Increasing use of gonadotropin-releasing hormone agonists for the treatment of localized prostate carcinoma
TLDR
The authors examined the time trends and patterns of use for androgen deprivation in the form of gonadotropin‐releasing hormone (GnRH) agonists or orchiectomy, in population‐based tumor registries.Abstract:
BACKGROUND
The role of androgen deprivation therapy in prostate carcinoma is controversial in earlier stages of disease. The authors examined the time trends and patterns of use for androgen deprivation in the form of gonadotropin-releasing hormone (GnRH) agonists or orchiectomy, in population-based tumor registries.
METHODS
Data were obtained from the linked Surveillance, Epidemiology and End Results-Medicare database. A total of 100,274 men with prostate carcinoma diagnosed from 1991 through 1999 were selected. The main outcome was the proportion of men who received ≥ 1 dose of a GnRH agonist in the first 6 months of diagnosis. This was plotted by year and stratified for age, grade, stage as well as primary versus adjuvant usage. Multiple logistic regression was used to examine predictors of GnRH agonist use in the subset of patients with localized cancer.
RESULTS
There was a consistent increase in GnRH agonist use by year for all ages, stages, and grades. Even in men ≥ 80 years with localized stage and low to moderate grade tumors, primary GnRH agonist use increased over the study period, from 3.7% in 1991 to 30.9% in 1999 (P < 0.001). The multivariable analysis showed that significant variability in GnRH agonist use existed among SEER geographic regions.
CONCLUSIONS
The use of GnRH agonists for prostate carcinoma increased dramatically during the 1990s. This increase occurred across all stages and histologic grades of prostate carcinoma, and was greatest in patients ≥ 80 years. Cancer 2005. © 2005 American Cancer Society.read more
Citations
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Predictors of overall and cancer-free survival of patients with localized prostate cancer treated with primary androgen suppression therapy: results from the prostate cancer outcomes study.
Julie N. Graff,Motomi Mori,Hong Li,Mark Garzotto,Mark Garzotto,David F. Penson,Arnold L. Potosky,Tomasz M. Beer +7 more
TL;DR: Advanced age, and factors that reflect tumor burden and biology were predictive of overall survival, while cancer specific survival was predicted by tumor factors and the burden of comorbid conditions.
Journal Article
Androgen deprivation therapy: indications, methods of utilization, side effects and their management.
Diana Magee,Rajiv K. Singal +1 more
TL;DR: An up-to-date summary of current literature on the indications for androgen deprivation therapy (ADT), ways in which ADT is used, and the main side effects associated with its use is provided.
Journal ArticleDOI
Levels of sex hormones have limited effect on cognition in older men with or without prostate cancer.
Shabbir M.H. Alibhai,S. Mahmoud,F. Hussain,Gary Naglie,Ian F. Tannock,Ian F. Tannock,George Tomlinson,George Tomlinson,Neil Fleshner,Neil Fleshner,Murray Krahn,Murray Krahn,Padraig Warde,Padraig Warde,L. Klotz,Henriette Breunis,Marc Leach,S. Duff Canning +17 more
TL;DR: Although cognitive function was not generally related to sex hormone levels in older men, there may be a weak association with working memory, and relationships between total testosterone and two of four measures of working memory were found.
Journal ArticleDOI
Androgen deprivation therapy, diabetes and poor physical performance status increase fracture risk in Chinese men treated for prostate cancer
Jeremy Yuen-Chun Teoh,Peter K. F. Chiu,Samson Yun Sang Chan,Darren Ming Chun Poon,Ho-Yuen Cheung,Simon S M Hou,Chi-Fai Ng +6 more
TL;DR: The fracture risk should be considered while deciding on ADT in Chinese men, especially in diabetic patients with poor performance status, as well as age, diabetes mellitus, hypertension, hyperlipidemia, ischemic heart disease and performance status.
Journal ArticleDOI
Adverse effects of androgen deprivation therapy in men with prostate cancer: a focus on metabolic and cardiovascular complications
Lauren Collins,Shehzad Basaria +1 more
TL;DR: Data evaluating metabolic and cardiovascular complications of androgen deprivation therapy is reviewed, finding no evidence of survival advantage in patients with localized disease and those experiencing biochemical recurrences.
References
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Studies on prostatic cancer: I. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate
TL;DR: Gutman et al. as mentioned in this paper showed that the acid phosphatase of serum is reduced in metastatic carcinoma of the prostate by decreasing the activity of androgens through castration or estrogenic injections and that this enzyme is increased by injecting androgens.
Journal Article
Studies on Prostatic Cancer. I. The Effect of Castration, of Estrogen and of Androgen Injection on Serum Phosphatases in Metastatic Carcinoma of the Prostate
TL;DR: It is demonstrated that a marked rise in acid phosphatase in serum is associated with the appearance or spread of roentgenologically demonstrable skeletal metastases and implies dissemination of the primary tumor and thus is of unfavorable prognostic significance.