Male Hot Flashes Are the Subject of New Study

02/19/04    Portland, Ore.

OHSU School of Medicine and OHSU Cancer Institute researchers start the first American clinical trial examining acupuncture to treat hot flashes experienced by prostate cancer patients

Joel Johnson had his first hot flash eight years ago, when doctors began treating his advanced prostate cancer with hormonal deprivation therapy.

"I had my first hot flash immediately following my first treatment," Johnson said. "I never thought hot flashes would be a part of my life. Sometimes I get one when I'm leaning over to lace my boots. Other times they happen when I'm just sitting still."

Johnson, of Gaston, Ore., takes drugs to cut off his body's supply of testosterone, the male sex hormone that drives prostate cancer cells to multiply. Hot flashes affect about 80 percent of the 22,000 men who receive hormonal deprivation therapy for advanced prostate cancer each year. For many men, hot flashes are a source of irritability, fatigue and insomnia.

"I have six to eight hot flashes a day. The worst are at night because they wake me up," said Johnson, who takes Effexor for relief. "It really doesn't help much," he said.

Current drug therapies offer only partial relief and can cause adverse effects, according to Tomasz M. Beer, M.D., director of the Prostate Cancer Program at the OHSU Cancer Institute. Beer is looking for more effective, less toxic treatments that improve cancer patients' quality of life.

"Acupuncture is a low-toxicity treatment that may offer important symptomatic relief to cancer patients who suffer from hot flashes," Beer said.

OHSU School of Medicine and OHSU Cancer Institute researchers are conducting the first American study to examine the effectiveness of acupuncture in diminishing hot flashes in men receiving hormonal deprivation therapy.

"Acupuncture carries few side effects, has shown promising results in preliminary studies, and is associated with a feeling of relaxation and well-being in the majority of patients," Beer said.

A Swedish pilot study of seven men treated with acupuncture for hot flashes due to hormonal deprivation therapy for prostate cancer shows promising results. Six of seven men completed a 10-week course of acupuncture. Frequency of hot flashes was reduced between 50 percent and 70 percent at various time during the study. No adverse effects were reported.

In a follow-up to this pilot study, Beer currently is enrolling 25 patients in a phase II clinical trial of acupuncture (IRB No. 7235). Study participants must be diagnosed with prostate cancer, older than 18, receiving hormonal therapy for the duration of the study and experiencing significant hot flashes. The men will receive 14 acupuncture treatments over 10 weeks -- twice weekly for four weeks, then once weekly for six additional weeks. Each treatment lasts about 30 minutes and involves the placement of 14 needles in the arms, legs, back and head.

Beer and his team will evaluate the impact of acupuncture on the frequency and intensity of hot flashes, and on the insomnia and loss of vitality they often cause. Researchers also will take blood and urine samples before, during and after acupuncture to evaluate its impact on neurotransmitters in the blood and central nervous system.

"We'd like to come away from this study with a better understanding of the biological changes associated with hot flashes and with acupuncture," Beer said. "For example, reduced levels of a particular neurotransmitter, serotonin, and its metabolites have been associated with hot flashes. Preliminary findings suggest that acupuncture can increase serotonin levels. We'd like to determine if the extent to which acupuncture provides relief for these men is associated with changes in their serotonin levels."

Positive study results of the clinical trial will lead to randomized confirmatory trials as well as exploratory trials combining acupuncture with medication in an effort to develop better treatments for hot flashes.

Men interested in participating in the study can contact the OHSU Cancer Institute Prostate Cancer Program by calling 503 494-1951. This study is funded by the National Cancer Institute.

Prostate cancer is the most common cancer in men and the second leading cause of cancer-related death in American men. Overall, one in six men will develop prostate cancer during his lifetime.