Did you have androgen deprivation therapy (ADT)? If you have you probably experienced hot flashes. Up to 80% of men treated with ADT for prostate cancer will experience hot flashes, ranging from very mild to very severe. Along with hot flashes many of us will also have insomnia, fatigue, irritability and a host of other side effects. Our quality of life is almost assured to decline while on ADT.

There are several pharmacologic interventions that can sometimes reduce hot flash frequency and intensity but as with all drugs they have the potential for additional adverse effects or do not work.

Acupuncture has been reported to substantially reduce hot flash frequency in postmenopausal women. There are a number of small clinical trials going on to evaluate the efficacy of acupuncture in men on ADT.

One such trial investigated the benefit of acupuncture in a group of eight men experiencing at least three hot flashes per day due to hormonal therapy for prostate cancer. They scored the hot flashes using 3 nationally accredited scoring systems; Hot Flash Score (HFS), Hot Flash Related Daily Interference Scale (HFRDIS) and Pittsburgh Sleep Quality Index (PSQI). Hot flashes were assessed on weekly basis and at one-month post intervention.

Acupuncture sessions were provided twice weekly for 4 consecutive weeks and once a week for the following 6 weeks. Pre- and post-acupuncture serum Serotonin is obtained.

Only four of the men completed the entire protocol with a one-month follow up. The mean pre-intervention hot flashes score was 12 for HFS, 59.2 for HFRIDS and 5 for PSQI. The post treatment scores were 4, 36.7 and 2.3 respectively. The overall mean reduction in hot flashes was 53%. Additionally, the mean pretreatment serotonin level was 226 compared to 183 in post therapy estimation.

The good news is that there were no immediate adverse effects reported.

In this trial, although the sample size is under powered, the use of acupuncture in this sample reduced the intensity and frequency of hot flashes in men with prostate cancer secondary to androgen ablation by 53%. The intervention was safe with no immediate adverse effects.

When I was on ADT (currently I am intermittent) I experience a hot flash around every two hours, both day and night. I tried a number of pharmaceuticals; none of them provided any relief. I signed up for a similar clinical trial at Columbia Presbyterian Hospital in New York City. My treatment protocol was one treatment each week. I personally experienced a significant reduction of the intensity and the number of flashes. I still had flashes, but there were fewer and more tolerable.

This study is still accruing patients. To find out more abut becoming a part of the trial go to: www.ClinicalTrials.gov and search for: ID#NCT00421902

Abstract No: 20678 at the ASCO 2008 conference

J Clin Oncol 26: 2008 (May 20 suppl; abstr 20678)
Author(s): H. Ashamalla, M. Jiang, A. Guirguis

Joel T Nowak MA, MSW