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Acupuncture Study Helps Men With Hot Flashes

   Portland, Ore.

Early results of a new study also show acupuncture may improve quality of life

Prostate cancer patients who have hot flashes caused by hormone therapy may benefit from acupuncture, according to an ongoing Oregon Health & Science University Cancer Institute study. Acupuncture significantly decreased the frequency and intensity of hot flashes in 60 percent of study participants who have completed treatment.

"We expect 25 percent of men to respond to placebos, so to have 60 percent of men experience a significant reduction in hot flashes is an encouraging preliminary result," said Tomasz Beer, M.D., director of the Prostate Cancer Program at the OHSU Cancer Institute.

Six weeks after concluding a 10-week course of acupuncture, six of 10 men had a 50 percent or greater reduction in hot flash frequency and intensity. Quality of life also improved. On an index of 0 to 100 for which a lower number indicates a better quality of life, the mean score decreased from 42.6 to 22.7, an improvement of 47 percent.

Hormone therapy reduces the production of testosterone which is known to cause the progression of prostate cancer, the most common malignancy and the second leading cause of cancer-related death among men in the United States. About 80 percent of men treated for advanced prostate cancer with horm one therapy experience hot flashes. For many men, hot flashes are a source of irritability, fatigue and insomnia.

Before beginning hormone therapy, prostate cancer patient and study participant Marlin Schuh, 59, was aware that hot flashes are a common side effect, but he was surprised by their frequency. "I was experiencing 12 to 15 hot flashes a day," Schuh said.

The hot flashes were interfering with his sleep and affecting his quality of life. "It wasn't uncommon for a hot flash to wake me in the middle of the night," Schuh said.

According to Beer, current drug therapies for reducing hot flashes offer only partial relief and can cause adverse effects. "Our study indicates acupuncture may offer less toxic, effective relief for cancer patients who suffer from hot flashes," Beer said.

Beer and colleagues plan to enroll a total of 25 patients in the phase II clinical trial (IRB No. 7235). To be eligible, men must have a confirmed diagnosis of prostate cancer. Also, they must be older than 18, receiving hormonal therapy for the duration of the study and experiencing significant hot flashes.

Study participants receive 14 acupuncture treatments during 10 weeks - twice weekly for four weeks, then once weekly for six additional weeks. Each treatment lasts about 30 minutes and involves the placement of 14 needles in the arms, legs, back and head.

"Honestly, I was very skeptical about the acupuncture," said Schuh, a West Linn, Ore., resident who is undergoing intermittent hormone therapy to treat his advanced disease. "Much to my surprise, after two weeks the hot flashes just diminished. The number is way down and so is the intensity."

In addition to assessing acupuncture's effect on the frequency and intensity of hot flashes, and related insomnia and loss of vitality, researchers also will evaluate blood and urine samples to measure neurotransmitters present in the blood and central nervous system before, during and after acupuncture.

"By measuring the effects of acupuncture on neurotransmitters, we seek to develop a better understanding of the biologic basis for acupuncture's effects," Beer said.

To date, researchers have evaluated data on 10 men. Six experienced a 50 percent or greater reduction in hot flash score. Four reached the benchmark after four weeks of therapy. Two patients reached the benchmark as the study progressed - one after 10 weeks of treatment and another six weeks after the final treatment. The hot flash score is calculated by multiplying each hot flash by its severity. Severity-adjusted hot flash numbers are added together over a seven-day period and then divided by seven to yield a daily hot flash score.

Quality of life is measured by a number of research-validated questionnaires that are answered by participants before treatment to establish a baseline score and at intervals over the course of treatment. These include the Hot Flash Daily Interference Scale given in weeks four, six and 10; the Pittsburgh Sleep Quality Index, given in weeks four and 10; and the MOS 36-Item Short Form Health Survey, given in weeks four and 10.

Men interested in participating in the study can contact the OHSU Cancer Institute Prostate Cancer Program by calling 503 494-1951. This study is funded by the National Cancer Institute, a component of the National Institutes of Health.

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Tomasz Beer, M.D., is an associate professor of medicine (hematology and medical oncology), OHSU School of Medicine; and director of the Prostate Cancer Program in the OHSU Cancer Institute.
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