Prostate Cancer Treatment May Increase Risk Of Dementia


Research suggests a link between a common prostate cancer treatment and future chance of dementia.


A prostate cancer treatment used to lower testosterone could be linked to dementia in later years according to a recent study published online by JAMA Oncology. Scientists who analysed the health records of nearly 10,000 patients discovered that when men were given Androgen Deprivation Therapy (ADT), their chances of having dementia within five years doubled.


When men were given Androgen Deprivation Therapy (ADT), their chances of having dementia within five years doubled.

ADT shuts down the body’s main supply of the male hormone and is a less radical alternative to physical castration. Prostate cancer cannot survive or grow without androgens which include testosterone and other male hormones. ADT lowers the amount of androgens in a man’s body. Reducing androgens can slow the growth of the cancer and shrink the tumour.

ADT has long been a standard treatment for men whose cancers have already begun to spread and cannot be eliminated by surgery or radiotherapy alone.

Of the 1,829 patients who received androgen deprivation therapy, 7.9% developed some form of dementia within five years. This is compared to 3.5% of those not treated with ADT.

“The risk is real and, depending on the prior dementia history of the patient, we may want to consider alternative treatment.” says Nigam Shah, MBBS, PhD, and associate professor of biomedical informatics research at Stanford. “Because the actual number of patients possibly at risk for dementia from androgen deprivation therapy is small, it makes sense when weighing the value of prescribing ADT to try to identify which prostate cancer patients might be vulnerable to dementia.”


However, Shah warns that prostate cancer patients who are receiving ADT should not make changes to their medications without discussing it with their physicians. He does not recommend altering clinical prostate cancer treatment based and this retrospective study’s results.

Prostate Cancer Treatment May Increase Risk Of Dementia

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Of the 1,829 patients who received androgen deprivation therapy, 7.9% developed some form of dementia within five years. This is compared to 3.5% of those not treated with ADT.

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 on the brain in diseases like Alzheimer’s to delve deeper into the possible reasons for this link.”

Studies such as this, which take advantage of the rich data held in medical records can be incredibly useful for highlighting trends and possible risk factors for further research.

Retrospective studies of patient medical records aren’t meant to replace randomized clinical trials. “If we had infinite funding” said Shah, “we’d do a trial for everything. But we don’t have that. These cheap, few-week studies can guide us where to point our clinical trial dollars.”

Kevin Nead, MD, DPhil, and lead author of this published research says he would like to see a prospective, randomized clinical trial to establish whether this prostate cancer treatment can be more firmly linked to a greater chance of dementia and to help identify which patients might be vulnerable to that greater chance. He believes that checking for dementia risk in patients treated with ADT will be part of future randomized, clinical trials that have a larger focus.


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Written by Hannah Kingston | Approved by Medical Director Dominic Rowley