National Practice Patterns and Time Trends in Androgen Ablation for Localized Prostate Cancer

Cooperberg, Matthew R.; Grossfeld, Gary D.; Lubeck, Deborah P.; Carroll, Peter R.

doi:10.1093/jnci/95.13.981

Cited by 318 publications

(228 citation statements)

References 32 publications

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“…Given that over 200,000 men are diagnosed with prostate cancer annually, 9 of which approximately half are treated with radical prostatectomy, 10 and a third of which will experience a PSA recurrence after surgery, 11 the need for accurate prognostic markers in this setting is great. PSADT following biochemical recurrence after radical prostatectomy is an excellent prognostic marker.…”

Section: Discussionmentioning

confidence: 99%

Limitations of Prostate Specific Antigen Doubling Time Following Biochemical Recurrence After Radical Prostatectomy: Results From the SEARCH Database

et al. 2008

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Purpose-PSA doubling time (PSADT) following biochemical recurrence after radical prostatectomy is a powerful predictor of prostate cancer-specific and overall death. To calculate PSADT requires multiple PSA determinations unaltered by secondary therapy separated by sufficient time. Physicians and patients may be unwilling to wait before starting secondary therapy, especially for high-risk recurrences. Hence, those with calculable PSADT may represent a select lower-risk group relative to all men with biochemical recurrence. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusions-Those with calculable PSADT represented a select, lower-risk cohort and the proportion of patients with calculable PSADT declined over time. This highlights the need for alternative markers for men with recurrent prostate cancer as one of our best current markers, PSADT, is only available in a limited number of patients. Methods-We NIH Public Access

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Section: Discussionmentioning

confidence: 99%

Limitations of Prostate Specific Antigen Doubling Time Following Biochemical Recurrence After Radical Prostatectomy: Results From the SEARCH Database

et al. 2008

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“…This earlier detection and downward stage migration has been accompanied by a proliferation of treatment alternatives, including its use as neoadjuvant or adjuvant therapy for surgery and radiotherapy, for biochemical relapse after surgery or radiation, and even as primary therapy for non-metastatic disease. 5 It appears now that patients are given androgen deprivation therapy (ADT) based on their PSA and not necessarily the presence of clinical symptoms, and they are likely to be on ADT for longer periods than in the past. The expansion of ADT has been most dramatic with external beam radiotherapy, i.e., from 9.8% to 74.6%.…”

Section: Introductionmentioning

confidence: 99%

“…The expansion of ADT has been most dramatic with external beam radiotherapy, i.e., from 9.8% to 74.6%. 5 In addition, the use of long-term neoadjuvant ADT (up to 3 years in combination with radiation therapy for highrisk PCa) will result in permanent castration to some men. Overall, it has been estimated that approximately 50% of PCa patients treated in industrialized nations will receive ADT at some point in their disease course.…”

Section: Introductionmentioning

confidence: 99%

Quality of life issues in men undergoing androgen deprivation therapy: a review

Casey¹,

Corcoran²,

Goldenberg³

2012

Asian J Androl

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Androgen deprivation therapy (ADT) has been an essential treatment option for treating prostate cancer (PCa). The role for hormonal treatment initially was restricted to men with metastatic and inoperable, locally advanced disease. Now it has been extended to neoadjuvant or adjuvant therapy for surgery and radiotherapy, for biochemical relapse after surgery or radiation, and even as primary therapy for non-metastatic disease. Fifty percent of PCa patients treated will receive ADT at some point. There is growing concern about the adverse effects and costs associated with more widespread ADT use. The adverse effects on quality of life (QoL), including physical, social and psychological well-being when men are androgen-deprived, may be considerable. This review examines the QoL issues in the following areas: body feminisation, sexual changes, relationship changes, cognitive and affective symptoms, fatigue, sleep disturbance, depression and physical effects. Further suggestions for therapeutic approaches to reduce these alterations are suggested.

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“…However, as use of ADT becomes more widespread, evaluation of the potential adverse effects associated with this treatment is imperative for treatment decision making and for ameliorating the impact of therapy on survivors' quality of life. [8][9][10][11][12] Major adverse effects of ADT that are attributed to decrease in estrogen levels include hot flashes and loss of libido. 10 Furthermore, numerous studies reported association of ADT with fatigue, decrease in bone mass, higher percentage of body fat, decrease in lean muscle mass, and increased incidence of fractures.…”

mentioning

confidence: 99%

Impact of androgen deprivation on physical well‐being in patients with prostate cancer

Sadetsky

Greene

Cooperberg

et al. 2011

Cancer

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BACKGROUND: As androgen deprivation therapy (ADT) becomes a standard of treatment for men with recurrent or metastatic prostate cancer, evaluation of adverse effects associated with this treatment is needed. In this study, the authors evaluated the effect of ADT administered as monotherapy and in combination with local treatment on physical well-being in a longitudinal sample of men with prostate cancer. METHODS: Exposure to ADT was defined by 3 groups: local (local treatment only), combination (local treatment with adjuvant and/or neoadjuvant ADT), and primary ADT. Associations between exposure to ADT and physical well-being measured by self-reported health-related quality of life outcomes over time were evaluated by repeated measures analysis using mixed modeling. Estimates adjusted for various clinical and demographic variables are reported. RESULTS: A total of 2922 men, who completed both pretreatment and follow-up health-related quality of life assessment, were identified from the CaPSURE (Cancer of the Prostate Strategic Urologic Research Endeavor) registry. During 24 months of follow-up, exposure to ADT was associated with worse physical well-being compared with local treatment at all time points (P < .001). Being exposed to ADT as primary therapy was associated with more severe declines compared with combination therapy. CONCLUSIONS: The potential consequence of decline in physical well-being in patients exposed to ADT has to be included in treatment decision making. Cancer 2011;117:4406-

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National Practice Patterns and Time Trends in Androgen Ablation for Localized Prostate Cancer

Abstract: Rates of both PADT and NADT are increasing across risk groups and treatment types. Future clinical trials must define more clearly the appropriate role of hormonal therapy in localized prostate cancer, and their results should shape updated practice guidelines.

Cited by 318 publications

References 32 publications

Limitations of Prostate Specific Antigen Doubling Time Following Biochemical Recurrence After Radical Prostatectomy: Results From the SEARCH Database

Limitations of Prostate Specific Antigen Doubling Time Following Biochemical Recurrence After Radical Prostatectomy: Results From the SEARCH Database

Quality of life issues in men undergoing androgen deprivation therapy: a review

Impact of androgen deprivation on physical well‐being in patients with prostate cancer

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