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Abstract
To assess the prevalence, onset, duration and severity of hot flashes in men after bilateral orchidectomy (BO) for prostate cancer, to evaluate body temperature changes during hot flashes and to determine whether an elevated temperature within a few days after BO can be caused by deprivation of androgen. Patients (n = 101) were questioned about the characteristics of their hot flashes after BO for prostate cancer. A subgroup of these men (n = 17) were instructed to record their oral and forehead temperatures during and at fixed intervals between hot flashes daily for 4 weeks. The mean age was 71.6 years, mean follow-up after BO was 33.2 months. Hot flashes were reported by 87 men (86%) with previous spontaneous remission in 9 (10%). The median time between BO and the onset of hot flashes was 21 days (range 1-730), median number of hot flashes 3 per day (range 1-20), and median duration was 120 seconds (range 5 to 1800). There was no significant difference between median oral (36.4(o) C) and forehead (36.0(o) C) temperature in the normal state, but during hot flashes the median forehead temperature (37.0(o) C) was higher than the oral temperature (36.5(o) C) (p = 0.0004). Both median oral and forehead temperatures were higher during hot flashes (36.5(o) C and 37.0(o) C) than in the normal state (36.4(o) C and 36.0(o) C, respectively) (p < 0.0001). During hot flashes, the oral temperature was 38(o) C to 40(o) C in only 3.2% of 593 readings in 17 patients. The median oral and forehead temperatures are higher during hot flashes than in normal periods. Oral temperature elevation > 38(o) C within days after a BO is unlikely to be the result of androgen deprivation alone.
Highlights
Hot flashes are common in men with prostate cancer undergoing androgen deprivation therapy (ADT) – about 40-80% suffer hot flashes and 3040% report major discomfort during such episodes
Spontaneous remission had occurred in 9 (10%) and 90% said that they were not aware of the fact that hot flashes are related to androgen deprivation
In studies of men on ADT, 10% of the patients had severe distress during hot flashes, while our study showed that 25% had severe distress
Summary
Hot flashes are common in men with prostate cancer undergoing androgen deprivation therapy (ADT) – about 40-80% suffer hot flashes and 3040% report major discomfort during such episodes. Hot Flashes After Bilateral Orchidectomy neurons in the thermoregulatory center resulting in hot flashes (1 - 6). Several studies on women with post-menopausal hot flashes have been reported, relatively few studies have investigated the frequency, severity and body temperature changes during hot flashes in men (2, 7 - 14). The present study was triggered by a clinical question concerning a patient with advanced prostate cancer and renal cell cancer who underwent laparoscopic nephrectomy and simultaneous bilateral orchidectomy (BO). He developed a fever from day two post-surgery, for which no apparent reason could be found. There was no obvious answer in the literature, this study was undertaken to assess temperature changes after BO in men with prostate cancer
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