Understanding prostate cancer hormone therapy “syndrome”

By Anne Harding

NEW YORK (Reuters Health) – Men with prostate cancer may be
put on hormone therapy, to block testosterone production in an
effort to halt or slow tumor growth. While some health effects
of so-called “androgen deprivation therapy” (ADT) for prostate
cancer are clearcut — for example sexual dysfunction — there
is this whole set of less specific, more vague symptoms, like
changes in mood, memory, feeling unwell, being tired. A new
study suggests that these symptoms are likely due to the fact
that the patients are older, sicker and have more advanced
disease.

“Androgen deprivation is probably not playing a big role in
causing these symptoms,” Dr. Vahakn B. Shahinian of the
University of Texas Medical Branch in Galveston told Reuters
Health.

Based on the findings, he added, the therapy should not be
avoided in patients for whom it is indicated based on concerns
that they will develop symptoms collectively known as “androgen
deprivation syndrome.”

Shahinian and colleagues assessed the rate of depression,
cognitive impairment or constitutional symptoms (weight loss,
fever, fatigue, malaise) in 50,476 men with prostate cancer and
50,476 men without the disease. They report their findings in
the Archives of Internal Medicine.

Among men who received ADT, 31 percent had at least one
diagnosis of depression, cognitive problems or constitutional
symptoms, compared to 24 percent of prostate cancer patients
who weren’t given the therapy, and 23 percent of the non-cancer
cohort.

However, after adjustment for age, other illnesses, stage
of disease and other relevant variables, the differences
between the prostate cancer groups either disappeared or were
greatly diminished.

After adjustment, men on the therapy were 8 percent more
likely to have a depression diagnosis, 1 percent less likely to
have cognitive impairment, and 17 percent more likely to have
constitutional symptoms.

Therefore, ADT is probably not a major player in causing
these symptoms, the authors conclude.

SOURCE: Archives of Internal Medicine February 27, 2006.