Acupuncture for treating hot flushes in men with prostate cancer: a systematic review

GOALS OF WORK

The goal of the study was to assess the effects of acupuncture as a treatment for hot flushes in prostate cancer (PC) patients.

MATERIALS AND METHODS

The literature was searched using 14 databases with dates ranging from their inceptions to December 2008 and without language restrictions. All clinical studies of any type of acupuncture in PC patients were included. Their main outcome measures had to be vasomotor symptoms. Their methodological quality was assessed using the modified Jadad score.

RESULTS

Six studies met all the inclusion criteria. One randomised clinical trial compared the effects of manual acupuncture with acupuncture plus electro-acupuncture. The other five studies were uncontrolled observational studies and therefore had limitations.

CONCLUSION

The evidence is not convincing to suggest acupuncture is an effective treatment for hot flush in patients with PC. Further research is required to investigate whether acupuncture has hot-flush-specific effects.

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

BACKGROUND

Hot flushes are common and distressing among men with castrational treatment for prostate cancer. Of the few treatments, most have side effects.

OBJECTIVE

Assess changes in hot flushes of electrostimulated (EA) and traditional acupuncture (TA).

DESIGN, SETTING, AND PARTICIPANTS

Thirty-one men with hot flushes due to prostate cancer treatment were recruited from three urological departments in Sweden, from 2001 to 2004.

INTERVENTION

Thirty-one men were randomized to EA (12 needle points, with 4 electrostimulated) or TA (12 needle points) weekly for 12 wk.

MEASUREMENTS

PRIMARY OUTCOME

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).

RESULTS AND LIMITATIONS

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.

LIMITATIONS

small number of patients; no placebo control, instead a small group controlled for 6 wk pretreatment.

CONCLUSIONS

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.