Evaluation of core and surface body temperatures, prevalence, onset, duration and severity of hot flashes in men after bilateral orchidectomy for prostate cancer.

OBJECTIVE: 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. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Evaluation of core and surface body temperatures, prevalence, onset, duration and severity of hot flashes in men after bilateral orchidectomy for prostate cancer

OBJECTIVE: To assess the prevalence, onset, duration and severity of hot flashes in men after bilateral orchidectomies (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. MATERIALS AND METHODS: 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. RESULTS: The mean age was 71.6 years, mean follow-up after BO was 33.2 months. Hot flashes were reported by 87 men (86 percent) with previous spontaneous remission in 9 (10 percent). 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 (36.4º C) and forehead (36.0º C) temperature in the normal state, but during hot flashes the median forehead temperature (37.0º C) was higher than the oral temperature (36.5º C) (p = 0.0004). Both median oral and forehead temperatures were higher during hot flashes (36.5º C and 37.0º C) than in the normal state (36.4º C and 36.0º C, respectively) (p < 0.0001). During hot flashes, the oral temperature was 38º C to 40º C in only 3.2 percent of 593 readings in 17 patients. CONCLUSIONS: The median oral and forehead temperatures are higher during hot flashes than in normal periods. Oral temperature elevation > 38º C within days after a BO is unlikely to be the result of androgen deprivation alone.

Cimicifuga racemosa for the treatment of hot flushes in women surviving breast cancer.

OBJECTIVES: To examine the effect of Cimicifuga racemosa (CR BNO 1055) on hot flushes caused by tamoxifen adjuvant therapy in young premenopausal breast cancer survivors. This treatment presents an off-label use of CR BNO 1055. METHODS: Between May 1999 and December 2001, we accrued 136 breast cancer survivors aged 35-52 years. After treatment with segmental or total mastectomy, radiation therapy and adjuvant chemotherapy, participants were in open-label randomly assigned (1-2) to receive tamoxifen 20 mg per day orally (usual-care group; n=46) or tamoxifen (same dose and posology) plus CR BNO 1055 (Menofem/Klimadynon, corresponding to 20 mg of herbal drug; intervention group n=90). Duration of treatment was 5 years for tamoxifen, according to international standards for adjuvant therapies, and 12 months for CR BNO 1055. Follow-up included clinical assessment every 2 months; the primary endpoint was to record the number and intensity of hot flushes. RESULTS: Comparing patients assigned to usual-care group with those assigned to intervention group, the number and severity of hot flushes were reduced after intervention. Almost half of the patients of the intervention group were free of hot flushes, while severe hot flushes were reported by 24.4% of patients of intervention group and 73.9% of the usual-care group (P<0.01). CONCLUSIONS: Hot flushes were the most frequent adverse reaction to tamoxifen adjuvant therapy in breast cancer survivors. The combined administration of tamoxifen plus CR BNO 1055 for a period of 12 months allowed satisfactory reduction in the number and severity of hot flushes.