scholarly journals Testosterone monitoring for men with advanced prostate cancer: Review of current practices and a survey of Canadian physicians

2017 ◽  
Vol 11 (6) ◽  
pp. 204 ◽  
Author(s):  
Bobby Shayegan ◽  
Frédéric Pouliot ◽  
Alan So ◽  
John Fernandes ◽  
Joseph Macri
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Testosterone Level ◽  
Advanced Prostate Cancer ◽  
Standard Of Care ◽  
Androgen Deprivation ◽  
Testosterone Levels ◽  
Radiation Oncologists ◽  
Cancer Review ◽  
Hormone Sensitive

Androgen-deprivation therapy (ADT) is a standard of care in the treatment of advanced prostate cancer; however, testosterone monitoring practices for men undergoing ADT vary across Canada. Although a testosterone level of 1.7 nmol/L or lower has historically been defined as the accepted castrate level, newer assays with improved sensitivity have shown that both medical and surgical castration can suppress testosterone levels to below 0.7 nmol/L. This review explores the evidence supporting a redefinition of the castrate testosterone level as 0.7 nmol/L or lower, and presents results of a survey of testosterone monitoring practices among 153 Canadian urologists, uro-oncologists, and radiation oncologists who manage the treatment of men with hormone-sensitive prostate cancer.

scholarly journals Prevalence and predictors of cannabis use among men receiving androgen-deprivation therapy for advanced prostate cancer

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Ahmad Mousa ◽  
Michele Petrovic ◽  
Neil E. Fleshner
Keyword(s):  
Prostate Cancer ◽  
Side Effects ◽  
Androgen Deprivation Therapy ◽  
Advanced Prostate Cancer ◽  
Symptom Relief ◽  
Therapeutic Benefit ◽  
Androgen Deprivation ◽  
Cannabis Use ◽  
Testosterone Levels ◽  
Treatment Side Effects

Introduction: Prostate cancer patients receiving androgen-deprivation therapy (ADT) often experience a combination of disease symptoms and treatment side effects. The therapeutic use of cannabis to alleviate these side effects has not been studied, despite increasing patient interest. With the increasing availability of cannabis, it is important for clinicians to understand the prevalence, predictors, and perceived benefits of cannabis use among patients with prostate cancer. Methods: A total of 222 men undergoing ADT were assessed in this two-part study. In part one, the cannabis-use questionnaire was administered to 56 men, probing demographics, usage habits, perspectives, and degrees of symptom relief related to cannabis use. In part two, 191 cryopreserved urine samples were retrieved and analyzed for the presence of tetrahydrocannabidiol (THC) metabolite 11-nor-Δ9-THC-COOH. The respondents were then stratified into two groups, users vs. non-users, and statistical analyses were conducted. Results: Questionnaire data revealed that 23.2% of surveyed men had recently used cannabis. In contrast, 5.8% of men had detectable levels of THC metabolite in their urine. Combined questionnaire and urine data revealed that cannabis users were significantly younger (p=0.003) and had lower testosterone levels (p=0.003) than non-users. The majority of men experiencing common ADT side effects reported some degree of relief following cannabis use. Conclusions: Cannabis use among men with advanced prostate cancer receiving ADT is more prevalent than in the general population and the majority of other oncological cohorts. Lower testosterone levels and reported therapeutic benefit among cannabis users warrants confirmation in appropriate clinical trials.

Network metanalysis and cost-effectiveness of abiraterone, docetaxel or placebo plus androgen deprivation therapy (ADT) for hormone-sensitive advanced prostate cancer.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. 6615-6615
Author(s):  
Pedro Nazareth Aguiar ◽  
Pui San Tan ◽  
Sarah Simko ◽  
CARMELIA MARIA NOIA BARRETO ◽  
Barbara Gutierres Aguiar ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cost Effectiveness ◽  
Androgen Deprivation Therapy ◽  
Advanced Prostate Cancer ◽  
Androgen Deprivation ◽  
Hormone Sensitive

scholarly journals Cardiovascular and Metabolic Effects of Androgen-Deprivation Therapy for Prostate Cancer

2018 ◽  
Vol 14 (10) ◽  
pp. 580-587 ◽  
Author(s):  
Dipti Gupta ◽  
Katherine Lee Chuy ◽  
Ji Can Yang ◽  
Megan Bates ◽  
Marissa Lombardo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Cardiovascular Events ◽  
Advanced Prostate Cancer ◽  
Serum Testosterone ◽  
Management Plan ◽  
Androgen Deprivation ◽  
Metabolic Effects ◽  
Increased Risk ◽  
Hormone Sensitive

Androgen-deprivation therapy (ADT) entails lowering serum testosterone levels to castrate levels and forms a cornerstone of the management of hormone-sensitive advanced prostate cancer; however, the benefit of ADT is partially offset by its detrimental metabolic and cardiovascular adverse effects. ADT decreases insulin sensitivity while promoting dyslipidemia and sarcopenic obesity, which leads to an increased risk of cardiovascular morbidity and potentially mortality. The risk seems to be highest in elderly patients who have had recent cardiovascular events before starting ADT. It is prudent to engage in an individualized risk–benefit discussion and develop a cohesive multidisciplinary management plan to medically optimize and closely observe these patients before and during treatment with ADT.

Is there a relationship between testosterone levels at the end of short-term androgen deprivation therapy and outcomes in intermediate risk prostate cancer? Prospective data from a phase III trial.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 78-78 ◽  
Author(s):  
Abdenour Nabid ◽  
Marie-Pierre Garant ◽  
Eric Vigneault ◽  
Luis Souhami ◽  
Celine Lemaire ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Testosterone Level ◽  
Cox Regression ◽  
Androgen Deprivation ◽  
Phase Iii ◽  
Intermediate Risk ◽  
Short Term ◽  
Testosterone Levels ◽  
Risk Prostate Cancer

78 Background: The purpose of this analysis was to assess whether the testosterone level measured at the end of short term androgen deprivation therapy (STADT) and prostate radiotherapy (RT) has an impact on treatment outcomes in patients with intermediate risk prostate cancer (IRPC) treated on a randomized trial (PCS III ClinicalTrials.gov #NCT00223145). Methods: From December 2000 to September 2010, 400 patients with IRPC received 6 months of STADT (bicalutamide 50mg die and goserelin 10.8mg x 2) and RT. Castrate level of testosterone was defined as <1.7 nmol/L: lower level <0.7 and upper level 0.7-1.7. In 347/400 patients, testosterone levels were available at the end of STADT and were divided into 3 groups based on measured testosterone levels: <0.7, 0.7 to 1.7 and >1.7 nmol/L. Patient’s characteristics were compared with ANOVA and Fisher’s exact test. Biochemical failure, prostate cancer recurrence and death were compared with Cox regression. Results: Patient’s characteristics were well balanced between the 3 groups with no statistical difference for age, performance status, PSA at start, Gleason score and stage. At the end of STADT 55.3% (192/347) presented testosterone levels <0.7 and 38.9% (135/347) levels between 0.7 and 1.7 for a total of 94.2% (327/ 347) reaching castrate levels ≤1.7 nmol/L. In 5.8% of patients (20/347) a castrate testosterone level was not achieved. With a median follow-up of 8.1 years, outcomes are shown in the table. Conclusions: In IRPC patients treated with STADT and RT, the majority of patients (94.2%) achieve a castrate level of testosterone (<1.7 nmol/L). Although we could not show a difference in outcomes between castrate and non-castrate patients, these data have to be viewed with caution given the small number of non-castrate patients studied. Source of Funding: AstraZeneca Pharmaceuticals Grant. Clinical trial information: NCT00223145. [Table: see text]

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