When I went on my first round of hormone therapy (ADT) I experienced severe cognitive side effects. I found it impossible to concentrate, read and remember anything. I lost the ability to navigate the New York City subways no less drive my car to a destination. Occasionally, when I was attempting to navigate the subway I found it necessary to get off the train, go upstairs (losing my fare) and call my wife Wendy so that I could describe what I saw so she could remind me where I was headed and how to get there from where I described.

Remembering what I had read from day to day was impossible. I finally went to a bookstore and bought a boy’s adolescent sailing novel about cannons and pirates, etc. Then, each night I went to bed and read the same first few chapters of the book. It was always new, exciting and I was able to follow the characters. Even though I had read the same chapters night after night it was always brand new and exciting!

When I reported this to my doctors they universally scoffed and told me that I was exaggerating. I was not it was this difficult for me.

Finally, the concept that chemo brain might exist for men on ADT has had some traction. Researchers from the University of South Florida have taken to heart this issue and decided to examine it from a scientific perspective. They have systematically reviewed the existing literature to determine the effect of ADT on performance across seven cognitive domains using a meta-analysis.

Through a search of PubMed Medline, PsycINFO, Cochrane Library, and Web of Knowledge/Science databases they found 157 unique abstracts reviewed by independent pairs of raters. Fourteen studies with a total of 417 men treated with ADT were included in the meta-analysis. Objective neuropsychological tests were categorized into seven cognitive domains: attention/working memory, executive functioning, language, verbal memory, visual memory, visuomotor ability, and visuospatial ability.

They found that men treated with ADT performed worse than controls or their own baseline only on visuomotor tasks (g?=?-0.67, p?=?.008; n?=?193). The magnitude of the deficits was larger in studies with a shorter time to follow-up (p?=?.04). No significant effect sizes were observed for the other six cognitive domains (p?=?.08-.98)

They concluded that prostate cancer survivors who received ADT performed significantly worse only on visuomotor tasks compared to non-cancer control groups. These findings are consistent with the known effects of testosterone on cognitive functioning in healthy men.

I guess I am truly an outlier.   Are there any other outliers out there?


Support Care Cancer. 2014 May 25. Epub ahead of print.  doi: 10.1007/s00520-014-2285-1; McGinty HL, Phillips KM, Jim HS, Cessna JM, Asvat Y, Cases MG, Small BJ, Jacobsen PB.


PMID: 24859915


Joel T. Nowak, M.A., M.S.W.