Men with Prostate Cancer Experience Higher Levels of Fatigue Due to Inflammation

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Men who are receiving androgen deprivation therapy treatment for prostate cancer experience higher levels of fatigue and depression when compared to men who are not receiving treatment and who have no history of cancer.

Men with prostate cancer and are receiving androgen deprivation therapy (ADT), a treatment that eliminates testosterone, may experience symptoms of fatigue due to an increase in the protein interleukin 6 (IL-6, a circulating marker of inflammation that helps regulate immune response), according to a study published in Cancer.

“To our knowledge, there have been no studies examining the association between inflammation and androgen deprivation therapy symptomology even though testosterone is known to modulate inflammation,” authors say. “These efforts are important to improving the quality of life in the large and growing population of patients with prostate cancer receiving androgen deprivation therapy.”

The study compared two groups: one of 47 men with prostate cancer who received ADT and another group of 82 men who did not receive treatment and had no history of cancer. Participants were assessed with the Fatigue Symptom Inventory, the Center for Epidemiological Studies Depression Scale, and a batter of neuropsychological tests, at the time of ADT therapy initiation, six months later, and 12 months later in those who received therapy, and comparable times in those who did not.

Results showed that fatigue and depression increased significantly over 12 months in men who received treatment when compared to those without cancer. Cognitive impairment rates stayed stable for men receiving treatment, while authors found a decrease in the other group of men.

Additionally, researchers saw a significant increase of IL-6 in men with prostate cancer who received ADT, and concluded that this increase could lead to an increase of fatigue symptoms over time. They however do not attribute the symptoms of depression and cognitive impairment to IL-6, but to treatment overall.

“Exercise has been shown to reduce fatigue in patients with prostate cancer, perhaps because of its effects on interleukin 6,” researchers note. “Research is needed to determine whether additional interventions to reduce overall inflammation or interleukin 6 specifically exert beneficial effect on fatigue among androgen deprivation therapy patients with prostate cancer who are unable or unwilling to exercise.”

The authors noted that the study was limited by its small sample size of 129 men, and concluded that a larger sample size is needed in future research examining whether a reduction in overall inflammation or IL-6 in particular could help relieve fatigue in men with prostate cancer, ultimately improving their quality of life during treatment and beyond.