Acupuncture for the Treatment of Hot Flashes in Men with Advanced Prostate Cancer
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cancer and women with breast cancer imply a neuromo-
dulatory mechanism via neurotransmitter release [13-15].
This hypothesis is also suppor ted by recent clinical trials
on selective serotonin reuptake inhibitors for the treat-
ment for ho t flashes in both men and women [14,15] and
recent in vitro data demonstrating that acupuncture may
increase circulating serotonin in a murine model [16].
A handful of other studies of acupuncture for hot
flashes induced by hormonal therapy in men also suggest
a potential neuromodulatory mechanism of action in-
cluding b-endorphin release and potential effect on cal-
citonin gene-related peptide immunoreactivity [7,13].
Based on our original hypothesis and current research,
we also suggest that the action of acupuncture in men
with hot flashes may be due to a neuromodulatory effect
that targets noradrenergic and serotonergic pathways that
are thought to be involved with hypothalamic thermore-
gulation following the reduction of testosterone and
hormonal fluctuations as a result of androgen ablation.
Moreover, fMRI research has recently implied that acu-
puncture modulates cortical activity and may powerfully
modulate human subjective experiences including res-
ponses to pain, hunger, and memory [17].
Limitations of our study include lack of a placebo or
sham control. However at the time of study design only
one case report existed in the literature and we felt that
pilot data needed to be collected first in order to support
a hypothesis for a larger trial.
Our study clearly demonstrates that acupuncture is
safe and effective in reducing hot flashes in men with
advanced prostate cancer undergoing androgen depriva-
tion therapy following 14 weeks of acupuncture treat-
ment. It is warranted for further controlled studies that
should investigate the potential mechanism of action of
acupuncture and may be a powerful treatment for a debi-
litating symptom in which there is limited medical ar-
mamentarium.
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