Abstract
Simple SummaryThe experience of a cancer diagnosis, cancer treatments, and the tumor itself may have impacts on cognitive performance. Patients with prostate cancer are a large population who may be more vulnerable to cognitive deterioration due to older age. Understanding the occurrence of cognitive impairment among these patients is essential for developing strategies aiming to slow down the progression of cognitive deterioration, to increase patients’ autonomy and quality of life, and to decrease the probability of non-compliance with treatment. This study describes the prevalence of cognitive impairment in patients recently diagnosed with prostate cancer and proposed for any type of cancer treatment. No significant differences were observed between the frequency of cognitive impairment in these patients before treatment and in the general population, suggesting that the impact of prostate cancer on cognitive performance could be negligible in the short term, contrary to what other studies have reported in other types of cancer.Cognitive impairment is common among patients with different types of cancer, even before cancer treatment, but no data were reported among patients with prostate cancer (PCa), who may be at high risk due to advanced age. This study aims to estimate the prevalence of cognitive impairment before PCa treatment. Between February 2018 and April 2021, the NEON-PC cohort recruited 605 patients with PCa proposed for treatment at the Portuguese Institute of Oncology of Porto. The Montreal Cognitive Assessment (MoCA) was used to assess cognitive performance. Participants with a MoCA < 1.5 standard deviations (SD) of age- and education-specific normative values were considered to have probable cognitive impairment (PCI) and were referred for a comprehensive neuropsychological assessment. Data from the population-based cohort EPIPorto (n = 351 men aged ≥40 years, evaluated in 2013–2015) were used for comparison. The prevalence of PCI was 17.4% in EPIPorto and 14.7% in NEON-PC (age- and education-adjusted odds ratio: 0.82, 95%CI: 0.58,1.18). Neuropsychological assessment was performed in 63 patients with PCa: 54.0% had cognitive impairment. These results suggest that the impact of PCa on cognitive performance could be negligible in the short term, contrary to what other studies have reported regarding other types of cancer.
Highlights
Cognitive impairment in cancer patients has been the focus of numerous studies over the few last decades, mostly regarding the effects of cancer treatments on this condition and, more recently, its occurrence before cancer therapy [1]
4.0% had a proposal of ADT with docetaxel
Cognitive impairment was confirmed by neuropsychological testing in just over half the patients with probable cognitive impairment (PCI), and executive function was the most frequently impaired domain
Summary
Cognitive impairment in cancer patients has been the focus of numerous studies over the few last decades, mostly regarding the effects of cancer treatments on this condition and, more recently, its occurrence before cancer therapy [1]. Cognitive impairment may have an important impact on the patients’ and their families’ lives, as well as on cancer treatments. Cognitive complaints in cancer patients may interfere with occupational reintegration and working performance, which has an important impact on patients’ quality of life, mental health and finances, and, at the societal level, on work capacity and productivity [5]. Pathophysiological processes induced by cancer, the experience of a cancer diagnosis, or cancer treatment may negatively impact cognitive performance, and cognitive impairment has been often reported among these patients [6,7]. Cancer is not a single disease, and even among tumors with the same typology, there is a large heterogeneity regarding cancer-related symptoms, including those related with the impairment of the patients’ cognitive status [8,9]
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