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Complementary/alternative therapies for reducing hot flashes in prostate cancer patients: reevaluating the existing indirect data from studies of breast cancer and postmenopausal women.

Abstract

Vasomotor hot flashes are a common problem in women who are postmenopausal or receiving antiestrogen treatment for breast cancer. Hot flashes are also a common problem after orchiectomy/luteinizing hormone-releasing hormone therapy, occurring generally in 50% to 66% of these men. Prescribed treatments for hot flashes for men on hormonal ablation treatment for prostate cancer are well documented. These conventional agents have shown good results, but their long-term efficacy, safety, and cost are still questioned. Therefore, the search for other viable agents, including nontraditional treatments, continues. Complementary/alternative treatments to alleviate hot flashes in women have generated an enormous amount of interest. However, these options have received little attention in men with hot flashes. Research with vitamin E, soy, black cohosh, red clover, and numerous other alternative treatments in women may provide some indirect but valuable insight on their potential effectiveness in men. Many of these alternatives have been a disappointment in recent randomized trials of women, and it is likely that there will be similar results with men. However, numerous supplements have yet to be tested in a clinical trial against a placebo, and clinicians should become aware of this ever-increasing list. Patients should be made aware of the primary importance of lifestyle interventions that could partially affect hot flashes and immediately affect overall health, especially during the period of androgen suppression, when it is not uncommon to observe accelerated weight changes and insulin insensitivity. Otherwise, recent research with older and newer conventional agents, such as antidepressants or estrogen/progesterone, should be emphasized at this time for moderate-to-severe hot flashes that profoundly affect daily activities and/or sleep. Antidepressant supplements (St. John's wort) or acupuncture could also be an attractive option in future investigations. Low-dose estrogen seems particularly attractive, because it is inexpensive and may simultaneously reduce hot flashes and the risk of osteoporosis in men receiving long-term androgen suppression therapy; however, the potential for cardiovascular complications must be further investigated. Ultimately, adequate research (vs placebo) should determine the fate of the alternative supplements proposed for hot flash reduction.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Department of Urology, University of Michigan Medical Center, Ann Arbor, Michigan 48109-0330, USA. moyad@umich.edu

    Source

    Urology 59:4 Suppl 1 2002 Apr pg 20-33

    MeSH

    Acupuncture
    Adult
    Antidepressive Agents
    Breast Neoplasms
    Complementary Therapies
    Dietary Supplements
    Female
    Hot Flashes
    Humans
    Life Style
    Male
    Middle Aged
    Phytotherapy
    Postmenopause
    Prostatic Neoplasms
    Soybean Proteins
    Trifolium
    Vitamin E

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    11937433

    Citation

    Moyad, Mark A.. "Complementary/alternative Therapies for Reducing Hot Flashes in Prostate Cancer Patients: Reevaluating the Existing Indirect Data From Studies of Breast Cancer and Postmenopausal Women." Urology, vol. 59, no. 4 Suppl 1, 2002, pp. 20-33.
    Moyad MA. Complementary/alternative therapies for reducing hot flashes in prostate cancer patients: reevaluating the existing indirect data from studies of breast cancer and postmenopausal women. Urology. 2002;59(4 Suppl 1):20-33.
    Moyad, M. A. (2002). Complementary/alternative therapies for reducing hot flashes in prostate cancer patients: reevaluating the existing indirect data from studies of breast cancer and postmenopausal women. Urology, 59(4 Suppl 1), pp. 20-33.
    Moyad MA. Complementary/alternative Therapies for Reducing Hot Flashes in Prostate Cancer Patients: Reevaluating the Existing Indirect Data From Studies of Breast Cancer and Postmenopausal Women. Urology. 2002;59(4 Suppl 1):20-33. PubMed PMID: 11937433.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Complementary/alternative therapies for reducing hot flashes in prostate cancer patients: reevaluating the existing indirect data from studies of breast cancer and postmenopausal women. A1 - Moyad,Mark A, PY - 2002/4/9/pubmed PY - 2002/4/11/medline PY - 2002/4/9/entrez SP - 20 EP - 33 JF - Urology JO - Urology VL - 59 IS - 4 Suppl 1 N2 - Vasomotor hot flashes are a common problem in women who are postmenopausal or receiving antiestrogen treatment for breast cancer. Hot flashes are also a common problem after orchiectomy/luteinizing hormone-releasing hormone therapy, occurring generally in 50% to 66% of these men. Prescribed treatments for hot flashes for men on hormonal ablation treatment for prostate cancer are well documented. These conventional agents have shown good results, but their long-term efficacy, safety, and cost are still questioned. Therefore, the search for other viable agents, including nontraditional treatments, continues. Complementary/alternative treatments to alleviate hot flashes in women have generated an enormous amount of interest. However, these options have received little attention in men with hot flashes. Research with vitamin E, soy, black cohosh, red clover, and numerous other alternative treatments in women may provide some indirect but valuable insight on their potential effectiveness in men. Many of these alternatives have been a disappointment in recent randomized trials of women, and it is likely that there will be similar results with men. However, numerous supplements have yet to be tested in a clinical trial against a placebo, and clinicians should become aware of this ever-increasing list. Patients should be made aware of the primary importance of lifestyle interventions that could partially affect hot flashes and immediately affect overall health, especially during the period of androgen suppression, when it is not uncommon to observe accelerated weight changes and insulin insensitivity. Otherwise, recent research with older and newer conventional agents, such as antidepressants or estrogen/progesterone, should be emphasized at this time for moderate-to-severe hot flashes that profoundly affect daily activities and/or sleep. Antidepressant supplements (St. John's wort) or acupuncture could also be an attractive option in future investigations. Low-dose estrogen seems particularly attractive, because it is inexpensive and may simultaneously reduce hot flashes and the risk of osteoporosis in men receiving long-term androgen suppression therapy; however, the potential for cardiovascular complications must be further investigated. Ultimately, adequate research (vs placebo) should determine the fate of the alternative supplements proposed for hot flash reduction. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/11937433/Complementary/alternative_therapies_for_reducing_hot_flashes_in_prostate_cancer_patients:_reevaluating_the_existing_indirect_data_from_studies_of_breast_cancer_and_postmenopausal_women_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090429502016412 DB - PRIME DP - Unbound Medicine ER -