Management of androgen deprivation therapy-associated hot flashes in men with prostate cancer

PROBLEM IDENTIFICATION: To determine best practices for managing hot flashes associated with androgen deprivation therapy (ADT) in men with prostate cancer. LITERATURE SEARCH: The CINAHL®, Embase®, PsycINFO®, PubMed®, and Scopus® databases were used to identify randomized controlled trials (RCTs) and quasiexperimental studies published between January 1994 and June 2018. DATA EVALUATION: Using the Cochrane Handbook for Systematic Reviews of Interventions, the authors reviewed 15 studies examining the effects of pharmacologic or complementary and alternative medicine interventions on ADT-associated hot flashes in men with prostate cancer. SYNTHESIS: Pharmacologic interventions (e.g., cyproterone, medroxyprogesterone, megestrol acetate) showed some promise for reducing hot flashes but were associated with side effects and risks. Acupuncture demonstrated potential benefit in reducing hot flashes without side effects. IMPLICATIONS FOR RESEARCH: Evidence is insufficient to support interventions for ADTassociated hot flashes in men with prostate cancer. Future RCTs should be sufficiently powered, include a control group, and use standardized outcome measures.