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

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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.