Estradiol and cognition during androgen deprivation in men with prostate carcinoma
Bibliographic record
Abstract
S alminen et al. 1 present evidence that LHRH analogs, by lowering endogenous estradiol levels, impair certain cognitive processes in prostate cancer (PCa) patients.Others have shown that estradiol cognitively protects spatial memory in older men. 2 Currently, estrogens are used as secondary, rather than primary, hormonal therapies for PCa patients.We propose that estradiol is likely to be more protective of cognition if it is used before patients start on an LHRH agonist.Salminen et al. do not cite data that has shown no cognitive benefits of estradiol treatment in PCa patients.3 To reconcile those differences, we suggest that estradiol's cognitive benefits are likely to be greatest in patients who have not already experienced cognitive decline-either from LHRH agonists or aging.We base this suggestion on data from menopausal women, which reveal a critical window of time at menopause when estrogenic compounds are protective of cognition.4 After cognitive decline has set in, exogenous estrogens may actually play a negative role.Extending these results to men, we should expect that estradiol will be most beneficial to PCa patients if used earlier rather than later.Estradiol lowers patients' risk of osteoporosis and incidences of hot flashes, while costing less than LHRH agonists.So, then, why not use estradiol as primary hormonal therapy for PCa?The risk of thromboembolism is real, but it can be greatly reduced if estradiol is applied transdermally.Supposedly, gynecomastia can be reduced with prophylactic radiotherapy; however, its effectiveness has not been proven in prospective studies, nor does it significantly reduce the incidence of breast complaints from patients on estradiol.Again, extrapolating from postmenopausal women, physicians should be aware that estrogens may increase urinary incontinence in patients already experiencing incontinence secondary to a prostatectomy and radiotherapy for localized PCa. 5 2032
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".