Editorial - Acupuncture for the alleviation of hot flashes in men treated with androgen ablation therapy

Editorial - Acupuncture for the alleviation of hot flashes in men treated with androgen ablation therapy

Written by John Robertson

Friday, 20 August 2010

BERKELEY, CA (UroToday.com) - In the online version of International Journal of Radiation Oncology, Biology, Physics, Dr. Hani Ashamalla and colleagues report on the use of acupuncture in men with hot flashes due to androgen deprivation therapy (ADT) for prostate cancer (CaP). Hot flashes occur in 45-70% of men undergoing ADT, and they can be unpredictable in frequency and severity. Selective serotonin re-uptake inhibitors, serotonin/norepinephrine reuptake inhibitors, and gabapentin have been used in patients with hot flashes during breast and prostate cancer treatment. Acupuncture is traditionally used for analgesic effects, but data suggests that endorphins and serotonin mediate acupuncture’s analgesic effects. As a result, these investigators performed a prospective study in 17 men with hot flashes due to ADT. Participants had to have three or more hot flashes per day for at least 3 days before enrollment and must not have been receiving any medications for hot flashes. Data was reported as the hot flash score (HFS), defined as the product of hot flash frequency times severity. Data was assessed prior to treatment, and at 2 and 6 weeks from the onset of acupuncture therapy. Post-treatment scores were obtained monthly and median follow-up time was 8 months. Acupuncture treatment was given by a single, experienced, licensed provider targeting 10 bilateral acupuncture points. After needle placement, electrostimulation at 2Hz was carried out on 4 of the 10 points. Patients received acupuncture sessions twice weekly for 4 weeks. Three of the 17 patients dropped out prior to initiation of treatment and were excluded from analysis. For the other 14 men, the mean baseline HFS score of 28.3 dropped at 2 and 6 weeks to 10.3 and 7.5, respectively. At the 8-month follow-up, the HFS was 7.0 for the 11 patients with adequate data. This was statistically significant compared with pre-treatment scores. The percentage improvement in HFS at 2 and 6 weeks was 68.4% and 89.2%, respectively. The percentage improvement in HFS at 8 months was 80.3%. All men in the study experienced >50% improvement in HFS at the longest follow-up interval. No significant side effects were encountered. Ashamalla H, Jiang ML, Guirguis A, Peluso F, Ashamalla M http://www.urotoday.com/61/browse_categories/prostate_cancer/editorial__acupuncture_for_the_alleviation_of_hot_flashes_in_men_treated_with_androgen_ablation_therapy08202010.html www.awcsandiego.com