Common prostate cancer treatment which shuts off the body’s supply of testosterone DOUBLES the risk of dementia

October 13, 2016

Androgen Deprivation Therapy shuts the main supply of the male hormone
It is a standard treatment and the less drastic option to physical castration
Men aged 70 and older were most at risk of developing a form of dementia
Experts urge patients on the hormone-reducing drugs not to change their treatment without consulting their doctors

Ben Spencer Medical Correspondent For The Daily Mail

Published:
10:00 EST, 13 October 2016

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Updated:
10:00 EST, 13 October 2016

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Hormone treatments taken by thousands of men with prostate cancer could double their risk of developing dementia, research suggests.

Roughly 18,000 men in Britain start taking hormone pills or injections every year – nearly 40 per cent of the 47,000 men diagnosed with prostate cancer.

The treatments work by lowering levels of testosterone, a hormone which is normally harmless but in prostate cancer patients can drive the growth of tumours.

The therapy is a standard treatment for men whose cancers have started to spread and cannot be eliminated by surgery or radiotherapy alone.

Androgen Deprivation Therapy – which shuts down the body’s main supply of testosterone – doubles the risk of dementia within five years, researchers found

But a study of nearly 9,300 patients in the US found that men treated with hormone therapies were more than twice as likely to develop Alzheimer’s and other forms of dementia within five years.

The participants, who had an average age of 67, had a 7.9 per cent chance of being diagnosed with dementia if they were on hormone treatments.

Men who did not receive hormone treatments had only a 3.5 per cent of dementia.

Lead researcher Dr Nigam Shah, from Stanford University in California, said: ‘The risk is real, and depending on the prior dementia history of the patient, we may want to consider alternative treatment.’

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The findings, published in the journal JAMA Oncology, showed that men aged 70 and older who had been on hormone treatments for at least 12 months were most at risk.

The scientists suspect that hormone treatments drive dementia risk because testosterone protects brain cells.

When testosterone levels are driven down – reducing the cancer risk – it may leave brain cells exposed, meaning dementia is more likely to develop.

The most common form of hormone therapy used in the UK is a drug called goserelin, sold under the brand name Zoladex, which is injected.

It is a standard treatment for men whose cancers have started to spread and cannot be eliminated by surgery or radiotherapy alone

It interferes with signals from the brain that instruct the testicles to make testosterone.

The scientists urged prostate cancer patients receiving hormone therapy not to change their treatment without consulting their doctors.

Co-author Dr Kevin Nead, from the University of Pennsylvania, US, said: ‘I was surprised at how ubiquitous the effects on all types of dementia were, but I would definitely not alter clinical care based on our results.’

He said more research was needed to look at the link between hormone treatments and dementia and identify what kinds of patients might be most at risk.

THE TEST THAT SAVED BEN STILLER’S LIFE

Ben Stiller’s prostate cancer battle brought the disease back into the spotlight and with it, the debate over whether men should be offered routine screening.

He revealed his tumour had been growing for five years and credited the prostate-specific antigen (PSA) tests he had done with saving his life.

The Hollywood actor revealed he was diagnosed with an ‘aggressive’ form of cancer two years ago – and secretly had surgery to remove his prostate.

By September that year, he was told he was cancer-free.

Now, he is urging men to speak to their doctors about being tested at an earlier age.

Male hormones are known to play a role in the health and growth of neurons, which may help explain the association, said the scientists.

Dr Matthew Hobbs, deputy director of research at the charity Prostate Cancer UK said: ‘Hormone therapy is a highly effective treatment for prostate cancer and can keep the disease at bay for many years.

‘However, all prostate cancer treatments can result in side effects and so it’s vital that men speak with their consultant to weigh up the benefits and risks of all available treatments so that they can make the right choice for them.

‘Although this research suggests that there may be a link between hormone therapy and dementia, it’s very hard to draw clear cut conclusions from studies like these and further research is needed to confirm the findings.

‘Men having treatment for prostate cancer are likely to be living with other health problems which may also increase their risk of dementia. No man should stop taking hormone therapy based on these findings.’

Dr Laura Phipps of Alzheimer’s Research UK, said: ‘While these results suggest a link between androgen deprivation therapy and an increased risk of dementia, they do not show that ADT is definitely causing this increased risk.

‘We need to better understand the impact of sex hormones in the brain in diseases like Alzheimer’s to delve deeper into the possible reasons for this link.

‘In the meantime, it is important to bear in mind that prostate cancer is a serious disease and any possible risks of ADT need to be carefully weighed against its role in treating prostate cancer.’