Do Common Prostate Cancer Treatments Cause Cognitive Decline?
Posted: Friday, July 30, 2021
Treatment of patients with metastatic castration-resistant prostate cancer using docetaxel, enzalutamide, abiraterone, and radium-223 does not appear to cause a decrease in cognitive function, according to the results of a multicenter, prospective, observational cohort study reported in the JAMA Open Network. Urban Emmenegger, MD, of Sunnybrook Health Sciences Centre, Toronto, and colleagues conducted this research, focusing on attention, executive function, and global cognition.
“Using three common, objective measures of cognitive function, this cohort study was unable to detect significant cognitive decline in any of the four treatments for advanced prostate cancer,” the investigators noted.
A consecutive sampling of 155 men, with some post-secondary education and similar baseline cognitive function, was studied in four cohorts, over 4 years, at university-affiliated centers across Ontario. Participants were at least 65 years of age and about to receive their first-line treatment for metastatic castration-resistant prostate cancer at the time of their first cognitive tests. They were tested again at the end of treatment using the same tests. Docetaxel and radium-223 treatment lasted 6 months, whereas abiraterone and enzalutamide treatment lasted approximately 11 months. The Montreal Cognitive Assessment test was used to assess global cognition. Trail Making Test Part A, using Trails A and B, were used to assess perpetual motor function and executive function, respectively.
There was no statistically significant change in score (defined by the International Cognition and Cancer Task Force as a decline of at least 1.5 standard deviations on at least two measures) on any of the tests across all patients included in the study. The only factor that was significantly associated with a cognitive decline was age. The small size of each cohort, the limited range of testing, as well as an absence of a control group and randomization suggest that larger, in-depth studies are warranted.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
