Androgen Deprivation Therapy Dementia Risks

Studies Tie Androgen Deprivation Therapy (ADT) with Dimentia. Our firm is investigating potential lawsuits on behalf of patients who have suffered dementia or other cognitive dysfunction issues after receiving androgen deprivation therapy (ADT) for the treatment of prostate cancer.

The prostate gland makes seminal fluid (semen) and lies just below the bladder in front of the rectum, surrounding the urethra. The urethra is the tube that carries urine and semen through the penis and out of the body, according to the National Cancer Institute (NCI)

After skin cancer, prostate cancer is the most common cancer in men in the United States and is the second leading cause of death from cancer in men, the NCI notes.

Prostate cancer occurs more often in African-American men than in Caucasian men

Prostate cancer occurs more often in African-American men than in Caucasian men and, African-American men diagnosed with prostate cancer are likelier to die from the disease than Caucasian men diagnosed with prostate cancer.

Nearly all prostate cancers are adenocarcinomas, which means that they are cancers that begin in cells that create and release mucus and other fluids, according to NCI.

Typically, prostate cancer has no early symptoms; however, once it becomes advanced, men may experience increased urination or a decreased urine flow, which are also signs of benign prostate conditions.

Prostate cancer is typically slow moving and most men diagnosed with the disease are older than 65 years of age and do not die from the cancer. Of note, discovering and treating prostate cancer before symptoms appear may not improve health or increase longevity; however, the NCI points out that determining risks for the disease and determining if screening tests are needed are important topics to be discussed with a physician.

ADT (Androgen Deprivation Therapy) use has risen significantly in the past few decades. As of October 2016, some 500,000 men receive ADT as a treatment for prostate cancer in the United States, CancerNetwork reports.

In research, androgens have been shown to play a part in both the health and maintenance of the neurons in the central nervous system and testosterone analogs, which have been shown to have a neuroprotective function.

This indicates a potential mechanism for the way in which ADT may impact dementia development, according to CancerNetwork, citing a recent study.

ADT, a key treatment for men diagnosed with prostate cancer, may also increase risks for dementia-including senile dementia, vascular dementia, frontotemporal dementia, and Alzheimer dementia-according to a study published in JAMA Oncology, wrote CancerNetwork.com. According to the recent study, there is increasing support of the ADT-dementia link.

The researchers sought to determine if evidence exists of an association between ADT

The researchers sought to determine if evidence exists of an association between ADT use in prostate cancer treatment and future dementia and if the so-called “clinical informatics tools” may be applied that may help identify relevant demographics, wrote The JAMA Network.

“ADT has a demonstrated survival benefit in some patients with prostate cancer. However, it also has been linked to several adverse health effects,” study authors, led by Kevin T. Nead, MD, of Stanford University School of Medicine, Stanford, California, wrote in October 2016. “A growing body of evidence supports a link between ADT and cognitive dysfunction, including Alzheimer disease.”

Cancer Network reported that researchers analyzed medical records for prostate cancer patients who were treated at an academic medical center between 1994 and 2013. The final study cohort involved 9,272 men diagnosed with prostate cancer and who did not have a prior dementia diagnosis.

This cohort study applied “a novel text-processing analytic approach to the electronic medical records of” the 9272 individuals diagnosed with prostate cancer, JAMA Network explained. Of these men, 1,826 patients received ADT as part of their treatment.

The mean age of the study participants was 66.9 years. Over half of the men-58.8 percent-were Caucasian, wrote CancerNetwork.

The researchers found that, following a median follow-up of 3.4 years, 314 cases of dementia were diagnosed. The study authors also found a statistically significant association between ADT use and risk of dementia.

The median time frame to diagnosis of dementia was four years

The median time frame to diagnosis of dementia was four years. Meanwhile, the risk of developing dementia at five years in men treated with ADT was 7.9 percent compared to a risk of 3.5 percent in men who were not treated with ADT.

Men who received ADT for at least one year experienced the greatest absolute risks for dementia. Similar results were seen when men who received chemotherapy were excluded from the study, according to CancerNetwork. Men treated with ADT who were 70 years or older experienced the “lowest cumulative probability of remaining dementia free,” according to a Kaplan-Meier analysis.

JAMA Network explained that the researchers concluded that the statistically significant association between ADT and increased risk of dementia means that future prospective studies must be conducted to further investigate this association and if the risk tied to ADT contributes to dementia more broadly.

“We show a dose response effect between greater duration of use of ADT and increased risk of dementia. Finally, we find that use of ADT increases the risk of dementia regardless of age, but that older men receiving ADT were the least likely to remain dementia free,” the authors wrote.

“This finding should be investigated in prospective studies given significant individual patient and health system implications if there are higher rates of dementia among the large group of patients undergoing ADT,” the study authors concluded.

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