Acupuncture for treating hot flushes in men with prostate cancer: a systematic review

  • Myeong Soo LeeEmail author
  • Kun-Hyung Kim
  • Byung-Cheul Shin
  • Sun-Mi Choi
  • Edzard Ernst
Review Article


Goals of work

The goal of the study was to assess the effects of acupuncture as a treatment for hot flushes in prostate cancer (PC) patients.

Materials and methods

The literature was searched using 14 databases with dates ranging from their inceptions to December 2008 and without language restrictions. All clinical studies of any type of acupuncture in PC patients were included. Their main outcome measures had to be vasomotor symptoms. Their methodological quality was assessed using the modified Jadad score.


Six studies met all the inclusion criteria. One randomised clinical trial compared the effects of manual acupuncture with acupuncture plus electro-acupuncture. The other five studies were uncontrolled observational studies and therefore had limitations.


The evidence is not convincing to suggest acupuncture is an effective treatment for hot flush in patients with PC. Further research is required to investigate whether acupuncture has hot-flush-specific effects.


Acupuncture Hot flushes Prostate cancer Systematic review 



M. S. Lee, K. H. Kim, and S. M. Choi were supported by the Korea Institute of Oriental Medicine (K08010).


  1. 1.
    Andersson S, Lundeberg T (1995) Acupuncture–from empiricism to science: functional background to acupuncture effects in pain and disease. Med Hypotheses 45:271–281. doi: 10.1016/0306-9877(95) 90117-5 PubMedCrossRefGoogle Scholar
  2. 2.
    Arai YC, Ushida T, Osuga T, Matsubara T, Oshima K, Kawaguchi K, Kuwabara C, Nakao S, Hara A, Furuta C, Aida E, Ra S, Takagi Y, Watakabe K (2008) The effect of acupressure at the extra 1 point on subjective and autonomic responses to needle insertion. Anesth Analg 107:661–664PubMedCrossRefGoogle Scholar
  3. 3.
    Ashamalla H, Jiang M, Guirguis A (2008) Phase I study of acupuncture as treatment of hot flashes for men with prostate cancer. J Clin Oncol 26:20678 Meeting AbstractsGoogle Scholar
  4. 4.
    Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, Pitkin R, Rennie D, Schulz KF, Simel D, Stroup DF (1996) Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA 276:637–639. doi: 10.1001/jama.276.8.637 PubMedCrossRefGoogle Scholar
  5. 5.
    Capodice JL, Jin Z, Stone BA, McKiernan JM, Olsson CA, Katz AE (2008) Results of a prospective pilot clinical trial administering acupuncture for hot flashes in patients undergoing hormonal therapy for prostate cancer. J Urol 179:184–185. doi: 10.1016/S0022-5347(08) 60535-2 CrossRefGoogle Scholar
  6. 6.
    Carpenter JS, Andrykowski MA, Freedman RR, Munn R (1999) Feasibility and psychometrics of an ambulatory hot flash monitoring device. Menopause 6:209–215PubMedGoogle Scholar
  7. 7.
    Carpenter JS, Andrykowski MA, Sloan P, Cunningham L, Cordova MJ, Studts JL, McGrath PC, Sloan D, Kenady DE (1998) Postmastectomy/postlumpectomy pain in breast cancer survivors. J Clin Epidemiol 51:1285–1292. doi: 10.1016/S0895-4356(98) 00121-8 PubMedCrossRefGoogle Scholar
  8. 8.
    Deng G, Vickers A, Yeung S, Cassileth B (2007) Randomized, controlled trial of acupuncture for the treatment of hot flashes in breast cancer patients. J Clin Oncol 25:5584–5590. doi: 10.1200/JCO.2007.12.0774 PubMedCrossRefGoogle Scholar
  9. 9.
    Egger M, Smith GD, Altman D (2001) Systematic reviews in Healthcare: meta-analysis in context. BMJ, LondonGoogle Scholar
  10. 10.
    Ernst E (2006) Acupuncture–a critical analysis. J Intern Med 259:125–137. doi: 10.1111/j.1365-2796.2005.01584.x PubMedCrossRefGoogle Scholar
  11. 11.
    Ernst E, Pittler MH (1997) Alternative therapy bias. Nature 385:480. doi: 10.1038/385480c0 PubMedCrossRefGoogle Scholar
  12. 12.
    Fink M, Gutenbrunner C, Rollnik J, Karst M (2001) Credibility of a newly designed placebo needle for clinical trials in acupuncture research. Forsch Komplementarmed Klass Naturheilkd 8:368–372. doi: 10.1159/000057254 PubMedCrossRefGoogle Scholar
  13. 13.
    Frisk J, Spetz A-C, Hjertberg H, Petersson B, Hammar M (2009) Two modes of acupuncture as a treatment for hot flushes in men with prostate cancer—a prospective multicenter study with long-term follow-up. Eur Urol 55:156–163. doi: 10.1016/j.eururo.2008.02.002 CrossRefGoogle Scholar
  14. 14.
    Hammar M, Frisk J, Grimas O, Hook M, Spetz AC, Wyon Y (1999) Acupuncture treatment of vasomotor symptoms in men with prostatic carcinoma: a pilot study. J Urol 161:853–856. doi: 10.1016/S0022-5347(01) 61789-0 PubMedCrossRefGoogle Scholar
  15. 15.
    Harding C, Harris A, Chadwick D (2009) Auricular acupuncture: a novel treatment for vasomotor symptoms associated with luteinizing-hormone releasing hormone agonist treatment for prostate cancer. BJU Int 10:186–190. doi: 10.1111/j.1464-410X.2008.07884.x CrossRefGoogle Scholar
  16. 16.
    Hayes M, Katovic NM, Donovan D, Emmons S, Benavides M, Montalto M, Ryan CW, Liu G, Beer TM (2005) Acupuncture for hot flashes in prostate cancer patients. J Clin Oncol 23:8160 Meeting AbstractsGoogle Scholar
  17. 17.
    Hervik J, Mjåland O (2008) Acupuncture for the treatment of hot flashes in breast cancer patients, a randomized, controlled trial. Breast Cancer Res Treat. doi: 10.1007/s10549-008-0210-3
  18. 18.
    Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12. doi: 10.1016/0197-2456(95) 00134-4 PubMedCrossRefGoogle Scholar
  19. 19.
    Juni P, Witschi A, Bloch R, Egger M (1999) The hazards of scoring the quality of clinical trials for meta-analysis. JAMA 282:1054–1060. doi: 10.1001/jama.282.11.1054 PubMedCrossRefGoogle Scholar
  20. 20.
    MacPherson H, White A, Cummings M, Jobst K, Rose K, Niemtzow R (2001) Standards for reporting interventions in controlled trials of acupuncture: the STRICTA recommendations. Complement Ther Med 9:246–249. doi: 10.1054/ctim.2001.0488 PubMedCrossRefGoogle Scholar
  21. 21.
    Michaelson MD, Smith MR, Talcott JA (2003) Prostate cancer (metastatic). BMJ Clin Evid 12:1804Google Scholar
  22. 22.
    Moyad MA (2002) Complementary/alternative therapies for reducing hot flashes in prostate cancer patients: reevaluating the existing indirect data from studies of breast cancer and postmenopausal women. Urology 59:20–33. doi: 10.1016/S0090-4295(02) 01641-2 PubMedCrossRefGoogle Scholar
  23. 23.
    Park J, White A, Stevinson C, Ernst E, James M (2002) Validating a new non-penetrating sham acupuncture device: two randomised controlled trials. Acupunct Med 20:168–174PubMedCrossRefGoogle Scholar
  24. 24.
    Pittler MH, Abbot NC, Harkness EF, Ernst E (2000) Location bias in controlled clinical trials of complementary/alternative therapies. J Clin Epidemiol 53:485–489. doi: 10.1016/S0895-4356(99) 00220-6 PubMedCrossRefGoogle Scholar
  25. 25.
    Sloan JA, Loprinzi CL, Novotny PJ, Barton DL, Lavasseur BI, Windschitl H (2001) Methodologic lessons learned from hot flash studies. J Clin Oncol 19:4280–4290PubMedGoogle Scholar
  26. 26.
    Streitberger K, Kleinhenz J (1998) Introducing a placebo needle into acupuncture research. Lancet 352:364–365. doi: 10.1016/S0140-6736(97) 10471-8 PubMedCrossRefGoogle Scholar
  27. 27.
    Swartzman LC, Edelberg R, Kemmann E (1990) The menopausal hot flush: symptom reports and concomitant physiological changes. J Behav Med 13:15–30. doi: 10.1007/BF00844897 PubMedCrossRefGoogle Scholar
  28. 28.
    Uchida S, Hotta H (2008) Acupuncture affects regional blood flow in various organs. Evid Based Complement Alternat Med 5:145–151. doi: 10.1093/ecam/nem051 PubMedCrossRefGoogle Scholar
  29. 29.
    Vincent A, Barton DL, Mandrekar JN, Cha SS, Zais T, Wahner-Roedler DL, Keppler MA, Kreitzer MJ, Loprinzi C (2007) Acupuncture for hot flashes: a randomized, sham-controlled clinical study. Menopause 14:45–52. doi: 10.1097/01.gme.0000227854.27603.7d PubMedCrossRefGoogle Scholar
  30. 30.
    White AR, Ernst E (1999) A systematic review of randomized controlled trials of acupuncture for neck pain. Rheumatol 38:143–147. doi: 10.1093/rheumatology/38.2.143 CrossRefGoogle Scholar
  31. 31.
    Wyon Y, Wijma K, Nedstrand E, Hammar M (2004) A comparison of acupuncture and oral estradiol treatment of vasomotor symptoms in postmenopausal women. Climacteric 7:153–164. doi: 10.1080/13697130410001713814 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Myeong Soo Lee
    • 1
    • 2
    Email author
  • Kun-Hyung Kim
    • 1
  • Byung-Cheul Shin
    • 3
  • Sun-Mi Choi
    • 1
  • Edzard Ernst
    • 2
  1. 1.Department of Medical ResearchKorea Institute of Oriental MedicineDaejeonSouth Korea
  2. 2.Complementary Medicine, Peninsula Medical SchoolUniversities of Exeter & PlymouthExeterUK
  3. 3.Department of Oriental Rehabilitation Medicine, School of Oriental MedicinePusan National UniversityBusanSouth Korea

Personalised recommendations