Authors
Mayank Ajmera, Kai-Jye Lou, Sydney Ng, Michele Helbing
Published in
Prostate cancer. Volume 2026. Pages 7791468. Epub Sep 10, 2026.
Abstract
Androgen-deprivation therapy (ADT) for prostate cancer (PCa) is associated with vasomotor symptoms (VMS; hot flashes and night sweats). However, the impact of VMS has not been well characterized. This systematic literature review analyzed patient-reported outcome (PRO) instruments used to assess the quality of life (QoL) impact of ADT-induced VMS as well as the associated humanistic burden and epidemiology.
MEDLINE In-Progress, Embase, Cochrane Database of Systematic Reviews (2011-2024), and major oncology and health economics and outcomes research conferences (2023-2024) were searched.
In total, 52 studies were included. Of 15 PRO instruments identified, the most common were the Hot Flash-Related Daily Interference Scale, the Expanded Prostate Index Composite-26, and hot flash daily diaries. No PRO instrument was specifically validated to assess the effect of ADT-induced VMS on QoL in PCa. VMS severity (including subjective burden) was significantly associated with QoL, whereas VMS frequency was not. However, no consensus exists on VMS severity definitions. VMS negatively affected sexual functioning, interpersonal relationships, and/or work productivity, and the associated anxiety, fatigue, insomnia, and poor sleep quality were found to impair QoL. VMS additionally appeared to mediate ADT's impact on sleep disturbance. ADT-induced VMS rates ranged from 1.4% to 68.9%, with higher frequencies reported within 3-6 months of ADT initiation and when adverse events were actively monitored or participants asked to report/record VMS events (30.7%-68.9%). Lower frequencies were seen when VMS were spontaneously captured or in retrospective analyses without active VMS monitoring/reporting (1.4%-15.8%) and with enzalutamide, apalutamide, and abiraterone as add-on therapy to ADT (13.9%-15.8%).
VMS severity in men with PCa is more consistently associated with QoL impact versus VMS frequency. A need for PRO instruments specific to treatment-related VMS in PCa and a lack of consensus on definitions of severity for ADT-induced VMS in PCa were identified.
PMID:
42724429
Bibliographic data and abstract were imported from PubMed on 11 Sep 2026.
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