Predicting Cognitive Decline From Androgen Deprivation Therapy

Inclusion Criteria:

Patient Participants-

* Age 18 years or greater.
* Fluent in reading, listening to, and writing English.
* Current or prior diagnosis of prostate adenocarcinoma based on a pathology report or as documented in a medical oncology, urology, or radiation oncology note.
* Access and ability to use a computer or mobile device with Internet connectivity to complete study procedures.
* Telephone Montreal Cognitive Assessment (T-MoCA) of 16 or greater.
* Eastern Cooperative Oncology Group (ECOG) performance status 0-2 (documented within past 3 months, otherwise patient-reported).

Study partner participants-

* Age 18 years or greater
* Fluent in reading, listening to, and writing English
* Identified by patient participant as a person who knows patient participant well, like a friend, family member or spouse.
* Access and ability to use a computer or mobile device with internet connectivity to complete study procedures.

Only the ADT cohort-

* Anticipated to start ADT, which includes one of the following two treatments

  * Gonadotropin-releasing hormone (GnRH) agonist (e.g., leuprolide, goserelin, and others).
  * GnRH antagonist (i.e., degarelix or relugolix).
* Anticipated to remain on ADT for at least 12 months.
* Concurrent first-generation anti-androgens (e.g., bicalutamide, flutamide, nilutamide) and novel androgen-signaling inhibitors (e.g., abiraterone, enzalutamide, and apalutamide) are allowed.
* Concurrent radiation is allowed.

Only the PC cohort-

* Has completed definitive local therapy (radical prostatectomy or radiation therapy) for localized prostate cancer at least 6 months prior to screening.
* For radical prostatectomy: undetectable prostate-specific antigen (PSA) within 12 months of screening.
* For radiation therapy: last PSA of \< 2.0 within 12 months of screening.

Exclusion Criteria:

Patient Participants-

* Small cell prostate carcinoma (pure or mixed).
* Receipt of ADT (GnRH agonist, GnRH antagonist, 1st-generation anti-androgen, or novel androgen signaling inhibitor) within 6 months before screening. ADT \>6 months prior to screening is allowed provided testosterone has recovered to 100 ng/ml or greater.
* Concurrent or anticipated (at any point during first 12 months of ADT) non-hormonal, antineoplastic systemic therapy, such as chemotherapy.
* Testosterone \<100 ng/ml.
* Prior or concurrent brain metastases (no prior or screening imaging is required).
* Major neurocognitive or psychiatric disorders, such as dementia or schizophrenia.
* Prior or concurrent malignancy other than prostate cancer whose natural history or treatment has the potential to interfere with study assessments.

Study partner participants-

* None.

Only the ADT cohort-

* None.

Only the PC cohort-

* Any prior, concurrent, or anticipated use of any hormonal systemic therapy, including GnRH agonist, GnRH antagonist, 1st-generation anti-androgen, or novel androgen signaling inhibitor.
* Any known or prior history of M1 prostate cancer (no screening imaging required).
* Current or prior biochemical recurrence following American Urological Association guidelines for radical prostatectomy or American Society for Therapeutic Radiology and Oncology (ASTRO) guidelines for radiation therapy.