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

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

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