Prostate cancer treatment linked to dementia risk

Posted on 13th October 2016

JAMA Oncology: Association Between Androgen Deprivation Therapy and Risk of Dementia

New research has highlighted a possible link between a prostate cancer treatment called androgen deprivation therapy (ADT) and the risk of dementia. The findings are published today (Thursday 13 October) in the Journal JAMA Oncology.

Androgens are a group of male hormones that includes testosterone. These hormones play a number of important roles in the body but can also stimulate the growth of prostate cancer cells in those affected by the disease. Androgen deprivation therapy blocks the effect of androgens on prostate cancer cells and is one treatment approach doctors may use to tackle the disease. Previous research by the authors suggested a link between ADT and Alzheimer’s disease, the most common cause of dementia. Dementia can be caused by a number of different diseases and this study broadened the analysis to see whether the therapy might be associated with a risk of all types of dementia.

The researchers reviewed the medical records of 9,272 men with prostate cancer, including 1,826 who had received ADT, taking into account established dementia risk factors such as age and cardiovascular health. The team found that, five years on from a diagnosis of prostate cancer, patients who didn’t receive ADT had a 3.5% risk of developing dementia compared to a 7.9% risk for those who did receive the therapy. Patients who received the treatment for at least a year showed the highest increased risk of developing dementia. The researchers suggested some possible causes for a link between ADT and dementia risk, highlighting that blocking androgens could affect the health and growth of nerve cells in the brain.

Dr Laura Phipps of Alzheimer’s Research UK, said:

“This study is part of an active area of research into the role that sex hormones like testosterone could be playing in the brain in dementia. Studies like this, which take advantage of the rich data held in medical records, can be very useful for highlighting trends and potential risk factors for further research. While these results suggest a link between androgen deprivation therapy and an increased risk of dementia, they do not show that ADT is definitely causing this increased risk. We need to better understand the impact of sex hormones in the brain in diseases like Alzheimer’s to delve deeper into the possible reasons for this link.

“In the meantime, it is important to bear in mind that prostate cancer is a serious disease and any possible risks of ADT need to be carefully weighed against its role in treating prostate cancer.  If anyone receiving ADT has any concerns, they should seek advice from their doctor.

“Age is the biggest risk factor for dementia, with genetics and lifestyle also playing a role. The weight of current evidence suggests that eating a healthy and balanced diet, not smoking, staying mentally and physically active, and keeping weight and blood pressure in check can all contribute to maintaining a healthy brain as we age.”

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