Keep your mind sharp during ADT

Dr Sylvia Rodrigues reviews what science says about cognitive decline during androgen deprivation therapy (ADT) for prostate cancer and offers ways to reclaim your mental sharpness.

If you’re on androgen deprivation therapy (ADT) for prostate cancer, you might 

have noticed some mental fog—misplacing things, struggling to focus, or feeling like your brain 

isn’t as sharp as it used to be. You’re not imagining it. Research suggests that ADT can affect memory, attention, and thinking speed in some men.  

But here’s the good news: You are not powerless against it. Just like physical therapy helps your body recover, there are science-backed ways to protect—and even boost—your brainpower while on ADT.  

The science behind ADT and brain fog  

ADT works by lowering testosterone, which is great for fighting prostate cancer but can have side effects on the brain. 

Testosterone helps with memory (recalling names, dates, where you left your phone or your keys), focus (staying on task without distraction), and quick thinking (processing information fast).  

Studies show that some men on ADT experience mild cognitive changes, especially in executive function (planning, multi-tasking), verbal memory (remembering conversations), and spatial skills (judging distances, reading maps).  

But not everyone is affected the same way; some men notice no changes at all. The key is to stay proactive, so you can keep your mind as sharp as possible.  

Five ways to fight back against brain fog

1. The number 1 brain booster 

Exercise isn’t just for your muscles; it’s rocket fuel for your brain. Studies show that aerobic exercise (walking, swimming, or cycling) increases blood flow to the brain and even helps grow new brain cells.  

Try: 

• 30-minute brisk walks, 5 x a week (bonus points if outdoors as nature helps reduce stress too).
• Light strength training (even resistance bands at home count).
• Yoga or tai chi (improves balance and mental clarity). 
• A new sport (golf, bowls, or dancing). 

2. Feed your brain the right fuel  

Your brain runs on what you eat. A Mediterranean-style diet (rich in fish, nuts, berries, and olive oil) is linked to better memory and slower cognitive decline.  

Brain-boosting foods  

• Fatty fish (salmon, sardines).
• Omega-3s protect brain cells (consider an omega-3 daily supplement). 
• Blueberries and dark leafy greens are packed with antioxidants 
• Nuts and seeds are healthy fats for focus. 
• Avoid sugary snacks and processed foods as they can worsen brain fog.  

3. Train your brain like a muscle  

If you don’t use it, you lose it. Challenging your brain keeps it strong.  

Fun ways to stay sharp 

• Learn something new (language, instrument, or even sudoku). 
• Play strategy games (chess, Scrabble, or brain-training apps like Lumosity). 
• Read and discuss books (book clubs keep your verbal memory active).  

4. The silent brain killers  

Poor sleep and chronic stress worsen cognitive function. ADT can disrupt sleep, so it’s extra important to prioritise rest.  

Quick fixes  

•  Stick to a sleep schedule (even on weekends). 

•  Try mindfulness or deep breathing (just five minutes a day helps).

•  Limit screens before bed (blue light messes with sleep hormones).  

5. Talk to your doctor about options  

If brain fog is really bothering you, ask your oncologist about:  

• Intermittent ADT (if appropriate for your case).
• Vitamin D levels (low vitamin D, higher cognitive risk). 
• Mental health support (anxiety/depression can mimic brain fog and treatments are available to assist).  

You are stronger than you think 

Yes, ADT can be tough but your brain is far more resilient than you might expect. 

By staying active, engaged, and proactive, you can keep your mind sharp and your spirit strong.  

Remember, you are not just fighting cancer, you are living well despite it and that is something to be proud of.