ADT-Related Inflammation May Cause Fatigue in Patients with Prostate Cancer

Inflammation due to treatment with androgen deprivation therapy (ADT) may be the cause of increased fatigue in patients being treated for prostate cancer, according to a new study.

ADT is a standard treatment for prostate cancer where levels of testosterone and other androgens in the body are reduced. Lower androgen levels are associated with slower prostate cancer cell growth and may shrink tumors over time. Patients undergoing ADT often report higher levels of fatigue, depression, and cognitive impairments.

In this study, researchers from the Moffitt Cancer Center in Florida assessed ifinflammation caused by ADT is to blame for these symptoms.

“Because the blocking of testosterone can increase inflammation in the body, we believe that inflammation may also be contributing to these symptoms,” said co-author Heather Jim, PhD, Senior Member of Moffit’s Health Outcomes & Behavior Program, in a press release.

A cohort of 47 men being treated with ADT for prostate cancer were age- and education-matched with a group of 82 men with no history of cancer. Patients receiving ADT were assessed around the time of treatment initiation and again at six months and one year. Data on fatigue, depressive symptoms, and cognitive impairment were collected via participant surveys and neuropsychological tests. In addition, researchers also measured levels of circulating inflammation markers such as interleukin 1 receptor antagonist (IL‐1RA), interleukin 6 (IL‐6), soluble tumor necrosis factor receptor II (sTNF‐RII), and C‐reactive protein (CRP).

At baseline, the two groups did not differ. Levels of fatigue and depressive symptoms, as well as serum IL-6 levels, increased significantly over the 12-month period in the ADT group compared with the control. Cognitive impairment also differed between the two groups over time. There were no significant changes in the other inflammation markers over the study period. Increased IL-6 levels were associated with more severe fatigue, though not depression or cognitive impairment.

According to the researchers, additional research on the effect of anti-inflammatory interventions are needed to see if these symptoms can be relieved.

This study was published in Cancer.