Standard treatments for some breast and prostate cancers include medications that downregulate hormonal (i.e., estrogen and testosterone) function in the body and brain. The role of sex hormones in cognitive function and dementia risk is becoming increasingly demonstrated in the literature. Understanding of how these endocrine therapies for cancer influence brain function and dementia risk is poor and understudied.

Clinical trials of endocrine therapies for breast and prostate cancers typically focus on its efficacy in terms of cancer treatment/recurrence, and very few have included capturing cognitive side effects. Some cohort and smaller observational studies have begun characterizing cognitive symptoms associated with these treatments but it remains poorly understood, in part because of the heterogeneity of symptoms and prevalence. Additionally, very few studies have taken an extended longitudinal approach to describe potential effects of these treatments on brain health years down the line from initiating treatment, despite signals from other fields that suggest manipulating hormonal function can alter dementia risk. There is a need for improved recognition of potential cognitive symptoms associated with endocrine therapy use, improved screening and documentation of symptoms, leading to improved patient counseling of potential symptoms and referrals to appropriate cognitive support services as indicated.