ADT-induced inflammation associated with malaise in patients with prostate cancer

According to a study published in the journal, an increase in circulating interleukin 6 (IL-6), an inflammatory marker in prostate cancer patients receiving androgen deprivation therapy (ADT), was associated with increased malaise. cancer..^1,2

“Interleukin-6 is an pro-inflammatory cytokine that is often associated with sleep disorders and thus fatigue,” said Aasha Hoogland, lead research author and applied research scientist in the Health Outcomes and Behavior Program at the Mofit Cancer Center. The doctor said: Press release.

“Studies have shown that testosterone can suppress the effects of IL-6, but ADT limits testosterone production in the body, so elevated levels may be seen in this group of patients. “Hoogland added.

Previous studies have established an association between ADT and increased levels of fatigue, depressive symptoms, and cognitive impairment in patients. However, no studies have focused on whether ADT-induced inflammation contributes to the development of these symptoms.

“This is the first study to investigate the association between inflammation and symptoms of fatigue, depression, or cognitive impairment in prostate cancer patients undergoing ADT,” said Health Outcomes &’s corresponding author and author. Co-leader Dr. Heather Jim said. The action program at Mofit, as described in the press release.

“We believe that blockade of testosterone can increase inflammation in the body, so inflammation may also contribute to these symptoms,” Jim added.

Mofit researchers evaluated two groups of men. The first consisted of 47 patients with prostate cancer treated with ADT. Patients were evaluated at the start of ADT and 6 and 12 months after the start of treatment. The second group consisted of a cohort of 82 men with no history of cancer and age- and education-matched, evaluated at similar times.

Researchers’ strategies look at circulatory markers of inflammation in patients undergoing ADT and investigate the potential relationship between these markers and increased fatigue, depression, and cognitive impairment associated with ADT. It was that.

Circulating markers of inflammation evaluated included interleukin-1 receptor antagonist (IL-1RA), IL-6, soluble tumor necrosis factor receptor II (sTNF-RII), and C-reactive protein (CRP). It was.

Fatigue was assessed on the Fatigue Symptom Inventory, depression was assessed on the Center for Epidemiological Studies Depression Scale, and cognitive impairment was assessed using a series of neuropsychological tests.

The results showed a significant increase in fatigue, depressive symptoms, and serum IL-6 over time between patients undergoing ADT and the cancer-free group. “The rate of cognitive impairment also changed significantly between groups,” the author writes.

Over time, no significant changes were detected in IL-1RA, sTNF-RII, or CRP.

Researchers have established a link between increased IL-6 and increased malaise. However, no such relationship has been established between increased IL-6 and increased depressive symptoms or cognitive impairment.

The next step, according to Moffit researchers, is an additional study to see if certain interventions, such as exercise and anti-inflammatory treatments, can reduce fatigue and depression in prostate cancer patients undergoing ADT.

References

1. Inflammation caused by androgen removal therapy can cause fatigue in patients with prostate cancer. Published online on January 4, 2020. https: //bit.ly/391Yl6I. Accessed on January 4, 2020.

2. Hoogland AI, Jim HSL, Gonzalez BD, etc.Systemic inflammation and symptomatology of prostate cancer patients treated with androgen depletion therapy: preliminary findings [published online December 30, 2020].. cancer.. Doi: 10.1002 / cncr.33397