Navigation Links
Patients receiving ADT should be counseled to improve mental and emotional well-being

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
Elsevier Health Sciences

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:
(Date:11/25/2015)... ... ... Dr. John Pierce, Medical Director at the Ageless Forever clinic in Las ... Pro laser therapy cap. FDA cleared for safety and efficacy, the Capillus272 offers men ... surgery, prescription pills, or topical foams. , “Capillus272™ Pro is a home-use device ...
(Date:11/25/2015)... ... November 25, 2015 , ... For the first time, ... Two Organizations, One Beat ” campaign. The partnership between the two groups began in ... in MAP International’s cause. , MAP International was founded in 1954 and is an ...
(Date:11/25/2015)... ... November 25, 2015 , ... Dental professionals who would ... OH , are invited to attend Dr. Mark Iacobelli’s Advanced Implant Mentoring (AIM) CE ... Cleveland, OH. , As the co-founders of Advanced Implant Mentoring (AIM), Dr. Iacobelli ...
(Date:11/25/2015)... ... 25, 2015 , ... The McHenry County law firm of Botto Gilbert ... Attorneys Francisco J. Botto and Alex C. Wimmer. Attorneys Botto and Wimmer represented the ... App (2d) 130884WC. , According to court documents, Adcock testified that on May 10, ...
(Date:11/25/2015)... ... November 25, 2015 , ... SCOTTSDALE, AZ) ... plastic surgeon specializing in both surgical and non-surgical treatments, announced the expansion of ... Hobgood Facial Plastic Surgery. , Highly trained and nationally recognized for his ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)... Nov. 25, 2015  ARKRAY USA ... to provide evidence demonstrating the accuracy of its blood ... on Insulin Resistance, Diabetes and Cardiovascular Disease in ... the Company,s GLUCOCARD ® 01 meter and the ... requirements. The ability to accurately measure glucose levels in ...
(Date:11/25/2015)... Kitov Pharma ceuticals ... biopharmaceutical company focused on the development of therapeutic candidates ... announced the closing of its previously announced underwritten public ... each representing 20 ordinary shares of the Company, and ... and warrants were issued in a fixed combination of ...
(Date:11/25/2015)... -- Trovagene, Inc. (NASDAQ: TROV ), a developer of ... Antonius Schuh, Ph.D., is scheduled to present a corporate ... Healthcare Conference. th Annual Piper Jaffray ... New York on Tuesday, December ... be available for one-on-one meetings during the conference. The ...
Breaking Medicine Technology: