GnRH Agonists For Prostate Cancer: Role of the Urologist
Principal Investigator: Vahakn Shahinian
Abstract: [unreadable] DESCRIPTION (provided by applicant): There is uncertainty regarding the efficacy of androgen deprivation therapy for earlier stages of prostate cancer. In addition, there are serious toxicities and a substantial financial cost associated with this therapy, particularly with the use of gonadotropin-releasing hormone (GnRH) agonists, which are now the predominant form of androgen deprivation. [unreadable] [unreadable] In the face of these concerns, recent studies have shown a dramatic rise in the use of GnRH agonists for prostate cancer over the 1990s, even in settings where there is no evidence of survival benefit. Wide differences in rates of GnRH agonist use between geographic regions suggest the presence of variations in practice patterns, possibly reflecting provider uncertainty about the risks and benefits of this therapy. [unreadable] [unreadable] We hypothesize that the provider plays an important role in influencing the observed time trends and variations in use of GnRH agonists for prostate cancer. This study will use linked SEER Medicare data and American Medical Association data to achieve the following objectives: 1) describe the variation among providers in use of GnRH agonists, 2) examine the effect of provider characteristics on the likelihood of use of GnRH agonists for prostate cancer and 3) determine the provider characteristics that influenced the change in use of GnRH agonists for prostate cancer over the 1990s. [unreadable] [unreadable] Collectively, the information derived from this proposal will help direct efforts at provider education and monitoring the use of GnRH agonists for prostate cancer. This will be especially important as more information on the risks and benefits of GnRH agonists become available, with the ultimate goal being the provision of quality care for men with prostate cancer. [unreadable] [unreadable] [unreadable]
Funding Period: 2005-08-01 - 2009-05-31
more information: NIH RePORT
- Prevalent and incident use of androgen deprivation therapy among men with prostate cancer in the United StatesScott M Gilbert
Department of Urology, University of Florida College of Medicine, Gainesville, FL 32610, USA
Urol Oncol 29:647-53. 2011..Androgen deprivation therapy (ADT) for prostate cancer increased substantially through the 1990s, but more recent national trends regarding incident and prevalent use have been incompletely characterized...
- Risk of the "androgen deprivation syndrome" in men receiving androgen deprivation for prostate cancerVahakn B Shahinian
Department of Internal Medicine, and Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX 77555 0562, USA
Arch Intern Med 166:465-71. 2006..We therefore sought to estimate the incidence of these effects and, by using a control group, ascertain whether these effects were related to androgen deprivation itself...
- Determinants of androgen deprivation therapy use for prostate cancer: role of the urologistVahakn B Shahinian
Department of Internal Medicine, University of Texas Medical Branch, John Sealy Annex 4 200, 301 University Blvd, Galveston, TX 77555 0562, USA
J Natl Cancer Inst 98:839-45. 2006....
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Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
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Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109 0725, USA
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- Gonadotropin-releasing hormone agonist use in men without a cancer registry diagnosis of prostate cancerYong Fang Kuo
Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
BMC Health Serv Res 8:146. 2008..We hypothesized that some men receive these agents after only a limited work-up for their cancer. Such cases may be missed by tumor registries, leading to underestimates of the total extent of GnRH agonist use...
- Cause of death in older men after the diagnosis of prostate cancerMelanie Ketchandji
University of Texas Medical Branch, Galveston, Texas, USA
J Am Geriatr Soc 57:24-30. 2009..To compare survival and cause of death in men aged 65 and older diagnosed with prostate cancer and with survival and cause of death in a noncancer control population...