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ADT may cause short-term changes in emotional quality of life
The use of androgen deprivation therapy may be linked to changes in emotional and mental well-being among men with localized prostate cancer, according to study results.
Notably, however, no clinically meaningful decrements in emotional quality of life were observed seen at 2 years after treatment with ADT.
Researchers analyzed data from 3,068 men enrolled in the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) registry. The patients, who were newly diagnosed with localized prostate cancer, underwent radical prostatectomy, external beam radiation therapy, brachytherapy or primary ADT. Of the patients identified for evaluation, 75% were on a regimen of local therapy, 20% underwent combination treatment and 5% received primary ADT.
Eighty-four percent of patients in the primary ADT group underwent luteinizing hormone-releasing hormone agonist monotherapy, whereas 16% were treated with combined androgen blockade. Patients in the combination and primary ADT groups were older, more likely to be single, and had less education and higher Cancer of the Prostate Risk Assessment (CAPRA) score risks (P<.01 for all) than patients in the local treatment group.
Researchers used the SF-36 social function, role emotional, vitality and mental health subscales to evaluate patients for emotional quality of life before intervention, as well as up to 24 months after.
Although the use of ADT was associated with changes in mental and emotional well-being, there were no clinically meaningful quality-of-life decreases at 24 months.
The researchers reported that decreases in vitality and the onset of fatigue appeared to be the most prevalent effects of ADT.
Clint Cary
“This result corroborates other studies documenting fatigue among the most commonly reported side effects of ADT,” researcher Clint Cary, MD, MPH, of the department of urology at the University of California, San Francisco, said in a press release. “It is not clear, though, whether the fatigue is a direct effect of ADT itself or a consequence of the physical side effects of ADT, such as sleep disturbances or hot flashes.”
Based on these findings, the researchers emphasized the need to counsel ADT patients on possible quality-of-life changes — and to outline strategies for coping with these changes — before starting treatment.
Disclosure: The researchers report no relevant financial disclosures.