Prostate Cancer Androgen Deprivation Therapy And Depression
Prostate cancer is a fairly common malignancy in males that is associated with a wide range of psychological, sexual and reproductive complications. There are several therapeutic options available to address prostate malignancy such as surgical removal, radiotherapy, chemotherapy. Hormone therapy and others. Each therapeutic regimen is associated with some pros and cons. It is very important to choose a therapeutic modality after carefully weighing the benefits and drawbacks of each therapy.
Hormone Therapy For Prostate Cancer And Depression
Androgen deprivation therapy is a recognized therapeutic regimen that is advised by doctors for the management of localized prostate cancers. But according to a new research, investigators from Boston, MA, suggested that men who undergo hormone therapy (androgen deprivation therapy) for prostate cancer treatment are at high risk of developing depression. The results of this study were published in the peer reviewed Journal of Clinical Oncology.
The researchers from Harvard Medical School suggested that men who undergo ADT (androgen deprivation therapy) experience weight gain, low sex drive, lack of energy and loss of interest in the surrounding; all suggestive of depression.
How Depression Is Related To The Androgen Deprivation Therapy?
Male testicles are the key producers of primary male hormone testosterone. It is noteworthy that adequate serum levels of testosterone are plays a vital role in the normal functioning and growth of prostate gland. Healthy prostate glands in turns play a key role in the production of semen and maintenance of healthy reproductive and sexual functions.
There are two main types of prostate cancers; androgen-dependent and androgen non-dependent. Androgen deprivation therapy aims at reducing the concentration or activity of androgens; thereby slowing the growth of androgen – dependent prostate cancer. Based on the data obtained from 78,552 men; it has been analyzed that ADT increases the risk of developing depression by 23%.
Facts About ADT – Androgen Deprivation Therapy
- More than 50,000 men rely on ADT for the management of prostate cancer each year in America.
- The duration of ADT regimen varies from subject to subject; mainly depending upon the risk of cancer recurrence.
- Men who are at lower risk of recurrence receive ADT for 4-6 months; and those who are at higher risk receives the therapy for up to 3 years
Based on the data collected between 1992-2006 from 78,552 men who were enrolled for the management of prostate cancer (stage 1-3); it was observed that the risk of in-patient psychiatric treatment increases by 29% in men who received ADT for management when compared to the control group. It was also reported that the risk of developing depression increases with the duration of treatment;
- About 12% patients experienced depression symptoms with treatment lasting under 6 months
- Risk of developing depression increases to 26% in men who took treatment for 6 to 11 months
- 37% people developed depression with treatment lasting 12 months or more
The research team concluded that depression is a recognized side effect of ADT and all the people who are on this treatment should be watched for symptoms. Likewise, those who are already at risk of developing depression due to personal or family history should be advised alternative treatments to minimize the risk of complications.
- D’Amico AV, Chen M, Renshaw A, Loffredo M, Kantoff PW. Long-term Follow-up of a Randomized Trial of Radiation With or Without Androgen Deprivation Therapy for Localized Prostate Cancer. JAMA. 2015;314(12):1291–1293. doi:10.1001/jama.2015.8577