JAN 20, 2022 3:00 AM PST

New Links Between Prostate Cancer Therapy and Depression

WRITTEN BY: Katie Kokolus

According to 2021 estimates, prostate cancer will account for more than a quarter of the cancer diagnoses and over 10% of the cancer-related deaths among men in the United States.  Oncologists typically treat primary, metastatic, and recurrent prostate cancers with regimens containing hormone therapy.  Hormone therapy depletes androgens, male sex hormones, from the body.  Androgens promote prostate cancer growth, so androgen depletion deprives the cells of stimulation needed to grow and survive. 

Hormone therapy, also called androgen deprivation therapy (ADT), can be achieved through various methods depending on the patient and prostate cancer presentation.  Surgical castration removes the testicles preventing the generation of androgens.  Drugs called luteinizing hormone-releasing hormone (LHRH) agonists, sometimes referred to as medical castration, can significantly reduce the androgens produced by the testicles without surgical removal.  Anti-androgen (AA) drugs, which block androgens from binding their receptors on prostate cancer cells, also inhibit cancer cell growth. 

Surgical castration, medical castration, and anti-androgen treatment generate very high response rates.  However, men with advanced prostate cancer often progress to castration-resistant disease and no longer respond to hormone therapies. The Standard of care treatment for castration-resistant prostate cancer (CRPC) is second-generation AA drugs, and these drugs display greater efficacy and potency than traditional AA drugs. 

Previous studies have linked ADT to depression among prostate cancer patients.  However, whether an association between second-generation AA drugs and clinical depression exists remains unclear.  A manuscript recently published in JAMA Network Open addressed the potential links between second-generation AA drugs and depression in prostate cancer patients.  The researchers collected data from the Surveillance, Epidemiology, and End Results (SEER) and Texas Cancer Registry databases.  The study divided patients into three treatment groups: (1) no hormone therapy, (2) traditional hormone therapy, and (3) second-generation AA group.

From these databases, the researchers identified over 30,000 prostate cancer patients who were at least 66 years old, had no prior use of hormone therapy, and had never been diagnosed with depression.  Approximately 59% of the patients received no hormone therapy, 38% received traditional hormone therapy, and 3% received a second-generation AA.

The patients receiving a second-generation AA tended to be older and present with more advanced disease than those receiving traditional hormone therapy or no hormone therapy.  Statistical modeling demonstrated that patients treated with second-generation AAs had a more than twice the risk of developing depression. 

As prostate cancer diagnoses remain prominent, the development of CRPC continues to be prevalent.  Subsequently, the use of second-generation AAs is on the rise.  Thus, developing a clear understanding of the links between depression and second-generation AAs and depression will significantly impact public health.  The authors suggest that incorporating early depression screening into patients' treatment plans using second-generation AAs could improve the quality of life in this vulnerable group of patients.

 

Sources: CA, JAMA, Prostate Cancer and Prostatic Dis, Frontiers Oncol, JAMA Network Open

About the Author
PhD
PhD in Tumor Immunology. I am interested in developing novel strategies to improve the efficacy of immunotherapies used to extend cancer survivorship.
You May Also Like
DEC 13, 2021
Cancer
Mistletoe: Parasite, Symbol of Romance, or Cancer Treatment?
DEC 13, 2021
Mistletoe: Parasite, Symbol of Romance, or Cancer Treatment?
As we approach the winter season, decorative swigs of mistletoe are starting to make their holiday debut.  You may ...
DEC 07, 2021
Immunology
Ancient Medicine and Synthetic Biology Collide to Combat Chemo Resistance
DEC 07, 2021
Ancient Medicine and Synthetic Biology Collide to Combat Chemo Resistance
  Strong chemical drugs used to obliterate all rapidly growing cells in the body have been used to treat cancer sin ...
APR 07, 2022
Cancer
Music Therapy Offers an Innovative Approach to Cancer Therapy
APR 07, 2022
Music Therapy Offers an Innovative Approach to Cancer Therapy
  Last month we explored the value of art therapy for cancer patients and survivors, and now we can ...
APR 11, 2022
Health & Medicine
Upcoming Preventative Cancer Vaccine Trial Will Investigate Effects in Lynch Syndrome
APR 11, 2022
Upcoming Preventative Cancer Vaccine Trial Will Investigate Effects in Lynch Syndrome
Clinical trials are soon to be underway to examine the effectiveness of vaccines meant to prevent or delay cancer in hig ...
APR 19, 2022
Health & Medicine
Microplastics Found in Human Lungs. Are They Dangerous?
APR 19, 2022
Microplastics Found in Human Lungs. Are They Dangerous?
Research out of Hull York Medical School in England found small plastic debris known as microplastics deep in the lungs ...
MAY 06, 2022
Immunology
Epstein-Barr Virus Vaccine Enters Phase 1 Trials
MAY 06, 2022
Epstein-Barr Virus Vaccine Enters Phase 1 Trials
The Epstein-Barr virus (EBV) infects most people; it's thought that when we're young, about 90 percent of us acq ...
Loading Comments...