Friday, December 11, 2015

Testosterone-Blocking Cancer Drugs Linked To Much Greater Alzheimer's Risk

While we're on the topic of prescription drugs and costs, we can also consider the set referred to as "anti-Androgen" or "testosterone-blocking". These are usually prescribed by oncologists after a treatment "failure" -  defined in the case of radiotherapy as three successive PSA increases after the defined PSA nadir (or lowest reading). Since treatment such as radiation often leaves tissues a "mess" it isn't generally a good idea to barge in with a radical prostatectomy - so anti-Androgens are prescribed to cut off the testosterone feeding the tumor.

As Dr. Mark Scholz observes in 'Invasion of the  Prostate Snatchers', p. 42:

"testosterone fuels prostate cancer growth  and prostate cancer is the only type of cancer susceptible to testosterone inactivating pharmaceuticals"

It is also true that anti-Androgens can be prescribed for men who've been biopsied and found to have localized prostate cancer but opt not to go for the extreme treatments like surgery or high dose brachytherapy - such as I had in 2012. It is now estimated that a half million American males are on these drugs for one or the other reason.

The Androgen deprivation therapy - also known as chemical castration - lowers levels of testosterone and other male hormones that can fuel the disease but can also wreak havoc including: a higher risk of cardiovascular disease, diabetes, high cholesterol, loss of muscle mass and impotence.

Now we learn males on this therapy probably need to also do more watchful waiting for Alzheimer's disease.

According to a WSJ article ('Alzheimer's Danger Seen in Prostate Drugs', p. A3, Dec. 10), a new study published in the Journal of Clinical Oncology found that men taking testosterone-blocking drugs had an 88 percent increased risk of  developing Alzheimer's disease compared to those not taking such drugs.

The researchers from Stanford and the University of Pennsylvania searched electronic medical records from Stanford Health Care in Palo Alto, CA and Mt. Sinai Hospital in New York City. They identified 16, 888 patients with "non-metastatic prostate cancer" between 1994 and 2013. Of those:

"Nearly 2,400 were treated with anti-Androgen therapy and they had an 88 percent increased change of being diagnosed with Alzheimer's disease in the next three years than those who weren't"

According to one urologist from Brigham and Women's Hospital in Boston, while this therapy "can extend survival when used with radiation in some cases", he also warned:

"But we should never use androgen deprivation therapy alone for localized prostate cancer".

My view is perhaps it shouldn't be used at all, especially after reading and reviewing How We Survived Prostate Cancer: What We Did and What We Should Have Done Victoria Hallerman. Hallerman writes of her husband who had brachytherapy and also the anti-Androgen treatment. She notes that basically, he was reduced to weeping at the slightest provocation and also losing the ability to think clearly. To me it showed the wisdom of me not adding this to my own high dose brachy treatment.

One is led to ask: 'What is the quality of life if it means getting Alzheimer's?' You are better off croaking earlier from the cancer than be converted to a living vegetable.

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