Prostate cancer hormonal treatments (e.g. androgen deprivation therapy) yield clinical benefits. However, there is increasing evidence these treatments may adversely impact cognitive functioning. This study aimed to qualitatively characterise the nature and impact of cognitive difficulties following these treatments.
Prostate cancer survivors (PCS) self-reporting cognitive difficulties following hormonal treatments (via an online survey) and their partners were invited to participate in semi-structured interviews. Telephone or videoconferencing interviews were conducted, then transcribed, double-coded and analysed using the Framework Method, following the principles of Interpretative Phenomenological Analysis.
Eleven participants (six PCS and five partners) were interviewed. PCS reported a range of cognitive difficulties, verified by their partners, including forgetfulness, "fogginess", fatigue and slowed processing speed. For some PCS, word-finding difficulties, tangential speech and memory problems were apparent during interviews. The aetiology of the reported cognitive difficulties was unclear as it was attributed to a possible combination of cancer treatments, compounding side-effects (e.g. fatigue, sleep problems, hot flashes), exacerbation of pre-existing conditions and/or age-related changes. Cognitive difficulties were reported to have led to shifts in self-perception, interpersonal dynamics and increased emotionality. Engagement in cognitively-stimulating activities and reliance on compensatory strategies were reported to be helpful in managing some cognitive difficulties. All participants endorsed the potential benefits of neuropsychological intervention.
There are a diverse range of cognitive difficulties following hormonal treatments for prostate cancer experienced by PCS and their partners. Understanding the impact of these difficulties is important for the development of targeted neuropsychological interventions.
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2024 Jul 22*** epublish ***
Lorna Pembroke, Kerry A Sherman, Haryana M Dhillon, Heather Francis, Howard Gurney, David Gillatt
Lifespan Health and Wellbeing Research Centre, Macquarie University, 2109, Sydney, NSW, Australia. ., Lifespan Health and Wellbeing Research Centre, Macquarie University, 2109, Sydney, NSW, Australia., Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, Faculty of Science, University of Sydney, 2006, Sydney, NSW, Australia., School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University & Macquarie University Hospital, 2109, Sydney, NSW, Australia., Macquarie University Clinical Trials Unit (CTU), Faculty of Medicine and Health Sciences, Macquarie University & Macquarie University Hospital, 2109, Sydney, NSW, Australia., Macquarie University Urology Clinic, Faculty of Medicine and Health Sciences, Macquarie University & Macquarie University Hospital, 2109, Macquarie Park, NSW, Australia.