***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We conducted a prospect i ve study of cognitive function in patients with small cell lung cancer ( SCLC ) . A previous study had shown SCLC patients to have deficits in memory , frontal lobe executive functioning , and motor skills before they received prophylactic cranial irradiation ( PCI ) . This study was performed to determine whether these deficits were related to chemoradiation treatment . We evaluated two groups of patients : one newly diagnosed and untreated , the other post-chemoradiation and before PCI .  Strict eligibility criteria were used to minimize any preexisting factors that might influence cognitive functioning . Results showed that patients with SCLC have cognitive deficits before receiving chemoradiation , specifically on tests of verbal memory , frontal lobe executive functions , and motor coordination . There was no difference between the treated and untreated patients on any test . Etiologic considerations currently under study include paraneoplastic phenomena Circulating testosterone ( T ) levels have behavioral and neurological effects in both human and nonhuman species . Both T concentrations and neuropsychological function decrease substantially with age in men . The purpose of this prospect i ve , longitudinal study was to investigate the relationships between age-associated decreases in endogenous serum T and free T concentrations and declines in neuropsychological performance .  Participants were volunteers from the Baltimore Longitudinal Study of Aging , aged 50 - 91 yr at baseline T assessment . Four hundred seven men were followed for an average of 10 yr , with assessment s of multiple cognitive domains and contemporaneous determination of serum total T , SHBG , and a free T index ( FTI ) . We administered  neuropsychological tests of verbal and visual memory , mental status , visuomotor scanning and attention , verbal knowledge/ language , visuospatial ability , and depressive symptomatology .  Higher FTI was associated with better scores on visual and verbal memory , visuospatial functioning , and visuomotor scanning and a reduced rate of longitudinal decline in visual memory . Men classified as hypogonadal had significantly lower scores on measures of memory and visuospatial performance and a faster rate of decline in visual memory . No relations between total T or the FTI and measures of verbal knowledge , mental status , or depressive symptoms were observed . These results suggest a possible beneficial relationship between circulating free T concentrations and specific domains of cognitive performance in older men And rogen deprivation ( AD ) is commonly used in neoadjuvant and adjuvant setting with prostate cancer ( PC ) radiotherapy . This prospect i ve study assessed whether cognitive functioning is impaired during 12 months of AD therapy . Longitudinal testing of 25 patients treated with AD and curative radiotherapy  was undertaken at baseline , and at 6 and 12 months . CogniSpeed © software was used for measuring attentional performances . Other cognitive performances were evaluated using verbal , visuomotor and memory tests . The Beck depression inventory was employed to evaluate depressive mood and EORTC QLQ-C30 for quality of life ( QoL ) . During longitudinal testing of the AD group , no impairment in cognitive performances was found . Instead , improvement was observed in object recall ( immediate , P=0.035 ; delayed , P<0.001 ) , and in semantic memory ( P=0.037 ) . In QoL , impairment in physical function was observed . And rogen deprivation of 12 months appears to be associated with preserved cognitive functioning , although physical impairment occurs . These results have implication s for counseling and psychosocial support of patients in the context of treatment options in PC OBJECTIVE To examine , in a prospect i ve study , the influence that temporary reversible medical castration for localized prostate cancer has on cognition , by assessing whether temporary 3 - 5 month treatment with a luteinizing-hormone releasing hormone ( LHRH ) agonist before radical radiotherapy had a short- or long-term affect on cognitive function . PATIENTS , SUBJECTS AND METHODS Thirty-two patients with localized prostate cancer had  cognitive assessment  s at baseline ( T1 ) before the start of drug treatment , at 3 months ( T2 ) or on completing drug treatment but before radiotherapy , and 9 months later ( T3 ) . Eighteen men with no prostate cancer ( controls subjects ) completed the  cognitive tests  at the same times . In addition , psychological functioning and quality of life were assessed at the same times , together with serum free and bound testosterone , beta-oestradiol and sex hormone-binding globulin levels . RESULTS There was a significant cognitive decline ( on at least one cognitive task ) at T2 in 15 ( 47 % ) patients vs three ( 17 % ) of controls ( odds ratio 4.412 , P = 0.033 ) . Most patients ( nine of 15 ) who had a change in performance declined on tasks of spatial memory and ability . At T3 there was significant cognitive decline in 11 ( 34 % ) patients and five ( 28 % ) control subjects ( odds ratio 1.37 , P = 0.631 ) . CONCLUSION This pilot study suggests that short-term LHRH therapy for early-stage prostate cancer has modest short-term consequences on men 's cognitive functioning ; a larger prospect i ve study is warranted PURPOSE Men with prostate specific antigen ( PSA ) only relapse of prostate cancer after primary therapy are generally fully functional and asymptomatic with a life expectancy of up to 10 or more years . These patients are often treated with and rogen suppression . We evaluate the effects of and rogen suppression on cognitive function . MATERIAL S AND METHODS Hormone naïve patients without evidence of metastases with an increasing PSA were treated with intermittent and rogen suppression consisting of 9 months of leuprolide and flutamide followed by an off treatment period determined by the increase in PSA .  Cognitive function tests were administered at baseline , after 9 months of and rogen suppression and after 3 months off treatment . Cognitive tests measured spatial abilities , spatial memory , verbal fluency , verbal memory and selective attention .  A total of 19 patients 52 to 76 years old completed the intermittent and rogen suppression study along with 15 healthy community dwelling control participants . RESULTS Combined and rogen blockade reduced PSA and testosterone in all patients compared to baseline . Patients did not significantly change on measures of verbal and spatial memory , executive functions or language . Patients declined on a measure of spatial rotation and improved on a measure of verbal memory during treatment which continued during the off treatment period . CONCLUSIONS Although preliminary , these findings demonstrate that 9 months of combined and rogen blockade result ed in a beneficial effect on verbal memory but adversely affected a measure of spatial ability .  Intermittent and rogen suppression for a period of 9 months in otherwise healthy men with prostate cancer may have beneficial and adverse effects on cognition that are selective This study examined the effects of and rogen suppression therapy ( AST ) on upper and lower body muscle strength and a range of direct measures of physical performance using a cross-sectional design with 118 men ( 48 men undertaking AST for prostate cancer and 70 healthy aged-matched controls ) from a single tertiary center . Primary end points included muscle strength for the upper- and lower-body ; functional performance — repeated chair rise , usual and fast 6-m walk , 6-m backwards walk and 400-m walk time ; and dual-energy X-ray absorptiometry assessment —whole body , regional soft tissue composition and bone mineral density ( BMD ) . Men on AST  had significantly reduced muscle strength for the upper- and lower-body and impaired functional performance compared to controls ( P<0.05 ) . As expected , AST patients had significantly lower whole-body and hip BMD and higher percent of body fat than controls ( P<0.05 ) , and tended to have lower whole-body lean mass ( −2.3 kg , P=0.077 ) . Appendicular skeletal muscle was positively associated with upper-body ( r=0.400–0.606 , P<0.001 ) and lower-body ( r=0.549–0.588 , P<0.001 ) muscle strength , and strength was related to functional performance . Men undertaking  AST were consistently impaired across a broad range of physical and functional musculoskeletal performance assessment s compared with their age-matched normal controls . These findings are relevant for those patients considering AST for sub clinical disease management , but whose physical reserve is marginal . Strategies to counter these adverse effects of AST need to be initiated so that independent living and quality of life can be maintained To investigate the effects of different management strategies for non‐localized prostate cancer on men 's quality of life and cognitive functioning Objective To report the first systematic investigation of the cognitive effects of luteinizing hormone‐releasing hormone ( LHRH ) analogues in male patients , as LHRH analogues have been associated with memory impairments in women using these drugs for gynaecological conditions Background and Purpose : And rogen deprivation therapy ( ADT ) has become an increasingly st and ard intervention for both early and advanced stages of prostate cancer ; however , decreased physical function and hypogonadism have been reported in men receiving ADT . The objectives of this study were : ( 1 ) to determine whether ADT ( and hypogonadism ) result ed in decreased strength and mobility and ( 2 ) to examine the effect of ADT on an associated test of cognitive and motor function by assessing visuomotor performance . Subjects and Methods : Physical function , walking speed , visuomotor performance , gonadal status , body composition , and Comorbidity Disease Index ( CMDI ) scores were assessed in a cohort of 100 participants that included : ( 1 ) men with prostate cancer who were not on ADT , ( 2 ) men with prostate cancer who were on short-term ADT ( < 6 months ) , ( 3 ) men with prostate cancer who were on long-term ADT ( ≥6 months ) , and ( 4 ) control subjects who did not have prostate cancer . Results : Walking speed varied significantly across the 4 groups , even after adjusting for age , CMDI , and percentage of body fat . Age and CMDI were significantly associated with measurements of physical performance . Adjusted for covariates , men on long-term ADT  walked 0.18 m/s slower than the control subjects . Physical function also varied significantly across the 4 groups . And rogen deprivation therapy did not have a significant effect on visuomotor performance . Discussion and Conclusion : The results suggest that ADT has a significant effect on walking speed and physical performance in men with prostate cancer The effects of testosterone ( T ) and estradiol ( E(2 ) ) on  cognition in men are confounded in extant studies . This r and omized , placebo-controlled trial was undertaken to investigate the possible effects of E(2 ) on cognition in older men . Twenty-five men with prostate cancer ( mean age : 71.0+/-8.8 years ) who required combined and rogen blockade treatment were enrolled . Performance on cognitive tests was evaluated at pre-treatment baseline and following 12 weeks of treatment with a gonadotropin-releasing hormone analog and the nonsteroidal anti and rogen bicalutamide to determine whether specific cognitive functions would decline when the production of both T and E(2 ) were suppressed . In the second phase of the study , either micronized E(2 ) 1mg/day or an oral daily placebo was r and omly added to the combined and rogen blockade for an additional 12 weeks to determine whether E(2 ) would enhance performance in specific cognitive domains ( verbal memory , spatial ability , visuomotor abilities and working memory ) . Compared to pretreatment , no differences in scores occurred on any cognitive test following 12 weeks of combined and rogen blockade . In the add-back phase of the study ( Visit 3 ) , the placebo-treated men , but not the E(2)-treated men , exhibited a trend towards improvement in their scores on both the immediate ( p=.075 ) and delayed recall ( p=.095 ) portions of a verbal memory task compared to baseline . Moreover , at Visit 3 , placebo-treated men performed significantly better than the E(2)-treated men on both the immediate ( p=.020 ) and delayed recall ( p=.016 ) portions of the verbal memory task . Thus , combined and rogen blockade plus add-back E(2 ) failed to improve short- or long-term verbal memory performance in this sample of older men being treated for prostate cancer OBJECTIVE To determine the baseline prevalence of cognitive impairment in older men treated with ADT and to assess changes in cognitive performance over time . METHODS AND RESULTS Thirty-two patients ( median age of 71 years , range 51 - 87 ) were administrated an extensive neuropsychological testing battery prior to ADT initiation , with 21 ( 65 % ) completing post-treatment evaluations 6 months later . At baseline , 45 % scored > 1.5 st and ard deviations below the mean on > or = 2 neuropsychological measures . Using st and ardized inferential statistics , no change in cognition was documented following treatment . The Reliable Change Index revealed that , on a case-by-case basis , 38 % demonstrated a decline in measures of executive functioning and 48 % showed improvement on measures of visuospatial abilities . Within exploratory analyses , patients who scored below expectation at baseline displayed no change in cognition , while patients with average or better scores at baseline displayed improvements in visuospatial planning and timed tests of phonemic fluency . CONCLUSIONS We found a high prevalence of lower than expected cognitive performance among a sample of patients just starting ADT for prostate cancer . Assessment of baseline cognitive function should be taken into account for future research and to inform clinical management OBJECTIVES To assess the effects of and rogen deprivation therapy on body composition in men with nonmetastatic prostate cancer . METHODS In a multicenter study , men with Stage M0 prostate cancer were prospect ively evaluated during initial and 
    Output:
    
Conclusions Prostate cancer patients who received ADT  performed significantly worse on visuomotor tasks compared to noncancer control groups .
These findings are consistent with the known effects of testosterone on cognitive functioning in healthy men .