GnRH Agonists For Prostate Cancer: Role of the Urologist

Summary

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

Top Publications

  1. pmc Prevalent and incident use of androgen deprivation therapy among men with prostate cancer in the United States
    Scott M Gilbert
    Department of Urology, University of Florida College of Medicine, Gainesville, FL 32610, USA
    Urol Oncol 29:647-53. 2011
  2. pmc Risk of the "androgen deprivation syndrome" in men receiving androgen deprivation for prostate cancer
    Vahakn 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
  3. pmc Determinants of androgen deprivation therapy use for prostate cancer: role of the urologist
    Vahakn 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
  4. pmc Comparison of stage at diagnosis of cancer in patients who are on dialysis versus the general population
    Shilpa Taneja
    Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
    Clin J Am Soc Nephrol 2:1008-13. 2007
  5. pmc Characteristics of urologists predict the use of androgen deprivation therapy for prostate cancer
    Vahakn B Shahinian
    Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109 0725, USA
    J Clin Oncol 25:5359-65. 2007
  6. pmc Gonadotropin-releasing hormone agonist use in men without a cancer registry diagnosis of prostate cancer
    Yong Fang Kuo
    Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
    BMC Health Serv Res 8:146. 2008
  7. pmc Cause of death in older men after the diagnosis of prostate cancer
    Melanie Ketchandji
    University of Texas Medical Branch, Galveston, Texas, USA
    J Am Geriatr Soc 57:24-30. 2009

Scientific Experts

Detail Information

Publications7

  1. pmc Prevalent and incident use of androgen deprivation therapy among men with prostate cancer in the United States
    Scott 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...
  2. pmc Risk of the "androgen deprivation syndrome" in men receiving androgen deprivation for prostate cancer
    Vahakn 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...
  3. pmc Determinants of androgen deprivation therapy use for prostate cancer: role of the urologist
    Vahakn 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
    ....
  4. pmc Comparison of stage at diagnosis of cancer in patients who are on dialysis versus the general population
    Shilpa Taneja
    Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
    Clin J Am Soc Nephrol 2:1008-13. 2007
    ..It is therefore unclear whether dialysis patients are disadvantaged in terms of cancer diagnosis. This study compared stage at diagnosis of cancer in a population-based sample of patients with ESRD versus the general population...
  5. pmc Characteristics of urologists predict the use of androgen deprivation therapy for prostate cancer
    Vahakn B Shahinian
    Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109 0725, USA
    J Clin Oncol 25:5359-65. 2007
    ..Using the Surveillance, Epidemiology, and End Results-Medicare linked database, we examined how individual urologist characteristics influenced the use of androgen deprivation therapy...
  6. pmc Gonadotropin-releasing hormone agonist use in men without a cancer registry diagnosis of prostate cancer
    Yong 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...
  7. pmc Cause of death in older men after the diagnosis of prostate cancer
    Melanie 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...