Contemporary patterns of androgen deprivation therapy use for newly diagnosed prostate cancer

Meng, Maxwell V.; Grossfeld, Gary D.; Sadetsky, Natalia; Mehta, Seema; Lubeck, Deborah P.; Carroll, Peter R.

doi:10.1016/s0090-4295(02)01560-1

Cited by 147 publications

(105 citation statements)

References 17 publications

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“…. Androgen deprivation therapy is one of the most common treatments for prostate cancer, with data suggesting that ~50% of men with prostate cancer will use ADT at some point in their treatment 20,21 . While ADT slows down the progression of the cancer by its direct action of reducing the production of testosterone, this leads to a variety of side-effects and symptoms that ultimately reduce their quality of life.…”

Section: Introductionmentioning

confidence: 99%

Body Composition, Physical Fitness, Functional Performance, Quality of Life, and Fatigue Benefits of Exercise for Prostate Cancer Patients: A Systematic Review

Keogh

MacLeod

2012

Journal of Pain and Symptom Management

182

167

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Context: Prostate cancer patients, especially those on androgen deprivation therapy (ADT) experience many symptoms that make it difficult to maintain their independence and quality of life. As ADT act via reducing testosterone production, exercise may offset many of the ADT side-effects and that of the cancer itself. Objectives: This article sought to conduct a systematic review of the literature on whether exercise could reduce symptoms and improve quality of life for prostate cancer patients. Methods: Using relevant databases and keywords, 12 training studies were found meeting the inclusion and exclusion criteria. Results: Grade A level evidence was observed for the benefits of exercise in improving muscular endurance, aerobic endurance and overall quality of life as well as reducing fatigue in prostate cancer patients. Grade B evidence also suggested that exercise may improve prostate cancer patients' muscle mass, muscular strength, functional performance (walking and sit to stand speed) as well as health-related, social and physical quality of life. These effects appeared greater for group-rather than home-based exercise; especially if these programs including resistance training. Conclusion: It is recommended that most prostate cancer patients be encouraged to exercise regularly by their clinicians and significant others. Where possible, this exercise should be group-based and include some resistance training. Future research in this area should directly compare group-and home-based as well as resistance, aerobic and combined resistance and aerobic training to better elucidate the most effective forms of exercise for this population and what factors affect initiation and adherence to such programs.

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Section: Introductionmentioning

confidence: 99%

Body Composition, Physical Fitness, Functional Performance, Quality of Life, and Fatigue Benefits of Exercise for Prostate Cancer Patients: A Systematic Review

Keogh

MacLeod

2012

Journal of Pain and Symptom Management

182

167

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“…3,6 As many as 46% of men with prostate cancer receive ADT at some point during their treatment. 7,8 Most commonly, ADT is achieved by medical castration with gonadotropin-releasing hormone (GnRH) agonists.…”

Section: Introductionmentioning

confidence: 99%

Androgen Deprivation Therapy and Cardiovascular Risk

Punnen

Cooperberg

Sadetsky

et al. 2011

JCO

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A B S T R A C T PurposeThe potential association between androgen deprivation therapy (ADT) and cardiovascular mortality (CVM) remains controversial. This study assessed mortality outcomes in a large national registry to further elucidate the association between treatment selection and cause of mortality. Patients and MethodsA total of 7,248 men in the CaPSURE registry were analyzed. Treatment was categorized as local only, primary ADT monotherapy, local treatment plus ADT, and watchful waiting/active surveillance (WW/AS). Competing hazards survival analysis was performed for prostate cancer-specific mortality (PCSM), CVM, and all-cause mortality. A propensity score-adjusted and a propensitymatched analysis were undertaken to adjust for imbalances in covariates among men receiving various treatments. ResultsPatients treated with ADT or WW/AS had a higher likelihood of PCSM than those treated with local therapy alone. Patients treated with primary ADT had an almost two-fold greater likelihood of CVM (HR, 1.94; 95% CI, 1.29 to 2.97) than those treated with local therapy alone; however, patients treated with WW/AS had a greater than two-fold increased risk of CVM (HR, 2.46; 95% CI, 1.53 to 3.95). A propensity-matching algorithm in a subset of 1,391 patients was unable to find a significant difference in CVM between those who did or did not receive ADT. ConclusionPatients matched on propensity to receive ADT did not show an association between ADT and CVM. This suggests that potential unmeasured variables affecting treatment selection may confound the relationship between ADT use and cardiovascular risk. However, an association may yet exist, because the propensity score could not include all known risk factors for CVM.

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“…While early disease can be successfully managed by surgery, radiotherapy or active surveillance, the options for locally advanced and metastatic disease remain few (2). Primary androgen deprivation by surgical or chemical castration remains a very important treatment option for this disease, and indeed is used as first line treatment in 41% of men overall (3). In a significant portion of these men, however, the disease will progress and become resistant to therapy, with these men eventually going on to develop castration-resistant prostate cancer.…”

mentioning

confidence: 99%

DCE and DW MRI in monitoring response to androgen deprivation therapy in patients with prostate cancer: A feasibility study

Barrett

Gill

Kataoka

et al. 2011

Magnetic Resonance in Med

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Androgen deprivation therapy (ADT) is a key primary treatment for advanced and metastatic prostate cancer and is an important neoadjuvant before radiotherapy. We evaluated 3.0 T dynamic contrast-enhanced MRI and diffusion-weighted (DW) MRI in monitoring ADT response. Twenty-three consecutive patients with prostate cancer treated by primary ADT were included. Imaging was performed at baseline and 3 months posttreatment with ADT. After 3 months therapy there was a significant reduction in all dynamic contrast-enhanced MRI parameters measured in tumor regions of interest (K trans , k ep , v p , IAUGC-90); P < 0.001. Areas of normal-appearing peripheral zone showed no significant change; P 5 0.285-0.879. Post-ADT, there was no significant change in apparent diffusion coefficient values in tumors, whilst apparent diffusion coefficient values significantly decreased in areas of normalappearing peripheral zone, from 1.786 3 10 23 mm 2 /s to 1.561 3 10 23 mm 2 /s; P 5 0.007. As expected the median ProstateSpecific Antigen (PSA) significantly reduced from 30 ng/mL to 1.5 ng/mL posttreatment, and median prostate volume dropped from 47.6 cm 3 to 24.9 cm 3 ; P < 0.001. These results suggest that dynamic contrast-enhanced MRI and diffusionweighted MRI offer different information but that both could prove useful adjuncts to the anatomical information provided by T2-weighted imaging. dynamic contrast-enhanced as a marker of angiogenesis may help demonstrate ADT resistance and diffusion-weighted imaging may be more accurate in determining presence of tumor cell death versus residual tumor. Magn Reson Med 67:778-785,

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Contemporary patterns of androgen deprivation therapy use for newly diagnosed prostate cancer

Cited by 147 publications

References 17 publications

Body Composition, Physical Fitness, Functional Performance, Quality of Life, and Fatigue Benefits of Exercise for Prostate Cancer Patients: A Systematic Review

Body Composition, Physical Fitness, Functional Performance, Quality of Life, and Fatigue Benefits of Exercise for Prostate Cancer Patients: A Systematic Review

Androgen Deprivation Therapy and Cardiovascular Risk

DCE and DW MRI in monitoring response to androgen deprivation therapy in patients with prostate cancer: A feasibility study

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