Does pharmacological castration as adjuvant therapy for prostate cancer after radiotherapy affect anxiety and depression levels, cognitive functions and quality of life?

Psychooncology. 2013 Feb;22(2):346-51. doi: 10.1002/pon.2095. Epub 2011 Nov 13.

Abstract

Introduction: Adjuvant hormonotherapy for prostate cancer patients after radical radiotherapy has a well-established value. However, the impact of such treatment on the patients' quality of life remains to be elucidated.

Objective: The objective is to assess the impact of adjuvant hormonotherapy with luteinizing hormone-releasing hormone analogue after radical radiotherapy on anxiety and depression levels, cognitive function, sexual function and quality of life of prostate cancer patients.

Material and methods: Two groups of patients were tested: men treated with adjuvant hormonotherapy (88 patients) and men without hormonotherapy (61 patients). Anxiety, depression and cognitive functions were evaluated. Patients answered questions addressing problems linked to hormonal equilibrium. The patients rated their mental status, physical status, quality of life and quality of their relationship.

Results: There were no statistically significant differences between patients on hormonotherapy and without hormonotherapy in the level of anxiety and depression (p = 0.844 and p = 0.954) as well as in cognitive function (p = 0.661). Satisfactory sexual performance was preserved in 9/65 patients (14%) on hormonotherapy and the same was applied to 19/49 patients (39%) without hormonotherapy. The difference was statistically significant (p = 0.003). Hormonotherapy was associated with decreased libido (p = 0.031), hot flushes (p < 0.001) and sweating (p < 0.001). No statistically significant differences were found between the groups in the self-rated physical and psychological well-being (p = 0.476 and p = 0.597), quality of life (p = 0.622) and quality of relationship (p = 0.064).

Conclusions: Adjuvant hormonotherapy enhances neither anxiety nor depression, does not impair cognitive function but has a negative effect on the patients' sexual function. It does not worsen self-rated quality of relationship and quality of life.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Anxiety / psychology
  • Anxiety Disorders / psychology
  • Chemotherapy, Adjuvant / psychology
  • Cognition / drug effects*
  • Cognition Disorders / psychology
  • Depression / psychology
  • Depressive Disorder / psychology
  • Gonadotropin-Releasing Hormone / analogs & derivatives
  • Humans
  • Male
  • Middle Aged
  • Prostatic Neoplasms / drug therapy
  • Prostatic Neoplasms / psychology*
  • Prostatic Neoplasms / radiotherapy
  • Quality of Life
  • Surveys and Questionnaires

Substances

  • Antineoplastic Agents, Hormonal
  • Gonadotropin-Releasing Hormone