Warning to Prostate Cancer Patients

Many oncologists that treat prostate cancer patients insist on using androgen-deprivation therapy (ADT) that blocks male hormone production and release. Most prostate cancer patients are informed about the numerous side-effects such as hot flashes, metabolic syndrome/weight gain, muscle mass loss, gynecomastia (developing breast tissue), and osteoporosis.

The vast majority of men receiving continuous ADT who are potent prior to therapy develop sexual dysfunction. Loss of libido in men receiving ADT usually develops within the first several months, and erectile dysfunction follows.

Recovery of erectile function is possible after discontinuation of short-term ADT (6 months or less),  however, it may be delayed and incomplete.

More difficult to assess and manage is the potential impact of ADT on cognitive function. Compelling data on this topic have been in short supply, but in a high-volume prostate cancer practice a substantial minority of patients report changes in cognitive function, often described as a loss of “sharpness” following ADT.

Because no differences in cognitive function were observed between the control groups, data from them were combined for analysis. Rates of impaired cognitive function were similar between the ADT group and the control groups at baseline. However, ADT patients demonstrated greater dysfunction over time, including a 70% increase in impaired performance at 6 months and a >50% increase at 12 months (P<0.05 for both).