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Published on 28 July 2008

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Hormone therapy may lead to decrease in cognitive ability


A recent review has warned that clinicians and patients should be aware of a potential decrease in cognitive abilities associated with hormone deprivation therapy.

Hormone deprivation therapy – also known as androgen depletion therapy – has been used as an effective treatment for prostate cancer. The most common way to achieve androgen depletion is through chemical castration with drugs such as leuprolide and goserelin.

Prostate cancer patients who are prescribed these drugs often stay on them for life, and researchers have documented that men may experience osteoporosis, anaemia, fatigue, loss of libido, erectile dysfunction and are at increased risk of cardiovascular disease.

Only a handful of relatively small studies have investigated the impact of androgen depletion on cognitive functioning, and some of these studies have reported contradictory results.

Dr Christian Nelson, a psychologist at Memorial Sloan-Kettering Cancer Centre in New York, and his colleagues recently conducted the first review of these studies and summarised their overall results.

Dr Nelson’s team found that testosterone and its derivatives may impact cognition via several mechanisms in the brain.

For example, testosterone can modulate brain chemicals called neurotransmitters and stimulate the connections between neurons.

Also, studies that have examined the impact of androgen depletion therapy indicate that between 47% and 69% of men being treated decline in at least one cognitive area.

The study is published in the 1 September 2008 issue of Cancer, the journal of the American Cancer Society.

American Cancer Society

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