title: Impact of androgen deprivation therapy on mental and emotional well-being in men with prostate cancer: analysis from the CaPSURE™ registry.
abstract: OBJECTIVE
  While androgen deprivation therapy can delay cancer progression and reduce tumor burden, its use can be limited by adverse side effects. We evaluated the effect of androgen deprivation therapy on mental and emotional well-being in men with nonmetastatic prostate cancer.
  
  
  METHODS
  Participants were enrolled in the national CaPSURE (Cancer of the Prostate Strategic Urologic Research Endeavor) registry, and treated with radical prostatectomy, external beam radiation therapy or brachytherapy with no androgen deprivation therapy (local); local with androgen deprivation therapy (combination); or primary androgen deprivation therapy. Emotional quality of life was evaluated by SF-36® social function, role emotional, vitality and mental health subscales before and up to 24 months after treatment. Subscales were assessed as continuous scores and as clinically meaningful declines of at least half a standard deviation since pretreatment. Associations between treatment and quality of life changes over time were evaluated with mixed modeling. Quality of life declines were evaluated with logistic regression.
  
  
  RESULTS
  Among 3,068 men the combination and primary androgen deprivation therapy groups were older, single, with less education and higher clinical CAPRA (Cancer of the Prostate Risk Assessment) score risk than the local group (all values p <0.01). Androgen deprivation therapy exposure was associated with significant changes with time in adjusted role emotional (-8.4 points, p = 0.01) and vitality (-9.2 points, p = 0.02) scores. Treatment group was not associated with any clinically meaningful quality of life declines. A potential limitation is the observational nature of the study.
  
  
  CONCLUSIONS
  Use of androgen deprivation therapy was associated with changes in mental and emotional well-being but did not result in clinically meaningful declines at 24 months. Patients must be counseled on possible quality of life changes related to androgen deprivation therapy as well as interventions to attenuate these effects before receiving treatment for prostate cancer.
authors.affiliation: Department of Urology, University of California, San Francisco and UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California. Electronic address: clintcary20@gmail.com.
authors.forename: K Clint
authors.initials: KC
authors.lastname: Cary
authors.affiliation: Department of Urology, University of California, San Francisco and UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California.
authors.forename: Nirmish
authors.initials: N
authors.lastname: Singla
authors.affiliation: Department of Urology, University of California, San Francisco and UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Cowan
authors.affiliation: Department of Urology, University of California, San Francisco and UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Carroll
authors.affiliation: Department of Urology, University of California, San Francisco and UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Cooperberg
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D004644:Emotions; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000523:psychology*; D011788:Quality of Life; D012042:Registries
chemical_list: D000726:Androgen Antagonists
keywords: androgens; personal satisfaction; prostatic neoplasms; quality of life