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Study to Examine Androgen Deprivation Therapy Use in African American Men

Dr. Sally Malinski

February 26, 2021

Sally Maliski, PhD, RN, FAAN, dean of the University of Kansas School of Nursing and member of The University of Kansas Cancer Center’s Cancer Prevention and Control research program, has received a grant to investigate differences between African American and white men with prostate cancer in receiving androgen deprivation therapy. The two-year, $100,000 grant was awarded by The Oncology Nursing Foundation.

African American men are diagnosed with more advanced and aggressive prostate cancer at an earlier age than men of other ethnicities, and they are up to 75 percent more likely to develop metastatic prostate cancer. While overall mortality rates from prostate cancer have declined, they have not dropped as rapidly in African American men.

“Some studies indicate African American men are more likely to receive poor quality of treatment and care,” Dr. Maliski said. “These worrisome findings and the difference in survival rates between this group and other ethnicities must be better understood.”

Dr. Maliski and her team aim to better understand the factors influencing treatment decisions, namely the use of androgen deprivation therapy, also called ADT. Prostate cancer is fueled by androgens, which include testosterone and other hormones. ADT lowers androgen to castrate levels, and it is the standard of care for advanced and metastatic prostate cancer. More recently, ADT has proven to be beneficial as adjuvant treatment with primary radiation therapy. According to Dr. Maliski, little is known about disparities related to the use of ADT for African American men with prostate cancer, as well as to what degree it affects survival rates.

The team will review electronic health records, identify provider characteristics (for example, specialty, years in practice and age), determine ADT recommendation patterns, and conduct interviews with African American men and white men to explore perceptions of and experiences with ADT.

Dr. Maliski hopes the study gives providers, as well as oncology nurses who are crucial patient advocates, the framework to tackle disparities in prostate cancer treatment.

“The findings of this study will help foster the development of interventions and policies to address health inequities amongst African American men with prostate cancer,” Dr. Maliski said. “With increased understanding of the factors contributing to disparities in care and outcomes of prostate cancer among African American men, patient education can be developed that helps men and their loved ones better understand effective treatment options available to them, as well as help build providers’ awareness of the impact their counseling and guidance may have on mitigating disparities.”

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