Course and Moderators of Hot Flash Interference during Androgen Deprivation Therapy for Prostate Cancer: A Matched Comparison

Abstract

Purpose Many men receiving androgen deprivation therapy (ADT) for prostate cancer experience hot flashes. This study aimed to describe the course of hot flash interference (HFI) over time in ADT recipients relative to matched prostate cancer and cancer-free controls, from before the start of ADT to 12 months later. We also examined demographic, clinical, and genetic predictors of the impact of ADT on hot flash interference. Materials and Methods Three groups were examined: prostate cancer patients recruited before or within 21 days of starting ADT (n=60), age- and education-matched prostate cancer patients treated with prostatectomy only (n=83), and age- and education-matched men with no history of cancer (n=86). Participants provided blood samples and completed the Hot Flash Daily Interference Scale at baseline as well as 6 and 12 months later. Results ADT recipients reported increasing HFI over time relative to controls (p<.001). Group differences were evident at 6 and 12 months (ps<.001), with ADT recipients reporting greater HFI than controls. Several genetic polymorphisms were found to predict greater increases in HFI (ps<.01), including polymorphisms on genes associated with vasoconstriction, immune function, neurotransmission, and circadian rhythms. ADT recipients who were younger and had lower body mass index at baseline also exhibited greater increases in HFI over time (ps≤.01). Conclusions This study, the first to prospectively examine HFI in ADT recipients, found that those with certain genetic polymorphisms, younger age, and lower BMI had greater increases in HFI over time relative to controls.

Sleep disturbance in men receiving androgen deprivation therapy for prostate cancer: The role of hot flashes and nocturia

“…). As reported previously, ADT recipients reported greater hot flash interference over time compared with controls ( F = 68.14; P <.001).…”

“…Consistent with previous studies, preliminary analyses were conducted to determine whether the patients with prostate cancer not receiving ADT and the men with no history of prostate cancer could be combined into a single control group. The control groups did not differ with regard to subjective sleep disturbance (ie, Insomnia Severity Index scores) or hot flash interference at any assessment ( P s ≥ .18) or with regard to changes in these variables over time ( P s ≥ .61).…”

“…Hot flash interference was assessed in the full sample using the Hot Flash Related Daily Interference Scale, a 10‐item measure that asks respondents to report the interference on several aspects of functioning associated with hot flashes. This valid and reliable self‐report measure is widely used in prostate cancer research . Scores range from 0 to 100, with higher scores indicating greater interference.…”

“…Numerous studies have shown that androgen deprivation therapy (ADT) for prostate cancer results in side effects such as hot flashes, muscle loss, fatigue, depression, and cognitive impairment . Less research has focused on the effects of ADT on sleep; however, available data suggest that sleep is a problem in this population.…”

Characteristics and predictors of fatigue among men receiving androgen deprivation therapy for prostate cancer: a controlled comparison

“…ADT serves to stop or delay subsequent cancer growth and metastasis by depriving tumor cells the stimulating effects of androgens. Men receiving this treatment typically experience a variety of negative side effects, including hot flashes and loss of muscle mass [1–4]. …”