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Zanatelli M, Colleta SJ, Guerra LHA, Santos FCA, Góes RM, Vilamaior PSL, Taboga SR. Prolactin promotes a partial recovery from the atrophy of both male and female gerbil prostates caused by castration. Reprod Biol Endocrinol 2021; 19:94. [PMID: 34158080 PMCID: PMC8218528 DOI: 10.1186/s12958-021-00777-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/03/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The male and female prostates are controlled by steroid hormones, suffering important morphological and physiological changes after castration. Prolactin is involved in the regulation of the male prostate, having already been identified in the tissue, acting through its receptor PRLR. In the Mongolian gerbil, in addition to the male prostate, the female prostate is also well developed and active in its secretion processes. The aim of the present study was to evaluate the effects of exposure to exogenous prolactin in the prostate of both intact and castrated male and female gerbils in order to establish if prolactin administration can sustain prostate cell activity in conditions of sexual hormone deprivation. METHODS The morphological analyses were performed by biometric analysis, lesion histological analysis and morphometric-stereological aspects. In addition, immune-cytochemical tests were performed for prolactin and its receptor, as well as for the receptors of androgen and oestrogen and serum prolactin dosage. All data were submitted to ANOVA or Kruskal-Wallis tests for comparison between groups. P < 0.05 was considered to be statistically significant. RESULTS The results showed a strong influence of prolactin on the morphology of the prostate, with the development of important epithelial alterations, after only 3 days of administration, and an expressive epithelial cell discard process after 30 days of administration. Prolactin acts in synergy with testosterone in males and mainly with oestrogens in females, establishing different steroid hormonal receptor immunoreactivity according to sex. It was also demonstrated that prolactin can assist in the recovery from some atrophic effects caused in the gland after castration, without causing additional tissue damage. CONCLUSIONS The prolactin and its receptor are involved in the maintenance of the homeostasis of male and female gerbils, and also cause distinct histological alterations after exogenous exposure for 3 and 30 days. The effects of prolactin are related to its joint action on androgens and oestrogens and it can also assist in the recovery from the atrophic effects of castration.
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Affiliation(s)
- Marianna Zanatelli
- Department of Structural and Functional Biology, Institute of Biology, State University of Campinas - UNICAMP, SP, Campinas, Brazil
| | - Simone Jacovaci Colleta
- Laboratory of Microscopy and Microanalysis, Department of Biology, São Paulo State University - UNESP/IBILCE, Rua Cristóvão Colombo, 2265, Jardim Nazareth, SP, 15054-000, São José do Rio Preto, Brasil
| | - Luiz Henrique Alves Guerra
- Laboratory of Microscopy and Microanalysis, Department of Biology, São Paulo State University - UNESP/IBILCE, Rua Cristóvão Colombo, 2265, Jardim Nazareth, SP, 15054-000, São José do Rio Preto, Brasil
| | | | - Rejane Maira Góes
- Department of Structural and Functional Biology, Institute of Biology, State University of Campinas - UNICAMP, SP, Campinas, Brazil
- Laboratory of Microscopy and Microanalysis, Department of Biology, São Paulo State University - UNESP/IBILCE, Rua Cristóvão Colombo, 2265, Jardim Nazareth, SP, 15054-000, São José do Rio Preto, Brasil
| | - Patricia Simone Leite Vilamaior
- Laboratory of Microscopy and Microanalysis, Department of Biology, São Paulo State University - UNESP/IBILCE, Rua Cristóvão Colombo, 2265, Jardim Nazareth, SP, 15054-000, São José do Rio Preto, Brasil
| | - Sebastião Roberto Taboga
- Department of Structural and Functional Biology, Institute of Biology, State University of Campinas - UNICAMP, SP, Campinas, Brazil.
- Laboratory of Microscopy and Microanalysis, Department of Biology, São Paulo State University - UNESP/IBILCE, Rua Cristóvão Colombo, 2265, Jardim Nazareth, SP, 15054-000, São José do Rio Preto, Brasil.
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Chunchai T, Keawtep P, Arinno A, Saiyasit N, Prus D, Apaijai N, Pratchayasakul W, Chattipakorn N, Chattipakorn SC. A combination of an antioxidant with a prebiotic exerts greater efficacy than either as a monotherapy on cognitive improvement in castrated-obese male rats. Metab Brain Dis 2020; 35:1263-1278. [PMID: 32676884 DOI: 10.1007/s11011-020-00603-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/09/2020] [Indexed: 12/27/2022]
Abstract
Previous studies by ourselves and others have demonstrated that both obesity and testosterone deprivation have been related to cognitive decline. We have also shown that a prebiotic and n-acetyl cysteine (NAC) improved cognitive dysfunction in obese rats and castrated-male rats. However, the effects of NAC, a prebiotic (inulin), and a combination of the two on cognition in castrated-obese rats has never been investigated. The hypothesis was that NAC and inulin attenuated cognitive decline in castrated-obese rats by improving gut dysbiosis, and decreasing oxidative stress, glial activation and apoptosis. Male Wistar rats (n = 36) were fed with either a normal diet (ND: n = 6) or a high-fat diet (HFD: n = 30) for twenty-eight weeks. The resultant obese rats had a bilateral orchiectomy (ORX) and were randomly divided into five subgroups (n = 6/ subgroup). Each subgroup was treated with one of five therapies: a vehicle; testosterone replacement (2 mg/kg/day); NAC (100 mg/kg); inulin (10%, w/w), or a combination of the NAC and inulin for four weeks. The results demonstrated that castrated-obese rats developed gut dysbiosis, metabolic disturbance, brain pathologies, and cognitive decline. All of the pathological conditions in the brain were ameliorated to an equal extent by testosterone replacement, NAC, and inulin supplementation. Interestingly, a combination of NAC and inulin had the greatest beneficial effect on cognitive function by synergistically reducing hippocampal inflammation and ameliorating glial dysmorphology. These findings suggest that a combination of NAC and inulin may confer the greatest benefits in improving cognitive function in castrated-obese male rats.
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Affiliation(s)
- Titikorn Chunchai
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Puntarik Keawtep
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Apiwan Arinno
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Napatsorn Saiyasit
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Dillon Prus
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nattayaporn Apaijai
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Wasana Pratchayasakul
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nipon Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Siriporn C Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
- Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand.
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Gevariya N, Besançon M, Robitaille K, Picard V, Diabaté L, Alesawi A, Julien P, Fradet Y, Bergeron A, Fradet V. Omega-3 fatty acids decrease prostate cancer progression associated with an anti-tumor immune response in eugonadal and castrated mice. Prostate 2019; 79:9-20. [PMID: 30073695 DOI: 10.1002/pros.23706] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 07/13/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Several lines of evidence suggest effects of dietary fat on prostate cancer (PCa) development and progression. Targeting omega (ω)-3:ω6 fatty acids (FA) ratio could be beneficial against PCa by favorably modulating inflammation. Here, we studied the effects of ω3- and ω6-enriched diets on prostate tumor growth and inflammatory response in androgen-deprived and non-deprived conditions. METHODS Immune-competent eugonadal and castrated C57BL/6 mice were injected with TRAMP-C2 prostate tumor cells and daily fed with ω3- or ω6-enriched diet. FA and cytokine profiles were measured in blood and tumors using gas chromatography and multiplex immunoassay, respectively. Immune cell infiltration in tumors was profiled by multicolor flow cytometry. RESULTS ω3-enriched diet decreased prostate TRAMP-C2 tumor growth in immune-competent eugonadal and castrated mice. Cytokines associated with Th1 immune response (IL-12 [p70], IFN-γ, GM-CSF) and eosinophil recruitment (eotaxin-1, IL-5, and IL-13) were significantly elevated in tumors of ω3-fed mice. Using in vitro experiments, we confirmed ω3 FA-induced eotaxin-1 secretion by tumor cells and that eotaxin-1 secretion was regulated by androgens. Analysis of immune cell infiltrating tumors showed no major difference of immune cells' abundance between ω3- and ω6-enriched diets. CONCLUSIONS ω3-enriched diet reduces prostate tumor growth independently of androgen levels. ω3 FA can inhibit tumor cell growth and induce a local anti-tumor inflammatory response. These findings warrant further examination of dietary ω3's potential to slow down the progression of androgen-sensitive and castrate-resistant PCa by modulating immune cell function in tumors.
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Affiliation(s)
- Nikunj Gevariya
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
- Faculté de Medicine, Université Laval, Québec, Quebec, Canada
| | - Marjorie Besançon
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
- Faculté de Medicine, Université Laval, Québec, Quebec, Canada
| | - Karine Robitaille
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
| | - Valérie Picard
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
| | - Lamoussa Diabaté
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
- Faculté de Medicine, Université Laval, Québec, Quebec, Canada
| | - Anwar Alesawi
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
| | - Pierre Julien
- Faculté de Medicine, Université Laval, Québec, Quebec, Canada
- Endocrinology and Nephrology Axis, Centre de recherche du CHU de Québec-Université Laval-CHUL, Québec, Quebec, Canada
| | - Yves Fradet
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
- Faculté de Medicine, Université Laval, Québec, Quebec, Canada
| | - Alain Bergeron
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
- Faculté de Medicine, Université Laval, Québec, Quebec, Canada
| | - Vincent Fradet
- Laboratoire d'Uro-Oncologie Expérimentale, Oncology Axis, Centre de Recherche du CHU de Québec-Université Laval, Québec, Quebec, Canada
- Faculté de Medicine, Université Laval, Québec, Quebec, Canada
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Saki F, Kasaee SR, Sadeghian F, Koohpeyma F, Omrani GHR. Investigating the effect of testosterone by itself and in combination with letrozole on 1,25-dihydroxy vitamin D and FGF23 in male rats. J Endocrinol Invest 2019; 42:19-25. [PMID: 29560610 DOI: 10.1007/s40618-018-0875-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 03/09/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Testosterone deficiency might be associated with vitamin D levels in hypogonadal men, but it is not clear whether testosterone can affect vitamin D and fibroblast growth factor-23 (FGF23), either directly or indirectly via aromatization to estradiol. We aimed to investigate the role of testosterone on vitamin D metabolism and serum FGF23 in male rats. METHODS A total of 48 male rats were divided into 4 equal groups: sham; O, orchiectomy; O + T, orchiectomized rats treated with testosterone; and O + T + L, orchiectomized rats treated with combination of testosterone and letrozole. We compare the vitamin D metabolism biochemical parameters in these four groups, before and after the study. RESULTS We detected a significant reduction in 25-hydroxyvitamin D (25(OH)D), vitamin D binding protein (DBP), FGF23, and 1,25-dihydroxyvitamin D (1,25(OH)2D) serum level in O group compared to sham group (p = 0.004, p = 0.009, p < 0.001 and p < 0.001, respectively), and a significant increase in serum phosphorus, parathyroid hormone (PTH), and alkaline phosphatase (ALP) levels in orchiectomized rats in comparison to sham group (p < 0.001, p = 0.022, and p = 0.006, respectively). However, these changes were corrected by testosterone replacement in O + T and O + T + L groups. In addition, we found that DBP and 1,25(OH)2D serum levels were significantly higher in O + T group in comparison to O + T + L group (p = 0.030 and p = 0.026, respectively). CONCLUSIONS Testosterone plays a significant role on regulating 25(OH)D, DBP, FGF23, phosphate (Phos), PTH, and 1,25(OH)2D serum levels in male rats. Also, testosterone has a potent effect on 1,25(OH)2D and DBP by its conversion to estradiol.
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Affiliation(s)
- F Saki
- Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, P.O. Box: 71345-1744, Shiraz, Iran
| | - S R Kasaee
- Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, P.O. Box: 71345-1744, Shiraz, Iran
| | - F Sadeghian
- Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, P.O. Box: 71345-1744, Shiraz, Iran
| | - F Koohpeyma
- Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, P.O. Box: 71345-1744, Shiraz, Iran
| | - G H R Omrani
- Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, P.O. Box: 71345-1744, Shiraz, Iran.
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Nestorović N, Trifunović S, Manojlović-Stojanoski M, Jarić I, Ristić N, Filipović B, Šošić-Jurjević B, Milošević V. Soy Phytoestrogens Do Not Fully Reverse Changes in Rat Pituitary Castration Cells: Unbiased Stereological Study. Anat Rec (Hoboken) 2018; 301:1416-1425. [PMID: 29569839 DOI: 10.1002/ar.23809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 01/04/2018] [Accepted: 01/18/2018] [Indexed: 02/07/2023]
Abstract
The aim of the study was to examine the potential of the principal soy isoflavones, genistein and daidzein, or isoflavone rich soy extract to recover pituitary castration cells in orchidectomized adult male rats in comparison with the effects of estradiol. Two weeks post orchidectomy (Orx), animals received estradiol-dipropionate, genistein, daidzein or soy extract subcutaneously for 3 weeks. Control sham-operated (So) and Orx rats received just the vehicle. Changes in the volumes of pars distalis, of individual follicle-stimulating hormone (FSH) and luteinizing hormone (LH) containing cells, their volume, numerical density and number were determined by unbiased design-based stereology. The intracellular content of βFSH and βLH was estimated by relative intensity of fluorescence (RIF). Orchidectomy increased all examined stereological parameters and RIF. Compared to Orx, estradiol increased the volume of pars distalis, but reversed RIF and all morphometric parameters of gonadotropes to the level of So rats, except their number. Treatments with purified isoflavones and soy extract decreased RIF to the control So level, expressing an estradiol-like effect. However, the histological appearance and morphometrical features of gonadotropes did not follow this pattern. Genistein increased the volume of pars distalis, decreased the volume density of LH-labeled cells and raised the number of gonadotropes. Daidzein decreased the cell volume of gonadotropic cells but increased their number and numerical density. Soy extract induced an increase in number and numerical density of FSH-containing cells. Therefore, it can be concluded that soy phytoestrogens do not fully reverse the Orx-induced changes in pituitary castration cells. Anat Rec, 2018. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Nataša Nestorović
- Department of Cytology, University of Belgrade, Institute for Biological Research "Siniša Stanković,", Belgrade, 11060, Serbia
| | - Svetlana Trifunović
- Department of Cytology, University of Belgrade, Institute for Biological Research "Siniša Stanković,", Belgrade, 11060, Serbia
| | - Milica Manojlović-Stojanoski
- Department of Cytology, University of Belgrade, Institute for Biological Research "Siniša Stanković,", Belgrade, 11060, Serbia
| | - Ivana Jarić
- Department of Cytology, University of Belgrade, Institute for Biological Research "Siniša Stanković,", Belgrade, 11060, Serbia
| | - Nataša Ristić
- Department of Cytology, University of Belgrade, Institute for Biological Research "Siniša Stanković,", Belgrade, 11060, Serbia
| | - Branko Filipović
- Department of Cytology, University of Belgrade, Institute for Biological Research "Siniša Stanković,", Belgrade, 11060, Serbia
| | - Branka Šošić-Jurjević
- Department of Cytology, University of Belgrade, Institute for Biological Research "Siniša Stanković,", Belgrade, 11060, Serbia
| | - Verica Milošević
- Department of Cytology, University of Belgrade, Institute for Biological Research "Siniša Stanković,", Belgrade, 11060, Serbia
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Zhou XJ, Zhou RS, Fan T, Han CH. Experience with the treatment of testicular yolk sac tumor in children: a report of 14 cases. Eur Rev Med Pharmacol Sci 2014; 18:3831-3833. [PMID: 25555873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE This paper discusses the optimal treatment for testicular yolk sac tumor at stage I in children. PATIENTS AND METHODS Fourteen children with testicular yolk sac tumor (including 10 cases of stage I and 4 cases of stage II) underwent high ligation of internal spermatic cord vein and orchiectomy. Among these, seven cases of stage I were below 1 year of age. Retroperitoneal lymph node dissection without postoperative systemic chemotherapy was implemented in 9 cases (5 cases of stage I and 4 cases of stage II), and only one was positive. RESULTS Among the 12 cases followed, 9 cases were alive (of these, 5 children < 1 year old, in stage I, underwent high ligation of internal spermatic cord vein and orchiectomy, with a survival time of 25 months to 10 years and 4 cases with radical retroperitoneal lymph node dissection). Three cases older than 1 year died of retroperitoneal lymph node and lung metastases. CONCLUSIONS For the high ligation of internal spermatic cord vein, orchiectomy is a kind of simple and effective treatment for children younger than 1 year with stage I, without recurrence and metastases. However, attention to the accuracy of staging and close observation are important aspects of the treatment.
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Affiliation(s)
- X-J Zhou
- Department of Urological Surgery, Central Hospital of Xuzhou, Xuzhou, Jiangsu, China.
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DaJusta DG, Granberg CF, Villanueva C, Baker LA. Contemporary review of testicular torsion: new concepts, emerging technologies and potential therapeutics. J Pediatr Urol 2013; 9:723-30. [PMID: 23044376 PMCID: PMC3566290 DOI: 10.1016/j.jpurol.2012.08.012] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Accepted: 08/25/2012] [Indexed: 12/25/2022]
Abstract
Testicular torsion is one of the few emergencies in pediatric urology which requires an accurate and timely diagnosis in order to avoid testis loss. It is not an uncommon event affecting a young male population. In fact, testicular torsion is more common than testicular tumors for this same age group, yet testicular torsion has not been given the public attention it deserves as a male health risk. In this review we highlight the new information published over the past four years regarding testicular torsion. We will discuss a variety of topics associated with torsion including: medical legal issues, etiology and genetics, imaging diagnostics, innovative surgical techniques, management controversies, fertility, and new drug therapies.
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Affiliation(s)
- Daniel G DaJusta
- Children's Medical Center, University of Texas Southwestern Medical School, Dallas, TX, USA
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Abstract
BACKGROUND The Medicare Modernization Act led to moderate reductions in reimbursement for androgen-deprivation therapy (ADT) for prostate cancer, starting in 2004 and followed by substantial changes in 2005. We hypothesized that these reductions would lead to decreases in the use of ADT for indications that were not evidence based. METHODS Using the Surveillance, Epidemiology, and End Results (SEER) Medicare database, we identified 54,925 men who received a diagnosis of incident prostate cancer from 2003 through 2005. We divided these men into groups according to the strength of the indication for ADT use. The use of ADT was deemed to be inappropriate as primary therapy for men with localized cancers of a low-to-moderate grade (for whom a survival benefit of such therapy was improbable), appropriate as adjuvant therapy with radiation therapy for men with locally advanced cancers (for whom a survival benefit was established), and discretionary for men receiving either primary or adjuvant therapy for localized but high-grade tumors. The proportion of men receiving ADT was calculated according to the year of diagnosis for each group. We used modified Poisson regression models to calculate the effect of the year of diagnosis on the use of ADT. RESULTS The rate of inappropriate use of ADT declined substantially during the study period, from 38.7% in 2003 to 30.6% in 2004 to 25.7% in 2005 (odds ratio for ADT use in 2005 vs. 2003, 0.72; 95% confidence interval [CI], 0.65 to 0.79). There was no decrease in the appropriate use of adjuvant ADT (odds ratio, 1.01; 95% CI, 0.86 to 1.19). In cases involving discretionary use, there was a significant decline in use in 2005 but not in 2004. CONCLUSIONS Changes in the Medicare reimbursement policy in 2004 and 2005 were associated with reductions in ADT use, particularly among men for whom the benefits of such therapy were unclear. (Funded by the American Cancer Society.).
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Affiliation(s)
- Vahakn B Shahinian
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109-0725, USA.
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Carson AP, Howard DL, Carpenter WR, Taylor YJ, Peacock S, Schenck AP, Godley PA. Trends and racial differences in the use of androgen deprivation therapy for metastatic prostate cancer. J Pain Symptom Manage 2010; 39:872-81. [PMID: 20471547 PMCID: PMC3878612 DOI: 10.1016/j.jpainsymman.2009.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2008] [Revised: 09/10/2009] [Accepted: 10/16/2009] [Indexed: 11/15/2022]
Abstract
CONTEXT Androgen deprivation therapy (ADT) is widely used to manage the symptoms of advanced prostate cancer and has been shown to slow the progression of the disease. Previous research investigating racial differences in the use of ADT has reported inconsistent findings. OBJECTIVES The purpose of this study was to assess use trends for ADT overall and by type (orchiectomy and luteinizing hormone-releasing hormone [LHRH] agonists) and the factors associated with time to receipt for metastatic prostate cancer. METHODS Data from the Surveillance, Epidemiology, and End Results (SEER) cancer registry and Medicare claims database were obtained for 5,273 men, aged 65 years and older and diagnosed with Stage IV prostate cancer during 1991-1999 from seven SEER regions. An accelerated failure time regression model with log-normal distribution was used to examine factors associated with mean time to receipt of ADT. RESULTS African-American men were less likely than white men to receive any ADT after diagnosis (P<0.001). Differences were noted in the time to receipt of ADT, with African-American men having a longer mean time to receipt of orchiectomy (time ratio [TR]=1.50; 95% confidence interval [CI]=1.03, 2.17) or LHRH agonist (TR=1.42; 95% CI=1.06, 1.89) than white men. CONCLUSION African-American men with metastatic prostate cancer were significantly less likely to receive ADT and, when treated, had a slightly longer time to receipt than white men, which has implications for patients and physicians involved in the palliative management of metastatic prostate cancer.
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Affiliation(s)
- April P Carson
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
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Abstract
PURPOSE We quantified the burden of testis cancer in the United States by identifying trends in its incidence, its treatment and the use of health care resources to estimate the economic impact of the disease. MATERIALS AND METHODS The analytical methods used to generate these results were described previously. RESULTS The overall incidence of testis cancer in the United States increased 46% between 1975 and 2001. During the same period the ratio of seminoma to nonseminoma increased and there were fewer men presenting with stage II and III tumors. Survival rates increased successively, attaining the current level of 95.9%. Treatment patterns changed and active surveillance increased as a primary treatment modality. Overall hospitalization rates for men with testis cancer decreased from 1.8/100,000 in 1994 and 1.4/100,000 in 2000. Care for white men shifted to the outpatient setting, which did not occur for black men. The estimated annual expenditure for testis cancer for privately insured individuals between ages 18 and 54 years was $6,236. National estimates of annual medical expenditures placed the total cost of treatment at $21.8 million in 2000, representing an increase of 10% over the total in 1994. Of men with testis cancer 16% missed work for treatment of the disease with an average of 8.4 total hours of work missed. CONCLUSIONS The cost of testis cancer is estimated at almost $21.8 million annually. It appears to be increasing with time despite a shift to active surveillance treatments and less hospitalization.
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Affiliation(s)
- Mitchell H Sokoloff
- Section of Urologic Oncology, Division of Urology and Renal Transplantation, Department of Surgery, Oregon Health and Sciences University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA
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van der Velden MA. [The castration of a stallion; past, present and future]. Tijdschr Diergeneeskd 2005; 130:312-7. [PMID: 15938451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- M A van der Velden
- Hoofdafdeling Gezondheidszorg Paard, Faculteit der Diergeneeskunde, discipline Heelkunde, Universiteit Utrecht.
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Abstract
OBJECTIVE To assess long-term secular trends in the utilization of bilateral compared with unilateral orchiectomy in the community. PATIENTS AND METHODS This population-based descriptive study reviewed medical records of all Olmsted County, Minnesota, men undergoing orchiectomy between 1956 and 2000. RESULTS Over the 45-year study period, 381 Olmsted County men had a first unilateral orchiectomy, while 431 underwent bilateral orchiectomy (including 8 with a second unilateral orchiectomy). There was no change over time in the age-adjusted utilization of unilateral orchiectomy, which was performed for a wide range of indications, mostly cryptorchidism and testicular malignancy. Most bilateral procedures, on the other hand, were in elderly men for castration, and trends over time generally paralleled those reported for prostate cancer in this community. CONCLUSION The declining incidence of prostate cancer in recent years, combined with a shift to earlier stages and younger ages at diagnosis, and the development of pharmacological approaches to hormonal manipulation have led to a dramatic decline in the utilization of bilateral orchiectomy, while unilateral orchiectomy rates have remained unchanged.
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Affiliation(s)
- L J Melton
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minn. 55902, USA
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Schmidt JD, Mettlin CJ, Natarajan N, Peace BB, Beart RW, Winchester DP, Murphy GP. Trends in patterns of care for prostatic cancer, 1974-1983: results of surveys by the American College of Surgeons. J Urol 1986; 136:416-21. [PMID: 3735506 DOI: 10.1016/s0022-5347(17)44889-0] [Citation(s) in RCA: 124] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Data from a recent survey of patterns of care for prostatic cancer sponsored by the American College of Surgeons suggest several trends compared to similar data from a decade ago. The observed differences include increased diagnosis of localized cancer, and increased use of acid phosphatase determinations, bone scans, radical retropubic prostatectomy, radiotherapy (particularly interstitial techniques) and orchiectomy. In contrast, use of bone surveys, perineal prostatectomy and hormonal therapy has decreased. Transurethral resection continues to be the most common means to establish the diagnosis of prostatic cancer but the data do suggest that in more patients the tumors are being staged and graded. Five-year survival rates appear to be improving for all stages, and for white and black patients. Survival of black patients continues to lag behind that of white subjects, presumably owing to the more advanced stage of disease at diagnosis observed in these data. These findings may have important implications for understanding trends in survival of patients with this disease.
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