The impact of androgen deprivation and pelvic radiation on the development of bladder cancer.

439 Background: The male predilection of urothelial bladder cancer (UBC) as well as the expression of the androgen receptor in bladder tissue point to the role for androgens in UBC tumorigenesis. Animal studies demonstrate a potential role for androgen deprivation in diminishing UBC. More recently, two separate groups demonstrated decreased rates of both primary and recurrent UBC in prostate cancer patients previously receiving androgen deprivation therapy (ADT). Given the common use of radiation therapy (RT) in the treatment of localized prostate cancer, and previous data supporting the increased frequency of UBC in prostate cancer patients treated with RT, the interaction between ADT and RT in UBC remains an important consideration. Methods: Using the linked SEER-Medicare database, we investigated the interactions among ADT, RT and UBC by performing a retrospective cohort study of elderly (age 66-99) prostate cancer patients diagnosed between 1999-2011. Kaplan-Meier analysis and Cox proportional modeling were used to determine the risk of developing secondary bladder cancer after prostate cancer treatment (based on exposure to ADT, RT, both, or neither). All analyses were two-sided. Results: Of 121,927 patients with primary prostate cancer, 1,466 (1.20%) developed subsequent UBC with a median follow up of 5.08 years (range 0.003-12.00). Compared with patients never receiving ADT or RT (n = 43,809), the hazard ratios for the development of secondary bladder cancer in patients ever receiving ADT but no RT (n = 14,009), RT but no ADT (n = 16,672), or both ADT and RT (n = 17,465) were 0.76 (95% confidence interval [CI]: 0.63-0.91 ), 0.73 (95% CI: 0.64-0.83), and 0.69 (95% CI: 0.61-0.79), respectively. Conclusions: Both ADT and RT are independently associated with a reduced risk of secondary bladder cancers in prostate cancer patients. The finding of decreased UBC incidence in patients receiving RT was surprising, and in direct contradiction to previous studies of similar patient populations. Possible explanations include differences in cohort selection, changes in RT delivery, and differences in control groups.

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The Impact of Metformin Use with Survival Outcomes in Urologic Cancers: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2021/5311828 ◽

2021 ◽

Vol 2021 ◽

pp. 1-14

Author(s):

Xiangyang Yao ◽

Haoran Liu ◽

Hua Xu

Keyword(s):

Prostate Cancer ◽

Overall Survival ◽

Bladder Cancer ◽

Cancer Patients ◽

Kidney Cancer ◽

Subgroup Analysis ◽

Meta Analysis ◽

Effect Model ◽

Urologic Cancers ◽

The Impact

Background. Conflicting results exist between the potential protective effects of metformin and the prognosis of urologic cancers. This meta-analysis summarized the effects of metformin exposure on the recurrence, progression, cancer-specific survival (CSS), and overall survival (OS) of the three main urologic cancers (kidney cancer, bladder cancer, and prostate cancer). Methods. We systematically searched PubMed, Embase, Web of Science, Wanfang, and China National Knowledge Infrastructure databases (January 2010 to December 2019), which identified studies regarding metformin users and nonusers with urologic cancers and extracted patient data. A random effect model or fixed effect model was used to analyze hazard ratios (HRs) and 95% confidence intervals (CIs). Results. Among the 1883 confirmed studies, 27 eligible studies were identified, including 123,212 participants. In prostate cancer, patients using metformin have significant benefits for recurrence ( HR = 0.74 ; 95% CI: 0.61-0.90; P = 0.007 ; I 2 = 56 % ), CSS ( HR = 0.74 ; 95% CI: 0.61-0.91; P = 0.002 ; I 2 = 79 % ), and OS ( HR = 0.76 ; 95% CI: 0.65-0.90; P < 0.001 ; I 2 = 86 % ). Moreover, further subgroup analysis showed that the beneficial effects of metformin may be more significant for patients receiving radical radiotherapy. For kidney cancer, metformin was beneficial for progression ( HR = 0.80 ; 95% CI: 0.65-0.98; P = 0.14 ; I 2 = 46 % ). Analysis revealed that the effect of metformin on the overall survival of kidney cancer patients may be related to nationality (American: HR = 0.76 ; 95% CI: 0.59-0.98; P = 0.88 ; I 2 = 0 % ). For bladder cancer, no obvious benefits of metformin use were identified. However, subgroup analysis indicated that metformin may improve the recurrence of bladder cancer, but this improvement was only found in patients with a median follow-up time of more than 4 years ( HR = 0.43 ; 95% CI: 0.28-0.67; P = 0.61 ; I 2 = 0 % ).

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PD65-07 THE IMPACT OF ANDROGEN DEPRIVATION THERAPY ON T CELL CHARACTERISTICS IN PROSTATE CANCER PATIENTS

The Journal of Urology ◽

10.1016/j.juro.2018.02.2991 ◽

2018 ◽

Vol 199 (4S) ◽

Author(s):

Dixon T.S. Woon ◽

Genevieve Whitty ◽

Tatenda Nzenza ◽

Manvendra Saxena ◽

Damien Bolton ◽

...

Keyword(s):

Prostate Cancer ◽

T Cell ◽

Cancer Patients ◽

Androgen Deprivation Therapy ◽

Androgen Deprivation ◽

The Impact

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Biomarkers to Evaluate Androgen Deprivation Therapy for Prostate Cancer and Risk of Alzheimer’s Disease and Neurodegeneration: Old Drugs, New Concerns

Frontiers in Oncology ◽

10.3389/fonc.2021.734881 ◽

2021 ◽

Vol 11 ◽

Author(s):

Vérane Achard ◽

Kelly Ceyzériat ◽

Benjamin B. Tournier ◽

Giovanni B. Frisoni ◽

Valentina Garibotto ◽

...

Keyword(s):

Prostate Cancer ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cancer Patients ◽

Androgen Deprivation Therapy ◽

Androgen Deprivation ◽

Cortical Activation ◽

Current Evidence ◽

The Impact

Androgen deprivation therapy (ADT) is a standard treatment for prostate cancer patients, routinely used in the palliative or in the curative setting in association with radiotherapy. Among the systemic long-term side effects of ADT, growing data suggest a potentially increased risk of dementia/Alzheimer’s disease in prostate cancer patients treated with hormonal manipulation. While pre-clinical data suggest that androgen ablation may have neurotoxic effects due to Aβ accumulation and increased tau phosphorylation in small animal brains, clinical studies have measured the impact of ADT on long-term cognitive function, with conflicting results, and studies on biological changes after ADT are still lacking. The aim of this review is to report on the current evidence on the association between the ADT use and the risk of cognitive impairment in prostate cancer patients. We will focus on the contribution of Alzheimer’s disease biomarkers, namely through imaging, to investigate potential ADT-induced brain modifications. The evidence from these preliminary studies shows brain changes in gray matter volume, cortical activation and metabolism associated with ADT, however with a large variability in biomarker selection, ADT duration and cognitive outcome. Importantly, no study investigated yet biomarkers of Alzheimer’s disease pathology, namely amyloid and tau. These preliminary data emphasize the need for larger targeted investigations.

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The impact of long‐term androgen deprivation therapy on cognitive function and socioeconomic decision making in prostate cancer patients

Psycho-Oncology ◽

10.1002/pon.5442 ◽

2020 ◽

Vol 29 (8) ◽

pp. 1338-1346

Author(s):

Sarah Katharina Charlotte Holtfrerich ◽

Sophie Knipper ◽

Janna Purwins ◽

Jasmin Castens ◽

Burkhard Beyer ◽

...

Keyword(s):

Prostate Cancer ◽

Decision Making ◽

Cognitive Function ◽

Cancer Patients ◽

Androgen Deprivation Therapy ◽

Androgen Deprivation ◽

The Impact

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The impact of marriage on the overall survival of prostate cancer patients: A Surveillance, Epidemiology, and End Results (SEER) analysis

Canadian Urological Association Journal ◽

10.5489/cuaj.5413 ◽

2018 ◽

Vol 13 (5) ◽

Cited By ~ 4

Author(s):

Yu Liu ◽

Qi Xia ◽

Jianling Xia ◽

Hua Zhu ◽

Haihong Jiang ◽

...

Keyword(s):

Prostate Cancer ◽

Marital Status ◽

Cancer Patients ◽

The Other ◽

Seer Database ◽

Chi Square ◽

Kaplan Meier ◽

Cox Proportional Hazard Models ◽

The Impact ◽

End Results

Introduction: Marital status has long been associated with positive patient outcomes in several malignances; however, little is known about its influence on prostate cancer. We analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database to evaluate whether married patients with prostate cancer had a better prognosis than unmarried patients. Methods: We identified 824 554 patients diagnosed with prostate cancer between 1973 and 2012 in the SEER database. Using the Cox proportional hazard models, we analyzed the impact of marital status (single, married, divorced/separated, and widowed) on survival after diagnosis with prostate cancer. Chi-square tests were used to analyze the association between marital status and other variables, and the Kaplan-Meier method was used to estimate survival curves. Results: Married men were more likely to be diagnosed with a lower Gleason score and undergo surgery than patients in the other groups (p<0.001). The married group had a lower risk of mortality caused by prostate cancer than the other groups. The five-year survival rate for married patients was higher than that for patients in the other groups. Conclusions: Marital status is a prognostic factor for the survival of prostate cancer patients, as being married was associated with better outcomes.

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