sex hormone-binding globulin levels.


RESULTS
There was a significant cognitive decline (on at least one cognitive task) at T2 in 15 (47%) patients vs three (17%) of controls (odds ratio 4.412, P = 0.033). Most patients (nine of 15) who had a change in performance declined on tasks of spatial memory and ability. At T3 there was significant cognitive decline in 11 (34%) patients and five (28%) control subjects (odds ratio 1.37, P = 0.631).


CONCLUSIONS
This pilot study suggests that short-term LHRH therapy for early-stage prostate cancer has modest short-term consequences on men's cognitive functioning; a larger prospective study is warranted.
Jenkins
Valerie A
VA
Cancer Research UK, Psychosocial Oncology Group, Brighton & Sussex Medical School, University of Sussex, Brighton, UK. val@sussex.ac.uk
Bloomfield
David J
DJ
Shilling
Valerie M
VM
Edginton
Trudi L
TL
D000368:Aged; D000726:Androgen Antagonists / Q000009:adverse effects*; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D003072:Cognition Disorders / Q000139:chemically induced*; D017373:Cyproterone Acetate / Q000009:adverse effects*; D017273:Goserelin / Q000009:adverse effects*; D006801:Humans; D007360:Intelligence; D008297:Male; D008569:Memory Disorders / Q000139:chemically induced; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects*; D010865:Pilot Projects; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000523:psychology; D011788:Quality of Life; D013064:Speech Disorders / Q000139:chemically induced; D011795:Surveys and Questionnaires
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D017273:Goserelin; D017373:Cyproterone Acetate