ESMO 2023 | Cognitive function in prostate cancer: assessment, impact, and management

Daniele Raggi, MD, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, underscores the complexity of assessing cognitive function in prostate cancer, referencing cognitive domains outlined by the DSM manual. Up to 30% of patients exhibit cognitive impairment pre-treatment, rising to 75% during treatment, affecting cancer mortality. Comorbidities and history contribute to early cognitive decline. Dr Raggi recommends assessing medical history, medication, emotional distress, and utilizing screening tools. Notably, clinical trials reveal androgen deprivation therapy’s association with cognitive changes, highlighting differences in novel hormonal agents’ profiles. Survivorship guidelines for managing cognitive changes are limited, emphasizing cognitive training, physical activity, mind-body treatments, and potential drug interventions. Ongoing and future directions include ketogenic diets, exercise, and online training programs for cognitive rehabilitation. This interview took place at the Global Congress on Prostate and Bladder Cancer (PROSCA/BLADDR) 2023 in Malaga, Spain.

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