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Prostate cancer treatment and the relationship of androgen deprivation therapy to cognitive function

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Abstract

Prostate cancer is the second most common form of cancer in men. For advanced, high risk prostate cancer, androgen deprivation therapy (ADT) is the preferred treatment and can induce remission, but resistance to ADT brings biochemical recurrence and progression of cancer. ADT brings adverse effects such as erectile dysfunction, decreased libido, and diminished physical strength. It is estimated that between 25 and 50% of men on ADT manifest some form of cognitive dysfunction that may be self-reported or reported by a family member. There is concern that impaired cognitive function with ADT is due to loss of testosterone support. Testosterone and its metabolites are known to possess neuroprotective properties. While a direct causal relationship between ADT and cognitive decline in prostate cancer patients has not been established, this review describes the controversy surrounding the possible connection between ADT and neurocognitive deterioration. The cellular and molecular mechanisms believed to underlie the protection of neuronal integrity by androgens are discussed. Results from animal models and human clinical studies are presented. Finally, we call attention to lifestyle modifications that may minimize cognitive issues in prostate cancer patients.

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Acknowledgements

We thank Mr. Robert Buescher and Mr. Edmonds Bafford for their support.

Funding

This work was supported by the Alzheimer’s Foundation of America (Award # (AWD00004772) and The Herb and Evelyn Abrams Family Amyloid Research Fund.

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Authors and Affiliations

  1. Biomedical Research Institute, NYU Long Island School of Medicine, 101 Mineola Boulevard, Suite 4-004, Mineola, NY, 11501, USA

    A. B. Reiss, U. Saeedullah, D. J. Grossfeld, A. D. Glass, A. Pinkhasov & A. E. Katz

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  1. A. B. Reiss
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  2. U. Saeedullah
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  3. D. J. Grossfeld
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  4. A. D. Glass
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  5. A. Pinkhasov
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  6. A. E. Katz
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Contributions

Conceptualization: ABR, AP, AEK. Writing—original draft: ABR, DJG, US, ADG. Writing-review and editing: ABR, AP, AEK, DJG, US, ADG.

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Correspondence to A. B. Reiss.

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Reiss, A.B., Saeedullah, U., Grossfeld, D.J. et al. Prostate cancer treatment and the relationship of androgen deprivation therapy to cognitive function. Clin Transl Oncol 24, 733–741 (2022). https://doi.org/10.1007/s12094-021-02727-1

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  • DOI: https://doi.org/10.1007/s12094-021-02727-1

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