Featured Research

from universities, journals, and other organizations

Patients receiving ADT should be counseled to improve mental, emotional well-being

Date:
January 23, 2014
Source:
Elsevier Health Sciences
Summary:
A new study 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 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.

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.


Story Source:

The above story is based on materials provided by Elsevier Health Sciences. Note: Materials may be edited for content and length.


Journal Reference:

  1. K. Clint Cary, Nirmish Singla, Janet E. Cowan, Peter R. Carroll, Matthew R. Cooperberg. Impact of Androgen Deprivation Therapy on Mental and Emotional Well-Being in Men with Prostate Cancer: Analysis from the CaPSURE (Cancer of the Prostate Strategic Urologic Research Endeavor) registry. The Journal of Urology, 2013; DOI: 10.1016/j.juro.2013.10.098

Cite This Page:

Elsevier Health Sciences. "Patients receiving ADT should be counseled to improve mental, emotional well-being." ScienceDaily. ScienceDaily, 23 January 2014. <www.sciencedaily.com/releases/2014/01/140123222340.htm>.
Elsevier Health Sciences. (2014, January 23). Patients receiving ADT should be counseled to improve mental, emotional well-being. ScienceDaily. Retrieved July 29, 2014 from www.sciencedaily.com/releases/2014/01/140123222340.htm
Elsevier Health Sciences. "Patients receiving ADT should be counseled to improve mental, emotional well-being." ScienceDaily. www.sciencedaily.com/releases/2014/01/140123222340.htm (accessed July 29, 2014).

Share This




More Health & Medicine News

Tuesday, July 29, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Generics Eat Into Pfizer's Sales

Generics Eat Into Pfizer's Sales

Reuters - Business Video Online (July 29, 2014) Pfizer, the world's largest drug maker, cut full-year revenue forecasts because generics could cut into sales of its anti-arthritis drug, Celebrex. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
Nigeria Ups Ebola Stakes on 1st Death

Nigeria Ups Ebola Stakes on 1st Death

Reuters - Business Video Online (July 29, 2014) Nigerian authorities have shut and quarantined a Lagos hospital where a Liberian man died of the Ebola virus, the first recorded case of the highly-infectious disease in Africa's most populous economy. David Pollard reports Video provided by Reuters
Powered by NewsLook.com
Running 5 Minutes A Day Might Add Years To Your Life

Running 5 Minutes A Day Might Add Years To Your Life

Newsy (July 29, 2014) According to a new study, just five minutes of running or jogging a day could add years to your life. Video provided by Newsy
Powered by NewsLook.com
Ebola Outbreak Poses Little Threat To U.S.: CDC

Ebola Outbreak Poses Little Threat To U.S.: CDC

Newsy (July 29, 2014) The Ebola outbreak in West Africa poses little threat to Americans, according to officials with the Centers for Disease Control and Prevention. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins