An investigation into the adverse effects of temporary androgen suppression treatment in men with prostate cancer, and their resolution after treatment withdrawal

Nigel Spry

    Research output: ThesisDoctoral Thesis

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    Abstract

    [Truncated abstract] There has been a substantial increase in the use of temporary Androgen Suppression Treatment (AST) in the management of prostate cancer. Previously, it was employed mainly to treat symptomatic patients. In the 1990s there were two major developments that have resulted in a substantial change in the way AST is employed for men with prostate cancer. First, the introduction of the Prostate Specific Antigen (PSA) blood test into routine practice, led to both a marked increase in the diagnosis of the disease and substantial downshift in the presentation disease load, resulting in subclinical presentations becoming common. Second, adjuvant roles for AST in the management of subclinical disease were identified; such as improved time to PSA failure, and longer survival. However, these benefits only manifest years later, and then only for a proportion of those treated. In contrast, there is a distinct lack of data about the longitudinal toxicity that might follow on from the use of AST. It has been widely assumed that toxicities arising from temporary "adjuvant" periods of AST will resolve following treatment withdrawal, however, there is little data to support or refute this statement. Furthermore, descriptions of toxicity employ prevalence data derived from cross sectional acute exposure studies.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Publication statusUnpublished - 2008

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