A recent study of over 150,000 men with prostate cancer showed androgen deprivation therapy (ADT) exposure was associated with subsequent diagnosis of Alzheimer disease or dementia over a follow-up period of at least 10 years.
Among 154,000 older patients, 13% who received hormone-blocking treatment developed Alzheimer’s, compared with 9% who had other treatment or chose no therapy, the study found.
This same study showed a risk for dementia from strokes in the group choosing ADT.
Lastly, there seems to dose-response relationship here, meaning, that those who received more ADT were at higher risk of both Alzheimer’s and dementia versus patients who received less than about 8 doses of ADT
What is ADT?
Androgen Deprivation Therapy or ADT is a group of drugs that over stimulates the middle area of your brain called the pituitary gland, which then leads to testicular shut down of testosterone production where over 90% of testosterone is made.
(If curious, the other portion of testosterone is made in the adrenal glands which sit on top of your kidneys)
There are many ADT drugs in the market but the most common is leuprolide acetate or better known by its trade name, Lupron.
The idea for using Lupron for advanced prostate cancer to significantly reduce testosterone production should then lead to overall survival in patients with prostate cancer.
There are numerous long-term adverse effects to ADT including, fatigue, development of metabolic syndrome/insulin resistance, and low sexual interest.
While the association with ADT and dementia and Alzheimer’s is not new, it is one that is less spoken about in clinical settings.
Here’s the deal though; it’s a fine line between staying alive from prostate cancer and not succumbing to serious negative effects from the treatment that’s supposed to keep you alive.
In other words, the patient on ADT should strive for both, life and quality of life.
Why choose one over the other?
That does not need to happen.
How to Prevent Alzheimer’s and Dementia while on ADT for Prostate Cancer
I spend countless hours researching how to help my patients and you, my readers to help guys live their best life despite prostate cancer or strong treatments like ADT.
With the exception of sexuality and hot flushes (which is more of a challenge to treat while on ADT) I firmly believe men can live a fully functional life while on ADT.
(Excuse the pun – “firmly”)
In other words, there’s no reason to succumb to memory issues, broken bones or metabolic syndrome.
I see men living great lives during ADT for prostate cancer.
But it will not happen by chance.
It takes work.
10 Ways To Prevent Alzheimer’s and Dementia while on ADT for prostate cancer:
- Let your oncologist know if you have a paternal family history of dementia or Alzheimer’s disease.
- Get blood tested for Apolipoprotein E (Apo E) – a gene responsible for creating many good things in the body, but those with a particular type, ApoE4, have a dramatic risk of developing Alzheimer’s disease. Then let your oncologist know that you have a predisposition to Alzheimer’s disease based on this gene.
Note: you can have the ApoE4 gene and not develop Alzheimer’s, a man on ADT should let their oncologist know about it to best monitor how to prescribe the hormone deprivation drug.
- One of the signs of Alzheimer’s disease is the development of plaques in the brain. Such abnormalities in the brain are called beta-amyloid plaques.
- Essential, omega-3 fatty acids, especially docosahexaenoic acid (DHA) has shown to destroy plaques in the brain that leads to Alzheimer’s. While I am not exactly sure why DHA works in preventing Alzheimer’s, it might be by reducing inflammatory chemicals in the brain.
- Extracts from the Indian herb, Bacopa monnieri may also reduce the chances of men on ADT from developing Alzheimer’s disease.
- Huperzine A from the Chinese herb, Huperzine serrate, has shown to improve cognition and help people already diagnosed with Alzheimer’s disease.
- Having ample vitamin D levels in the body of men on ADT has multiple benefits, one being for cognition. Low vitamin D levels in the blood have been associated with poor memory and overall cognition.
- Exercise regimen requires weight resistance exercise. While “cardio” exercises are good, adding weight resistant exercise, specifically in men on ADT is most important.
- Mediterranean style of eating is a cornerstone for the CaPLESS Method eating approach. Eating this way requires optimal dietary choices, mainly low-glycemic fruits, vegetables, fish, whole-grains (gluten-free, preferably), nuts and seeds.
10. Have a strong mind. Just because you forgot where you left your keys, for example, and are on ADT does not mean that you will suffer from dementia or Alzheimer’s disease.
I am not on ADT and I forget where I leave my keys all the time, so either, that’s because I just have too much in my head to remember relatively small things like keys placement or I’m in deep trouble too.
The power of the mind is real. While I am not suggesting to just think positively, I am saying that if you forget someone’s name, or keys, or anything, then begin thinking that you are developing dementia because you are on ADT that may become a self-fulfilling prophecy. Don’t go there. There’s no need.
The mind is a powerful thing. Use it well. (no scientific reference here, just truth)