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Researchers explore prostate cancer survivorship, cognitive effects of treatment
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The University of Minnesota received $500,000 from the Th!nk Different Foundation to study survivorship among men with prostate cancer.
The research — conducted by Charles Ryan, MD, professor of medicine in the division of hematology, oncology and transplantation at University of Minnesota, and colleagues — will include investigation of how treatment affects cognitive function.
“We have a number of projects that we are launching in which we will examine various modalities for improving survivorship for men with prostate cancer,” Ryan said during an interview with HemOnc Today. “In addition to examining the effect of hormone therapy on cognitive function and various ways to improve this effect, we will also examine the side effects of hormonal ablation through exercise.”
HemOnc Today spoke with Ryan about the research underway and how he hopes the results will help clinicians and researchers care for men with prostate cancer.
Question: What prompted this research ?
Answer: The foundation of treatment for prostate cancer is the depletion of testosterone. We are successful in putting the cancer into long-term remission, and sometimes short-term remission by lowering testosterone levels by 90%. When we talk about the side effects of this treatment, we are really talking about what it is like for a man to live without testosterone, which is a fundamentally important hormone for male life.
Q: What will the focus of your research include?
A: The focus of our research will include looking at how testosterone depletion and blocking the androgen receptor with other agents can affect cognitive function. It has been known for quite some time that men receiving hormone therapy for prostate cancer may have a slowing of their executive function — they may have difficulties with spatial orientation and short-term memory processing. However, a lot of these effects do not show up in the clinic because patients adapt to these changes or do not bring them up with their physician because they do not think that they are related to treatment. We are going to approach this from a few different perspectives. We will conduct tests among patients in our clinics to assess short-term memory, spatial orientation and executive function. In addition, we will use MRI to examine blood flow in the brain during hormonal therapy, and we will conduct a series of genetic analyses to determine whether we can identify which patients may be at risk for cognitive dysfunction related to their hormonal therapy. We have teamed up with Alzheimer disease researchers who have been able to identify genetic factors that may put men and women at risk for dementia. We will test whether these risk factors for dementia are also risk factors for the cognitive effects of hormonal therapy of prostate cancer.
Q: What research is currently underway?
A: We are exploring exercise in men with prostate cancer through a series of prospective clinical trials. Epidemiologists have discovered that men who exercise vigorously several times per week, even after they have been diagnosed with prostate cancer, cut their risk for death by upwards of 40% to 50% relative to those who do not exercise. Although this is an interesting observation, it is not proven. What we are doing in collaboration with the Movember Foundation is conducting a prospective clinical trial to assess vigorous exercise with a trainer and looking to see if survival is improved in these men. We plan to accrue nearly 900 men across Australia, Europe, North America and elsewhere.
Q: Is there anything else that you would like to mention?
A: There are many people who are living much longer on treatment for prostate cancer, but are now dealing with long-term side effects from treatment. The fact that oncologists are now focusing on survivorship is a sign of success that we are having in turning advanced cancers into chronic conditions. – by Jennifer Southall
For more information:
Charles Ryan, MD, can be reached at University of Minnesota, 420 Delaware St. SE, MMC 480, Minneapolis, MN 55455; email: ryanc@umn.edu.
Disclosure: Ryan reports no relevant financial disclosures.