Prostate Cancer Coverage from Every Angle

Effect of Androgen-Deprivation Therapy on Systemic Symptomatology in Men With Prostate Cancer

By: Noelle Cutter, PhD
Posted: Tuesday, April 6, 2021

Men undergoing androgen-deprivation therapy (ADT) for prostate cancer often experience symptoms of fatigue, depression, and cognitive impairment. Recent preliminary research published in Cancer examines markers of inflammation that may be associated with systemic symptomatology, including worsening fatigue, depressive symptoms, or cognitive impairment. The investigators found, however, that treatment-related increases in interleukin-6 (IL-6) were linked to increases in fatigue but not depressive or cognitive symptoms. These findings reported by Aasha Hoogland, PhD, of the Moffitt Cancer Center in Tampa, and colleagues may provide insight into improving quality of life for men with prostate cancer.

Fatigue, depression, cognitive impairment, and neuropsychological tests were assessed in 47 patients undergoing ADT at the start of the study and again at 6 and 12 months after treatment. A control group of 82 men without a history of cancer was assessed at comparable time points. Patient serum was evaluated for circulating markers of inflammation, including IL-6, soluble tumor necrosis factor receptor-2 (TNF-R2), and C-reactive protein (CRP) using immunoassays. 

Results of the study indicated that men who received ADT over the 12-month period had a significant increase in fatigue and depressive symptoms compared with healthy controls. In addition, serum IL-6 levels also increased significantly over time. There were no significant changes observed for IL-1RA, soluble TNF-R2, or CRP (P ≥ .47). The effects of ADT on increasing IL-6 levels appeared to be associated with worsening fatigue (indirect effect, –0.10; 95% confidence interval = –0.26 to –0.02) but not depressive symptomology or cognitive impairment (P > .05).

“Studies have shown testosterone can suppress the effects of IL-6, but ADT limits testosterone production in the body, which is why we may be seeing increased levels in this patient group,” revealed Dr. Hoogland in a Moffitt press release. Additional research is needed to determine whether interventions such as anti-inflammatory medications and exercise may help reduce circulating inflammation and improve fatigue in men with prostate cancer. 

Disclosure: For full disclosures of the study authors, visit acsjournals.

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