Navigation Links
Patients receiving ADT should be counseled to improve mental and emotional well-being
Date:1/23/2014

New York, NY, January 23, 2014 A new study published in the Journal of Urology reports that prostate cancer patients treated with androgen deprivation therapy (ADT) experienced changes in mental and emotional well-being during treatment, although there was no meaningful decline in emotional quality of life two years after treatment. Investigators at the University of California-San Francisco recommend counseling men about the potential adverse effects of ADT as well as the interventions to improve mental and emotional health such as exercise programs and diet.

Nearly 240,000 men were expected to be diagnosed with prostate cancer in the United States in 2013, with around 30,000 deaths. Treatment for prostate cancer is associated with significant physical side-effects. Some of these patients are likely to experience more adverse side-effects and complications from the treatment than from the cancer itself. Earlier studies have suggested that treatment may also affect mental and emotional health.

ADT, which suppresses the production of testosterone by either medical or surgical castration, remains the gold standard for treating advanced prostate cancer, either alone or with radiation therapy. Benefits include reduction of tumor burden, delayed cancer progression, and overall improvement in survival in some cases. However, ADT has a number of physical side-effects, including hot flashes, decreased libido, fatigue, decreased bone and muscle mass, increased total body fat content, and possible harmful cardiovascular effects.

Previous studies have reported cognitive and affective symptoms following ADT, particularly in the elderly. Symptoms include emotional upset (tearfulness, irritability, and anger), decreased motivation, hopelessness, and cognitive interruptions in attention, memory, and visual processing. Some studies have linked ADT use to depression, although it is not clear whether such effects are a direct consequence of ADT itself or perhaps associated with age, comorbidities, hot flashes, fatigue, and insomnia.

The current authors evaluated the effects of ADT on mental and emotional well-being in men diagnosed with localized prostate cancer using data from the CaPSURE (Cancer of the Prostate Strategic Urologic Research Endeavor) registry, which consists of data from largely community-based practices across the United States. Over 3,000 men completed a pretreatment and at least one posttreatment quality of life assessment checklist.

The authors focused on men newly diagnosed with localized (non-metastatic) prostate cancer in 1995-2011 and treated with radical prostatectomy, brachytherapy, radiation therapy, or primary androgen deprivation therapy (PADT). Of men included in the study 75% were treated with local therapy, 20% combination treatment, and five percent PADT. Among men in the PADT group, 84% were treated with luteinizing hormone-releasing hormone agonist monotherapy and 16% received combined androgen blockade.

Approximately 36% of patients reported some type of mental impairment at pretreatment evaluation, including depression, insomnia, confusion, poor concentration, sleep disturbances, nervousness, or poor memory. There were no overall differences in rates of mental health symptoms at diagnosis among treatment groups, although 18% of the PADT group reported poorer memory compared to 12% in the local group and 15% in the combination group.

Analysis demonstrated that exposure to ADT was associated with significant changes in mental and emotional well-being but did not result in clinically meaningful declines at 24 months. "These results could be related to men in the ADT group adapting to their symptoms over time, thus reporting improves scores," explains lead investigator Clint Cary, MD, MPH, of the Department of Urology at the University of California-San Francisco.

The most pronounced effect of ADT was on vitality. "This result corroborates other studies documenting fatigue among the most commonly reported side effects of ADT," says Cary. "It is not clear though whether the fatigue is a direct effect of ADT itself or a consequence of the physical side effects of ADT, such as sleep disturbances or hot flashes."

Cary recommends that patients are counseled on possible ADT-related quality of life changes, as well as ways to minimize these changes before treatment for prostate cancer. "All patients should be well informed about the potential adverse effects of ADT, and interventions to improve mental and emotional health such as exercise programs and dietary/lifestyles changes could be of particular importance," he concludes.


'/>"/>

Contact: Linda Gruner
jumedia@elsevier.com
212-633-3923
Elsevier Health Sciences
Source:Eurekalert

Related medicine news :

1. Getting a cancer drug to patients takes both scientific and business smarts
2. UCLA researchers develop risk calculator to predict survival in heart failure patients
3. 5 physicians honored for outstanding care of patients near the end of life
4. ROI grants $200,000 to evaluate the value of RT and patient outcomes among lung cancer patients
5. Dr. Todd McCracken Offers Dental Implants to Patients Resolving to Replace Missing Teeth This New Year in Denton, TX
6. North Shore-LIJ Completes Last Phase of $50M Upgrade of its Diagnostic Imaging Systems, $12M for GE Low-Dose CT Scanners to Reduce Patients’ Radiation Exposure
7. Long Island Prolotherapy Doctor Provides New York Pain Patients with Platelet-Rich Plasma Treatment
8. Colorectal Robotic Surgery Is Now Provided by Los Angeles Colon & Rectal Surgical Associates for All Patients
9. Patients with multiple sclerosis in Taiwan may be at increased risk of developing cancer
10. Soon to Be Published: New, Unique Guide for Plastic Surgery Patients
11. Dr. Kanani Announces Complimentary Consultations for First Time Patients
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:7/24/2017)... TX (PRWEB) , ... July 24, 2017 , ... ... student scholarship will be awarded for the fall semester to a deserving student. ... Emergency Centers Spring 2017 scholarship was awarded to Mariana Castillo who is a nursing ...
(Date:7/24/2017)... ... July 24, 2017 , ... Horizon Goodwill ... a unique opportunity that helps high school girls succeed in STEM programs as ... Horizon Goodwill will host over 20 high school girls at their corporate ...
(Date:7/24/2017)... ... ... The International Essential Tremor Foundation (IETF) will host a free educational forum in ... take place on Saturday, Aug. 26 at the Embassy Suites by Hilton Cleveland Rockside ... a.m. to 12 p.m., with check-in beginning at 8 a.m. The event is sponsored ...
(Date:7/24/2017)... (PRWEB) , ... July 24, 2017 , ... ... of media initiatives designed to promote awareness for Topricin’s revolutionary, natural, after-burn skin ... is one of the leading causes of long term skin conditions, including cancer. ...
(Date:7/24/2017)... ... July 24, 2017 , ... Puregraft, the global leader ... issuance of United States Patent Number 9,695,398 (the '398 patent) and South Korean ... '398 and '324 patents cover methods and systems for optimizing fat grafts for ...
Breaking Medicine News(10 mins):
(Date:7/17/2017)...  MedX Holdings, Inc., the manufacturer and global distributor ... equipment, today announced the national roll out of its ... gold standard for the treatment of low back injuries ... How it works: ... practice who prescribe the MedX Home Back Machine Program ...
(Date:7/14/2017)... , July 13, 2017 It should come ... States is in the midst of a crippling ... , since 1999, the number of overdose deaths from opiate-based ... in over half a million dead from 2001 to 2015". ... oxycodone, and hydrocodone has similarly quadrupled, drawing a compelling link ...
(Date:7/13/2017)...  New York City-based market research firm Kalorama Information notes ... of.  From new products to new costs, to the threat ... completed study, Potential Pipeline Disruptors . Among ... 1.  Age-Driven Growth - True Impact Moment Arriving   ... impact the growing population and, to a more extreme extent, ...
Breaking Medicine Technology: