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New study says ADT doubles risk of dementia

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Posted 10/13/2016 11:15 PM (GMT 0)
This is a scary thought, but this new study from U of Penn and Stanford is saying the ADT may double the risk of dementia.

This is especially concerning for my husband considering his mom and all of her siblings died of Alzheimers.

http://www.cbsnews.com/news/prostate-cancer-treatment-adt-hormone-therapy-dementia-risk[url]
Posted 10/13/2016 11:37 PM (GMT 0)

peanut307 said...
This is a scary thought, but this new study from U of Penn and Stanford is saying the ADT may double the risk of dementia.

This is especially concerning for my husband considering his mom and all of her siblings died of Alzheimers.

www.cbsnews.com/news/prostate-cancer-treatment-adt-hormone-therapy-dementia-risk

Wow...

"They also looked at the risk over time and found that the absolute increased risk of dementia after five years was 7.9 percent among men who’d undergone ADT treatment compared with 3.5 percent in those who hadn’t had the hormone therapy".

that's a mouthful.

My brother-in-law (similar stats as your husband) has been on it for just about a year. My sister tells me it hasn't bothered him "all that much". BUT....she said she's noticed that he has a harder time remembering stuff and she thinks it's due to his Lupron treatment. He's one of those "braniac" type guys. He really thinks long before he speaks anyway. And, this is just getting worse.


My mom has it bad. We attended a local seminar on it. If memory serves....I believe the specialist who was speaking said that if a parent has it, there's a 50% chance of any one child developing it. That said...if nothing else got us first...I guess we'd all get it at some point.
Posted 10/13/2016 11:48 PM (GMT 0)
Very scary! I have noticed that I am having a bit harder time remembering names of people and things, etc. Sometimes it takes me a minute or to of thinking to come up with the name. My wife says that I sometimes now talk like Jimmy Stewart. I hoping that this was only temporary and the result of just ending 38 rounds of salvaging radiation as well being on Lupron since June.

Oh well...
Posted 10/13/2016 11:51 PM (GMT 0)
I ran across this as well...

www.practiceupdate.com/journalscan/30960/3/0?elsca1=emc_enews_top-10&elsca2=email&elsca3=practiceupdate_uro&elsca4=urology&elsca5=newsletter&rid=MTU0MTU5NzU5MjQ1S0&lid=10332481

probably nothing to worry about, just something to maybe be aware of. (After my prostatectomy, I had dvt. Blood thinner for a few months and the scans are clear now)



But having an operation while on it....it might be worth mentioning

Post Edited (island time) : 10/13/2016 5:56:34 PM (GMT-6)

Posted 10/13/2016 11:55 PM (GMT 0)
Well, no, it doesn't say that ADT doubles the risk of dementia. It says that men who were taking ADT had twice the incidence of dementia compared to men not talking ADT, 7.9% vs. 3.5% after 5 years. Whether that observation was due to ADT or some other cause (e.g., the anesthesia they received during prostatectomy) is not known.
Posted 10/14/2016 12:08 AM (GMT 0)
NOBODY does ADT unless they have PC and are risk of dying from it...Dementia is the LEAST of their worries....Skip the ADT and you automatically skip the dementia..
Posted 10/14/2016 12:23 AM (GMT 0)

Dr WHO said...
Very scary! I have noticed that I am having a bit harder time remembering names of people and things, etc. Sometimes it takes me a minute or to of thinking to come up with the name. My wife says that I sometimes now talk like Jimmy Stewart. I hoping that this was only temporary and the result of just ending 38 rounds of salvaging radiation as well being on Lupron since June.

Oh well...

We're the same age. about a year ago I noticed a marked decrease in my ability to come up with "the right word" when talking. It was really was a nuisance!

We're at that age. It doesn't mean a fatal disease is causing it.
Posted 10/14/2016 1:00 AM (GMT 0)
Well on the other hand my time on Eligard and Lupron will allow me to live long enough to become senile.

That is meant to be humorous as we have dementia in the family. My mother and grandmother both suffered and lived with it into their mid nineties

Every treatment has its costs and benefits. Weigh them properly and make your decisions you can live positively with. But don't let "scary" headlines influence you.
Posted 10/14/2016 1:39 AM (GMT 0)
Earlier this year I saw a group of people that we see only occasionally. People I've known casually, but met several times before.

I walked in, and found to my dismay that while I recognized the faces I could hardly pull up a single name. Like, none of them. It was shocking. The three years I've been on hormone therapy may have taken a toll. I'm not getting any younger either, so there's that as well.

I'm very open with my staff at work, and they all know I may have memory gaps and will repeat things sometimes. It's ok, it doesn't hurt the work which is my main priority. But man, having memory issues bothers me. I always wonder what the initial personal perception is when one develops memory loss, mental issues, dementia, whatever. Do we notice? Do we know it's happening?
Posted 11/26/2016 8:23 PM (GMT 0)
I have watched these post for last 5 years but rarely chime in. This subject touches home though and I'd like to share my husband's experience on Lupron. He began what was supposed to be a two year program of 6 month shots in the summer of 2010. After his third 6-month shot he felt he could no longer tolerate the treatments and did not have the final shot. During treatment he did have "foggy brain" but we assumed that would resolve once off the Lupron. His urologist (who we like very much) downplayed the "foggy brain" effect. My husband has a post-masters degree and had functioned very successfully in the workplace without difficulty prior to going on lupron. He was able to hide the memory gaps very well and although I knew something was wrong, it was just hard to put my finger on what it was. Working became impossible for him even though he dropped down to half time for his final year. He ended up resigning rather than forcing the employer to have to take action. It wasn't until I saw him find a calculator to multiply 16 X 10, that I began to understand the depth of the problem. His ability to do any math in his head is nonexistent. We have a 5 year old granddaughter and when I asked "are we going for i-c-e c-r-e-a-m" he couldn't make sense of what I was spelling. When trying to organize digital photos, he couldn't remember his sister's name, or the names of many other family members. He is extremely embarrassed about the decrease in functioning and refused to talk to his doctors about it. I finally spoke to his gen practitioner without his knowledge and once he knew she was aware of the problems, he agreed to be treated. Bottom line, at 61 he is between late stage MCI to early vascular dementia. Prior to Lupron, he had none of the risk factors for vascular dementia (fam. history/high blood pressure/diabetes) and I am convinced that it is the Lupron that caused this.

I would advise anyone having a family member on Lupron to watch for problems with abstract thinking or any decrease in their ability to do prior activities. Don't be afraid to get them help because they may not be able to help themselves.

As for the prostate cancer - 5 years from treatment and still undetectable. :-)
Posted 11/26/2016 9:58 PM (GMT 0)
This is a great concern for me, too. I did ADT2 for one year and then got a 9-month vacation. The HT did a big hit on my short-term memory. It was BAD -- just huge gaps. Oddly enough, it did not impact any medium or long-term memory. I did just fine at my job, which does require some mental acuity (Math Prof at a University). Anyway, when I went on my HT vacation, I was thrilled that starting 3 months into it, my brain fog pretty much dissolved.

Then I did my second year on HT and slowly the same memory issues developed. I am now near the end of my second HT vacation (it will be about 12 1/2 months this time). During this vacation, after about 3 months, the memory issues cleared up, but then backtracked. I am about 70% better than last time. I am disappointed that it didn't completely resolve, and I am so not looking forward to my third round of HT!

Mel
Posted 11/27/2016 12:29 AM (GMT 0)
I think i'll file this under BFD (whatever that means) cool

ed
Posted 11/27/2016 10:54 AM (GMT 0)
For about a year after the surgery I had cognitive impairment pretty bad. It backed off somewhat after that, but remained noticeable the whole time I was on Eligard. Now, 2 years after the last hit of Eligard I am more-or-less normal for me.. I still get occasional moments, but at 66 that is not a real surprise.

I would recommend a serious aerobic workout program, a healthy diet and plenty of rest. Mindfulness meditation helps as well. (See page 1 of Healing Well)
Posted 11/27/2016 2:28 PM (GMT 0)
Interesting discussion. When I mentioned to my VA primary care doc I was having significant problems with short-term memory he scheduled me with a psychologist and I spent an hour doing various memory tests . One segment was trying to remember the names and events in a story he read to me. I failed that very badly.

Surprisingly I did extremely well remembering an abstract figure with various shapes he showed me, I redrew the graphic collection perfectly. So it seems I can remember numbers and various shapes but not so much with words.

His analysis was I didn't spend enough time interacting with people (whatever that meant), I told him I was fortunate enough to retire very early at 49 years old and he was convinced that was a primary contributor to my problem. I didn't tell him as soon as I retired, I got involved with so many volunteer activities I was getting stressed out just like when I had a career and had to start saying no.

Now I'm wondering if Lupron and radiation has been exacerbating the usual cognitive/memory decline associated with aging.
Posted 11/27/2016 3:55 PM (GMT 0)
Compiler said: "… Oddly enough, it did not impact any medium or long-term memory. I did just fine at my job."

Mel, that's certainly good to hear, as blanking out in front of one's class of thirty or more students would certainly be awkward.

I remember once having a conversation with a couple of my fellow librarians in the break room one day while I was still working, on this very subject. Some of us were teaching the Introduction to the Libraries course for freshmen, and somehow the subject of blanking out while in the middle of teaching the class came up.

Then one of my colleagues described a very handy strategy he had devised for handling this situation, should it ever arise.

And it's a strategy that can be modified to apply in most any situation of going blank while addressing a group, which is why I'm mentioning it here.

What he would do is go up to the podium to start teaching the class, but the first thing he would do is place a clear-plastic bottle of water on the podium in view of the class. Then he would proceed to teach. Then, if at any point he realized that he was losing touch with what he was saying to the class, he would pause, turn to the class and say "Excuse me for a moment." Then he would take the bottle of water, slowly remove the cap, and very slowly take several drinks of water, all the while thinking to remember where he was in his presentation, perhaps looking at the blackboard for help.

And if that didn't work, he even had a plan B. Which was to turn to the class and say: "To make sure you're all getting this, I would like to have a little class participation." Then, calling upon his brightest student there in the class, he would say: "Mr. Smith, would you be so good as to summarize what we've just been discussing?" And when the student did so, that would likely be enough to recall the subject for him, and he could then proceed with teaching the class.

As noted, perhaps a useful technique that could also be employed in other work settings, where one is addressing a group, and the mind suddenly loses track of where one is.
Posted 11/27/2016 4:49 PM (GMT 0)
Regarding short- versus longer-term memory, last year my brother developed an extremely rare brain virus while in the hospital for a bone marrow transplant. The virus completely wiped out his short-term memory by setting up in his hippocampus. I'd be visiting him in the hospital and if I walked outside and came back in two minutes later he would have no idea that I had just been there.

OTOH, we could talk about anything else from movies to literature to growing up together. One day he told me a fascinating history of his small town in Michigan. Yet he had zero short-term memory.
Posted 11/27/2016 5:26 PM (GMT 0)
81-- Excellent ideas. I also have a bottle of water to use as ... a bottle of water (trying to stay hydrated), especially during some lecture-heavy presentations! Oddly enough, I have never had a memory blackout while teaching. I've been lucky that way. But the HT short-term memory blackouts were very scary to me. My wife would talk about something we did a few days ago, and I would have ZERO memory of it. In the normal RARE memory lapse (before HT), if she would convey some detail, it would come to me. At it's worst, she would mention a movie we saw on Tv or at the cinema, and I would have no recollection whatsoever. I would not even remember going to the cinema. Anyway, that was at its worst, usually about 6-9 months into HT. Yet, no issues at all at work. I think what I do at work, I've done for many many years and it is imprinted in a different part of my brain. I then think of true Alzheimers and it is scary to actually be that way and get worse.

Michael-- did he recover his short-term memory?

I remember reading a book about a guy, written by his wife, who was a musical genius. He got such a virus and never regained his short term memory. He was very personable. Every time he saw you, it was like he had not seen you in a long time.

Mel
Posted 11/27/2016 8:20 PM (GMT 0)
Mel...he passed away from complications from the transplant without ever regaining his short-term memory. He lived about six months with no short-term memory. And yes, it was just like that--every time I would see him in person it was like he hadn't seen me in a long time. I would call him daily and he had no recollection of previous calls--once the call dropped and I called back immediately and he didn't know we had been speaking.

He was a previous Jeopardy champion and he never lost his ability to recite trivia and minutiae. Clearly, all of that must reside in a different part of the brain.
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