One of the more common experiences many of us have when fighting advanced prostate cancer is fatigue. Despite how common fatigue is in men with advanced disease there has not been even one published controlled trial of interventions for fatigue!
A research team at the Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York has just completed a 6-week, randomized, double-blind, placebo-controlled design evaluated the efficacy of methylphenidate (Ritalin, Concerta, Metadate or Methylin) to treat fatigue in prostate cancer patients.
The study evaluated men with advanced prostate cancer who also suffered with moderate to severe fatigue. The study population consisted of thirty-two subjects who were randomized to methylphenidate (n = 16) or placebo (n = 16). Men with major depression, hypothyroidism, uncontrolled hypertension, arrhythmia, or anemia were excluded from participating. Fatigue levels, blood pressure, pulse, and other safety concerns were monitored regularly.
1- Brief Fatigue Inventory total scores significantly decreased for both groups; however, the methylphenidate group, as compared with placebo, reported greater decrease on Brief Fatigue Inventory severity scores (P = .03) and a trend toward greater decrease on Brief Fatigue Inventory total scores (P = .07).
2- A significantly greater number of men in the methylphenidate group versus the placebo group demonstrated clinically significant improvement in fatigue on total Brief Fatigue Inventory scores (7 of 10 vs 3 of 13) and Brief Fatigue Inventory severity scores (8 of 10 vs 3 of 13).
3- Six (6) men in the methylphenidate group discontinued because of increased blood pressure or tachycardia. There were no serious adverse events.
Methylphenidate can be an effective treatment in men with advanced prostate cancer suffering from fatigue; however, oncologists need to monitor for possible pulse and blood pressure elevations.
Reference: Cancer. 2010 Jul 21. Epub ahead of print.
doi: 10.1002/cncr.25424; Roth AJ, Nelson C, Rosenfeld B, Scher H, Slovin S, Morris M, O’Shea N, Arauz G, Breitbart W.
Joel T Nowak, M.A., M.S.W.