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Androgen-Deprivation Therapy May Harm Cognition

Physicians urged to monitor prostate cancer patients for treatment-related cognitive effects

WEDNESDAY, July 30 (HealthDay News) -- In men with prostate cancer, androgen-deprivation therapy may be associated with subtle but significant cognitive declines, according to a study published online July 29 in Cancer.

Christian J. Nelson, Ph.D., of the Memorial Sloan-Kettering Cancer Center in New York and colleagues conducted a systematic literature search on the relationship between testosterone and cognitive function and the possible adverse effects on cognitive function associated with androgen-deprivation therapy.

The researchers found animal and human studies that suggested testosterone and its derivatives affect cognition through several brain mechanisms. They also found well-designed but small studies that showed 47 percent to 69 percent of men on androgen-deprivation therapy experienced declines in at least one cognitive area, most commonly in visuospatial abilities and executive functioning.

"It is possible that neuropsychological tests may not be sensitive enough to detect changes in cognitive functioning or may not test the limits of cognitive function," the authors write. "Brain imaging may be useful to determine the extent of the impact of androgen-ablation therapy on cognition. It is also important to consider the clinical implications of these findings. It would be valuable for physicians who use androgen ablation to treat men with prostate cancer to be aware of this relation so they can inform patients and monitor them for possible side effects, as appropriate."

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