Prostate cancer is one of the most frequently diagnosed cancers in men in the United States. Hormone therapy is a treatment option for a large number of patients. This type of therapy, also known as androgen deprivation therapy (ADT), works by lowering the body’s testosterone and androgen levels.
Reduced levels of androgen can cause prostate cancer cells to grow more slowly or cause tumors to shrink over time. Patients receiving ADT, on the other hand, frequently experience increased levels of fatigue, depression, and cognitive impairment.
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Researchers at Moffitt Cancer Center are looking into whether inflammation in the body, which is a side effect of ADT, plays a role in these symptoms in prostate cancer patients.
A recent study in Cancer pinpoints a specific inflammation marker linked to increased fatigue in this group of patients.
“This is the first study that we know of that examines the association between inflammation and symptoms of fatigue, depression or cognitive impairment in prostate cancer patients receiving ADT,” says corresponding author Heather Jim.
“Because the blocking of testosterone can increase inflammation in the body, we believe that inflammation may also be contributing to these symptoms.”
The researchers evaluated two groups of men for the study: prostate cancer patients starting ADT and a control group of healthy men of similar age. The men were evaluated at the start of the study, six and twelve months later. Fatigue, depression, and other neuropsychological tests, as well as a blood draw, were all assessed. The bloodwork was performed to determine the presence of circulating inflammation markers, specifically interleukin-1 receptor antagonist (IL-1RA), interleukin-6 (IL-6), soluble tumour necrosis factor receptor-2 (sTNF-R2), and C-reactive protein (CRP).
While the groups were comparable at the start, the researchers observed a significant increase in fatigue and depressive symptoms in the ADT patients over a 12-month period. Additionally, they observed an increase in the level of one inflammatory marker, IL-6, in this group of patients.
“Interleukin-6 is a pro-inflammatory cytokine that is often associated with disruption of sleep and therefore fatigue,” says the lead author of the study Aasha Hoogland.
“Studies have shown testosterone can suppress the effects of IL-6, but ADT limits testosterone production in the body, which is why we may be seeing increased levels in this patient group.”
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Additional research is needed, according to the researchers, to see if interventions such as anti-inflammatory medications and exercise can help ADT patients with fatigue and depressive symptoms.
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