Psychological Side Effects of Hormone Therapy

About half of all men treated for prostate cancer will be prescribed hormone therapy, otherwise known as Androgen Deprivation Therapy (ADT) wherein testosterone levels are significantly reduced.  Although ADT is not usually considered curative, it can keep prostate cancer in check for years and even decades.  ADT is often initiated prior to radiation therapy to improve its efficacy.  This use of ADT is called neo-adjuvant therapy.  ADT is also used in the event of residual  cancer after initial surgery or radiation therapy.  Such use is referred to as adjuvant therapy.  Systemic therapy is when ADT is used to treat cancer that has spread beyond the prostate gland.  While ADT has obvious benefits, it also causes an array of side effects in addition to the well-known hot flushes.  For example, the risks of osteoporosis, bone fracture, anemia, cardiovascular and kidney disease as well as diabetes and fatigue are increased. Also, weight is gained at the expense of muscle mass (sarcopenic obesity).  There are also psychological effects of ADT as well.  Recent controlled studies have indicated that ADT is notably associated with an increased risk of depression.  There have also been several studies which suggest that ADT may impact mental cognitive functions involved in how one perceives, reasons, thinks and remembers.  In addition, ADT can negatively affect a man’s interactions with the person he is normally closest to, such as a spouse or partner.  This can also have repercussions on the latter’s health.  In general, the psychological distress associated with cancer is greater on females than on males whether they are the patient or the partner.  On a positive note, when it comes to dealing with physical or psychological side effects of ADT, physical exercise helps uniformly.  It not only protects the heart, muscles and bones but it can improve mood and memory, reduce depression and fatigue and even improve sexual function.  In fact, exercising together with a spouse or partner can help maintain intimacy and strengthen their spousal bond.  Finally, one recent study noted that the survival benefit for prostate cancer patients in having a supportive spouse beats the benefits of chemotherapy.  This entire article linked herein recently appeared in the February 2015 issue of the Prostate Cancer Research Institute (PCRI) Insights.  The reader is highly encouraged to read and subscribe to the entire article, issue and periodical.

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