Markers of irritation related to elevated fatigue in prostate most cancers sufferers handled with ADT
Prostate cancer is one of the most common types of cancer in men in the United States. For many patients, hormone therapy is a treatment option. This type of therapy, also called androgen deprivation therapy (ADT), reduces testosterone levels and other androgens in the body. Lowering androgen levels can cause prostate cancer cells to grow more slowly or tumors to shrink over time. However, patients who receive ADT often experience higher levels of fatigue, depression, and cognitive impairment.
Researchers at the Moffitt Cancer Center are investigating whether inflammation in the body, a side effect of ADT, contributes to these symptoms in prostate cancer patients. In a new study published in the journal Cancer, they identify a specific marker of inflammation associated with increased fatigue in this group of patients.
This is the first study known to us that investigates the relationship between inflammation and symptoms of fatigue, depression, or cognitive impairment in prostate cancer patients receiving ADT. Since blocking testosterone can increase inflammation in the body, we believe that inflammation can contribute to these symptoms as well. "
Heather Jim, Ph.D., Corresponding Author and Co-lead, Health Outcomes & Behavior Program, Moffitt Cancer Center
For the study, the research team evaluated two groups of men: prostate cancer patients starting ADT and a control group of healthy men of the same age. The men were examined at the start of the study and again after six and twelve months. The assessments included fatigue, depression, and other neuropsychological tests, as well as a blood draw. The blood count consisted of checking for circulating markers of inflammation, particularly interleukin-1 receptor antagonists (IL-1RA), interleukin-6 (IL-6), soluble tumor necrosis factor receptor-2 (sTNF-R2), and C-reactive protein (CRP) .
While the groups did not differ at the start of the study, the researchers found a significant increase in fatigue and depressive symptoms in the ADT patients over the period of 12 months. They also saw an increase in a marker of inflammation, IL-6, in this group of patients.
"Interleukin-6 is an inflammatory cytokine that is often associated with sleep disorders and, consequently, fatigue," said Aasha Hoogland, Ph.D., lead study author and applied research scientist in the Health Outcomes & Behavior Program at Moffitt. "Studies have shown that testosterone can suppress the effects of IL-6, but ADT limits testosterone production in the body, so we may see elevated levels in this population."
The researchers say additional studies are needed to determine whether interventions like anti-inflammatory drugs and exercise can help alleviate fatigue and depressive symptoms in ADT patients.
H. Lee Moffitt Cancer Center & Research Institute
Hoogland, A.I., et al. (2020) Systemic Inflammation and Symptoms in Patients with Prostate Cancer Treated with Androgen Depression Therapy: Preliminary Results. Cancer. doi.org/10.1002/cncr.33397.