Sunday, October 30, 2016

Hormone therapy for prostate cancer linked to increased risk of dementia

CANCER DIGEST – Oct. 30, 2016 – A new analysis of the electronic medical records of prostate cancer patients shows a link between hormone blockade therapy and the future risk of dementia.

The researchers at the Stanford University School of Medicine and the University of Pennsylvania Perelman School of Medicine, looked at deidentified records from Stanford Medicine’s clinical-research data warehouse culled from nearly 10,000 patients with prostate cancer.

Of the 1,829 whose treatment included reducing blood levels of male hormones that fuel cancer growth,  called androgen deprivation therapy (ADT), 7.9 percent developed dementia within five years, compared with 3.5 percent of those not treated with ADT.

“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,” co-author Kevin Nead, MD, DPhil said. He added that he would like to see a prospective, randomized clinical trial to establish whether ADT can be more firmly linked to an increased risk of dementia and to help identify what kinds of patients might be vulnerable to that increased risk. 

The paper describing the research was published online Oct. 13 in JAMA Oncology, and adds to the evidence linking the hormone treatment to Alzheimer’s and is notable for its use of electronic medical records for research.  

Led by Nigam Shah, MBBS, PhD, associate professor of biomedical informatics research at Stanford, the retrospective study took only a few weeks to complete. 

“We are working to make such studies as simple as a Google search,” Shah said. “We were down to weeks in this one, and our current efforts, which are funded by the Dean’s Office, have gotten us to close to two to three days.”

He anticipates that checking for dementia risk in people treated with ADT will be part of future randomized, clinical trials that have a larger focus.

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