Two modes of acupuncture as a treatment for hot flushes in men with prostate cancer--a prospective multicenter study with long-term follow-up.

Abstract

Hot flushes are common and distressing among men with castrational treatment for prostate cancer. Of the few treatments, most have side effects. Assess changes in hot flushes of electrostimulated (EA) and traditional acupuncture (TA). Thirty-one men with hot flushes due to prostate cancer treatment were recruited from three urological departments in Sweden, from 2001 to 2004. Thirty-one men were randomized to EA (12 needle points, with 4 electrostimulated) or TA (12 needle points) weekly for 12 wk. number of and distress from hot flushes in 24 h and change in "hot flush score." Secondary outcome: change in 24-h urine excretion of CGRP (calcitonin gene-related peptide). Twenty-nine men completed the treatment. Hot flushes per 24 h decreased significantly, from a median of 7.6 (interquartile range [IQR], 6.0-12.3) at baseline in the EA group to 4.1 (IQR, 2.0-6.5) (p=0.012) after 12 wk, and from 5.7 (IQR, 5.1-9.5) in the TA group to 3.4 (IQR1.8-6.3) (p=0.001). Distress by flushes decreased from 8.2 (IQR, 6.5-10.7) in the EA group to 3.3 (IQR, 0.3-8.1) (p=0.003), and from 7.6 (IQR, 4.7-8.3) to 3.4 (IQR, 2.0-5.6) (p=0.001) in the TA group after 12 wk, (78% and 73% reduction in "hot flush score," respectively). The effect lasted up to 9 mo after treatment ended. CGRP did not change significantly. Few, minor side effects were reported. small number of patients; no placebo control, instead a small group controlled for 6 wk pretreatment. EA and TA lowered number of and distress from hot flushes. The hot flush score decreased 78% and 73%, respectively, in line with or better than medical regimens for these symptoms. Acupuncture should be considered an alternative treatment for these symptoms, but further evaluation is needed, preferably with a non- or placebo-treated control group.