Cognitive and neurobehavioral symptoms in patients with non-metastatic prostate cancer treated with androgen deprivation therapy or observation: A mixed methods study
- PMID: 27019142
- PMCID: PMC4844757
- DOI: 10.1016/j.socscimed.2016.03.016
Cognitive and neurobehavioral symptoms in patients with non-metastatic prostate cancer treated with androgen deprivation therapy or observation: A mixed methods study
Abstract
Background: Few studies have investigated prostate cancer patients' experiences of cognitive functioning or neurobehavioral symptoms (i.e., behavioral changes associated with neurological dysfunction) following androgen deprivation therapy (ADT).
Methods: Semi-structured interviews conducted from the US by phone and in-person were used to explore and characterize the: 1) experience of cognitive and neurobehavioral functioning in non-metastatic prostate cancer patients undergoing ADT (n = 19) compared with patients who had not undergone ADT (n = 20); 2) perceived causes of cognitive and neurobehavioral symptoms; 3) impact of these symptoms on quality of life; and 4) strategies used to cope with or compensate for these symptoms. Neuropsychological performance was assessed to characterize the sample.
Results: Overall, ADT patients experienced marginally more cognitive problems than non-ADT (nADT) patients even though there were no significant differences between groups in neuropsychological performance. ADT patients also experienced more declines in prospective memory and multi-tasking than nADT patients. Significant proportions of participants in both groups also experienced retrospective memory, attention and concentration, and information processing difficulties. With respect to neurobehavioral symptoms, more ADT patients experienced emotional lability and impulsivity (both aspects of disinhibition) than nADT patients. Among the causes to which participants attributed declines, both groups attributed them primarily to aging. A majority of ADT patients also attributed declines to ADT. For both groups, increased cognitive and neurobehavioral symptoms negatively impacted quality of life, and most participants developed strategies to ameliorate these problems.
Conclusion: ADT patients are more vulnerable to experiencing specific cognitive and neurobehavioral symptoms than nADT patients. This study highlights the importance of capturing: a) cognitive symptoms not easily detected using neuropsychological tests; b) neurobehavioral symptoms that can be confused with psychological symptoms, and c) causal beliefs that may affect how people cope with these symptoms. Effective interventions are needed to assist prostate cancer patients in managing these symptoms.
Keywords: Androgen deprivation therapy; Attributions; Cognitive functioning; Neurobehavioral functioning; Oncology; Prostate cancer; Quality of life.
Copyright © 2016 Elsevier Ltd. All rights reserved.
Similar articles
-
Cognitive problems in patients on androgen deprivation therapy: a qualitative pilot study.Urol Oncol. 2013 Nov;31(8):1533-8. doi: 10.1016/j.urolonc.2012.07.003. Epub 2012 Sep 10. Urol Oncol. 2013. PMID: 22975107 Free PMC article.
-
Dissociation of event-based prospective memory and time-based prospective memory in patients with prostate cancer receiving androgen-deprivation therapy: a neuropsychological study.Eur J Cancer Care (Engl). 2015 Mar;24(2):198-204. doi: 10.1111/ecc.12299. Eur J Cancer Care (Engl). 2015. PMID: 25711542
-
The impact of long-term androgen deprivation therapy on cognitive function and socioeconomic decision making in prostate cancer patients.Psychooncology. 2020 Aug;29(8):1338-1346. doi: 10.1002/pon.5442. Epub 2020 Jul 2. Psychooncology. 2020. PMID: 32539186
-
Cognitive functioning in men receiving androgen deprivation therapy for prostate cancer: a systematic review and meta-analysis.Support Care Cancer. 2014 Aug;22(8):2271-80. doi: 10.1007/s00520-014-2285-1. Epub 2014 May 25. Support Care Cancer. 2014. PMID: 24859915 Free PMC article. Review.
-
Cognitive effects of hormone therapy in men with prostate cancer: a review.Cancer. 2008 Sep 1;113(5):1097-106. doi: 10.1002/cncr.23658. Cancer. 2008. PMID: 18666210 Free PMC article. Review.
Cited by
-
Giftedness and atypical sexual differentiation: enhanced perceptual functioning through estrogen deficiency instead of androgen excess.Front Endocrinol (Lausanne). 2024 May 1;15:1343759. doi: 10.3389/fendo.2024.1343759. eCollection 2024. Front Endocrinol (Lausanne). 2024. PMID: 38752176 Free PMC article. Review.
-
A review of the objective cognitive function measurements in males receiving hormonal therapy for prostate cancer.Investig Clin Urol. 2023 Nov;64(6):521-540. doi: 10.4111/icu.20230103. Investig Clin Urol. 2023. PMID: 37932563 Free PMC article. Review.
-
Exercise Associated with Cognitive Function in Older Men with Prostate Cancer Undergoing Androgen Deprivation Therapy.Int J Behav Med. 2023 Dec;30(6):924-929. doi: 10.1007/s12529-022-10150-1. Epub 2023 Jan 30. Int J Behav Med. 2023. PMID: 36717389
-
How to Improve the Quality of Life of Patients with Prostate Cancer Treated with Hormone Therapy?Res Rep Urol. 2023 Jan 19;15:9-26. doi: 10.2147/RRU.S350793. eCollection 2023. Res Rep Urol. 2023. PMID: 36698681 Free PMC article. Review.
-
Circadian disruption and cancer- and treatment-related symptoms.Front Oncol. 2022 Oct 28;12:1009064. doi: 10.3389/fonc.2022.1009064. eCollection 2022. Front Oncol. 2022. PMID: 36387255 Free PMC article. Review.
References
-
- Andersson S, Bergedalen AM. Cognitive correlates of apathy in traumatic brain injury. Neuropsychiatry, Neuropsychology, and Behavioral Neurology. 2002;15(3):184–191. - PubMed
-
- Baddeley A, Eysenck MW, Anderson MC. Memory. 1st. New York: Psychology Press; 2009.
-
- Burgess PW, Veitch E, de Lacy Costello A, Shallice T. The cognitive and neuroanatomical correlates of multitasking. Neuropsychologia. 2000;38(6):848–863. [pii] - PubMed
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical