Hormone therapy for prostate cancer can affect men’s thinking

A new study finds men treated with hormone therapy for prostate cancer may experience temporary cognitive changes that can affect verbal fluency, visual recognition and visual memory. The study, published in the April 1, 2005 issue of CANCER, a peer-reviewed journal of the American Cancer Society, finds the degree of cognitive dysfunction appeared to be related to a decline in serum estradiol brought on by hormonal treatment.

Androgen-deprivation therapy (AD) is an effective adjuvant therapy in the treatment of prostate cancer. It effectively reduces levels of testosterone, which acts as a tumor stimulant, and estradiol, a form of estrogen in men. Testosterone and estradiol are known to be important in neurological development and play a particularly important role in the cognitive areas of learning and memory. Previous studies in women have shown declining estradiol levels to effect cognition but until now little data existed in men.

Eeva Salminen, M.D. and colleagues at Turku University Hospital in Turku, Finland investigated the relationship between serum estradiol and cognitive functioning in men with prostate cancer treated with androgen-deprivation therapy.

They found cognitive performance in several specific areas were associated with declines in estradiol brought on by the therapy. Six months into treatment, men were found to have temporary, marginal but significant declines in visual memory of figures and recognition speed of numbers. Tests at twelve months showed marginal improvement in verbal fluency associated with estradiol declines. No other cognitive areas were affected. The degree of cognitive change was related to the magnitude of estradiol declines.

Despite these “selective and marginal” changes associated with estradiol declines, “cognitive function appears to be well preserved during 12 months AD in men without previous neurological or psychological diseases.”