BERKELEY, CA (UroToday.com) - Androgen suppression with anti-androgen and luteinizing hormone releasing hormone agonist-antagonist (LHRH) are used very commonly today, both in patients with metastatic disease and no metastatic disease, but thought by the clinician or patient to be at high risk for recurrence. At least 50 000 patients would have rising prostate specific antigen today with no symptoms and metastasis. Clinicians very often treat the PSA rather than the patient due concern of elevated PSA.
Over the past few years, we have begun to notice side-effects of hormone treatment including hot flashes, hypogonadism, increased risk for metabolic syndrome, anemia, osteoporosis, and possible risk for coronary artery disease. Memory loss has often been reported in patients. In our study, using standard test, we did not notice change in memory over a 1-year period. Additionally, we used a serum marker A beta amyloid 40 and 42, a marker of Alzheimer’s. There was a transient small elevation at 2 and 4 months, however, the exact significance of this, at this time, is not known.
Memory loss at this point, secondary to androgen suppression, is still an unanswered question. We need to test with more sophisticated tools, including more sensitive cognitive tests that include spatial and executive function, PET, and brain scans to document the changes. Additionally, a longer period of follow up is needed where we try to correlate with markers of androgen suppression such as testosterone, LH and FSH. I believe there are changes, however, and their significance needs to be documented objectively.
Written by:
Winston W. Tan, MD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Division of Hematology, Oncology, Cancer Center, GU Oncology, Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA
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