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Effects of Androgen Deprivation Therapy on Pain Perception, Quality of Life, and Depression in Men With Prostate Cancer.

Abstract Previous animal and human research suggests that testosterone has antinociceptive properties. Castration in male rodents increases pain perception which is reversed by testosterone replacement. Pain perception also improves in hypogonadal men with testosterone therapy. However, it remains unclear whether androgen deprivation therapy (ADT) in men with prostate cancer (PCa) is associated with an increase in pain perception.
PMID
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Authors

Mayor MeshTerms
Keywords

GnRH agonists

Prostate cancer

depression

pain perception

pain tolerance

quality of life

quantitative sensory testing

testosterone

Journal Title journal of pain and symptom management
Publication Year Start




PMID- 28941963
OWN - NLM
STAT- In-Data-Review
LR  - 20180203
IS  - 1873-6513 (Electronic)
IS  - 0885-3924 (Linking)
VI  - 55
IP  - 2
DP  - 2018 Feb
TI  - Effects of Androgen Deprivation Therapy on Pain Perception, Quality of Life, and 
      Depression in Men With Prostate Cancer.
PG  - 307-317.e1
LID - S0885-3924(17)30496-7 [pii]
LID - 10.1016/j.jpainsymman.2017.09.017 [doi]
AB  - CONTEXT: Previous animal and human research suggests that testosterone has
      antinociceptive properties. Castration in male rodents increases pain perception 
      which is reversed by testosterone replacement. Pain perception also improves in
      hypogonadal men with testosterone therapy. However, it remains unclear whether
      androgen deprivation therapy (ADT) in men with prostate cancer (PCa) is
      associated with an increase in pain perception. OBJECTIVES: To evaluate the
      effects of ADT on pain perception, depression and quality of life (QOL) in men
      with PCa. METHODS: Thirty-seven men with PCa about to undergo ADT with leuprolide
      acetate (ADT group) were followed prospectively for six months to evaluate
      changes in clinical and experimental pain. Forty men who had previously undergone
      prostatectomy for localized PCa and were in remission served as controls (non-ADT
      group). All participants were eugonadal at study entry. Primary outcomes were
      changes in clinical pain (assessed with Brief Pain Inventory questionnaire) and
      experimental pain (assessed with quantitative sensory testing). Secondary
      outcomes included evaluation of depression, anxiety levels, and quality of life. 
      RESULTS: Serum testosterone levels significantly decreased in the ADT group but
      remained unchanged in the non-ADT group. There were no significant changes in
      pain thresholds, ratings, or other responses to quantitative sensory tests over
      the 6-month course of the study. Clinical pain did not differ between the two
      groups, and no changes from baseline were observed in either group. Men
      undergoing ADT did experience worsening of depression (0.93; 95% CI = 0.04-1.82; 
      P = 0.042) and QOL related to physical role limitation (-18.28; 95% CI = -30.18
      to -6.37; P = 0.003). CONCLUSION: ADT in men with PCa is associated with
      worsening of depression scores and QOL but is not associated with changes in
      clinical pain or pain sensitivity.
CI  - Copyright (c) 2017 American Academy of Hospice and Palliative Medicine. Published
      by Elsevier Inc. All rights reserved.
FAU - Gagliano-Juca, Thiago
AU  - Gagliano-Juca T
AD  - Research Program in Men's Health: Aging and Metabolism, Brigham and Women's
      Hospital, Harvard Medical School, Boston, Massachusetts, USA.
FAU - Travison, Thomas G
AU  - Travison TG
AD  - Program on Aging, Hebrew SeniorLife, Roslindale, Massachusetts, USA.
FAU - Nguyen, Paul L
AU  - Nguyen PL
AD  - Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston,
      Massachusetts, USA.
FAU - Kantoff, Philip W
AU  - Kantoff PW
AD  - Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell
      Medical College, New York, New York, USA.
FAU - Taplin, Mary-Ellen
AU  - Taplin ME
AD  - Department of Medical Oncology, Dana-Farber Cancer Institute, Boston,
      Massachusetts, USA.
FAU - Kibel, Adam S
AU  - Kibel AS
AD  - Division of Urology, Brigham and Women's Hospital, Harvard Medical School,
      Boston, Massachusetts, USA.
FAU - Manley, Robert
AU  - Manley R
AD  - Research Program in Men's Health: Aging and Metabolism, Brigham and Women's
      Hospital, Harvard Medical School, Boston, Massachusetts, USA.
FAU - Hally, Kathleen
AU  - Hally K
AD  - Research Program in Men's Health: Aging and Metabolism, Brigham and Women's
      Hospital, Harvard Medical School, Boston, Massachusetts, USA.
FAU - Bearup, Richelle
AU  - Bearup R
AD  - Research Program in Men's Health: Aging and Metabolism, Brigham and Women's
      Hospital, Harvard Medical School, Boston, Massachusetts, USA.
FAU - Beleva, Yusnie M
AU  - Beleva YM
AD  - Research Program in Men's Health: Aging and Metabolism, Brigham and Women's
      Hospital, Harvard Medical School, Boston, Massachusetts, USA.
FAU - Huang, Grace
AU  - Huang G
AD  - Research Program in Men's Health: Aging and Metabolism, Brigham and Women's
      Hospital, Harvard Medical School, Boston, Massachusetts, USA.
FAU - Edwards, Robert R
AU  - Edwards RR
AD  - Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical
      School, Boston, Massachusetts, USA.
FAU - Basaria, Shehzad
AU  - Basaria S
AD  - Research Program in Men's Health: Aging and Metabolism, Brigham and Women's
      Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address:
      [email protected]
LA  - eng
GR  - R21 CA171316/CA/NCI NIH HHS/United States
PT  - Journal Article
DEP - 20170921
PL  - United States
TA  - J Pain Symptom Manage
JT  - Journal of pain and symptom management
JID - 8605836
PMC - PMC5794536
MID - NIHMS908097
OTO - NOTNLM
OT  - GnRH agonists
OT  - Prostate cancer
OT  - depression
OT  - pain perception
OT  - pain tolerance
OT  - quality of life
OT  - quantitative sensory testing
OT  - testosterone
EDAT- 2017/09/25 06:00
MHDA- 2017/09/25 06:00
CRDT- 2017/09/25 06:00
PMCR- 2019/02/01 00:00
PHST- 2017/08/18 00:00 [received]
PHST- 2017/09/12 00:00 [revised]
PHST- 2017/09/14 00:00 [accepted]
PHST- 2019/02/01 00:00 [pmc-release]
PHST- 2017/09/25 06:00 [pubmed]
PHST- 2017/09/25 06:00 [medline]
PHST- 2017/09/25 06:00 [entrez]
AID - S0885-3924(17)30496-7 [pii]
AID - 10.1016/j.jpainsymman.2017.09.017 [doi]
PST - ppublish
SO  - J Pain Symptom Manage. 2018 Feb;55(2):307-317.e1. doi:
      10.1016/j.jpainsymman.2017.09.017. Epub 2017 Sep 21.