Assessment of Cognitive & Mood Effects from ADT in Men with Prostate Cancer

描述(申请人提供)：前列腺癌是男性最常见的癌症。尽管有了更好的手术和放射治疗技术，但大约40%的男性在初次治疗后会复发，许多人将接受雄激素剥夺疗法(ADT)。雄激素缺乏的长期生理后果可能包括肥胖、贫血、骨密度丧失、肌肉萎缩、血脂改变、体毛脱落、女性乳房发育以及情绪和认知变化。我们的实验室和其他实验室都报告说，接受ADT的男性会经历抑郁和焦虑的情绪，精力不足和认知能力下降。由于已有报道在其他癌症幸存者(如乳腺癌、肺癌)中发现了认知减退和情绪症状，因此尚不清楚ADT的这些变化是否与雄激素丢失、化疗和/或放射治疗的残余效应、应对危及生命的疾病的压力和情绪影响或这些因素的相互作用有关。该项目将评估接受间歇性雄激素抑制(IAS)临床试验的非转移性前列腺癌患者的认知、情绪和生活质量的变化。这项研究还将在停止ADT后的可预测时间内将睾丸素恢复到生理水平。使用“OFF-ON-OFF”设计将允许检查患者内部的变化。这项拟议的研究还将比较接受ADT治疗的患者与前列腺癌对照组(非转移性前列腺癌)自初次治疗以来的持续时间匹配的组间比较。增加我们对ADT引起的认知、情绪和生活质量变化的发生率和性质的了解，可能有助于医疗保健专业人员更好地识别和治疗ADT引起的情绪和认知变化，并告知患者在治疗前会发生什么。对ADT的心理社会和认知因素的前瞻性研究与适当的对照组一起，对前列腺癌的知识体系做出了很大的贡献。

DESCRIPTION (provided by applicant): Prostate cancer is the most common form of cancer diagnosed in men. Despite better surgical and radiation techniques, approximately 40% of men will relapse after primary therapy and many will undergo Androgen deprivation therapy (ADT). Long-term physiological consequences of androgen deprivation can include obesity, anemia, loss of bone mineral density, muscle atrophy, alterations of serum lipids, loss of body hair, gynecomastia as well as mood and cognitive changes. Our laboratory as well as others have reported that men undergoing ADT experience depressed and anxious mood, low energy and cognitive decrements. Because cognitive decrements and mood symptoms have been reported among other cancer survivors (e.g. breast, lung), it is unclear whether these changes from ADT are related to the loss of androgens, residual effects from chemotherapy and/or radiation or from the stress and emotional effects of dealing with a life-threatening illness or an interaction of these factors. This project will assess the cognitive, emotional and quality of life changes in men with non-metastatic prostate cancer who are treated on a clinical trial of intermittent androgen suppression (IAS). The study will also bring the testosterone back to physiological levels at a predictable time after stopping ADT. Use of the "off-on-off1 design will allow an examination of intra-patient changes. The proposed study will also compare the ADT treated patients to a prostate cancer control group (non-metastatic) matched for duration since primary treatment for between group comparisons. Increasing our understanding of the incidence and nature of cognitive, mood and quality-of-life changes from ADT, may help health care professionals better recognize and treat mood and cognitive changes from ADT as well as informing patients of what to expect prior to treatment. A prospective study of psychosocial and cognitive factors of ADT with an appropriate control group represents a large contribution to the body of knowledge with regard to prostate cancer.