What exactly causes my hot flashes. - Advanced Prostate...

Advanced Prostate Cancer

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What exactly causes my hot flashes.

dixiedad profile image
38 Replies

I know WHY they happen, ADT.

I'd like to know what is going on in my body to cause them.

Also, as long as you PSA is 'unmeasurable', does that, in itself,

mean that your cancer has NOT metastasized?

Or are there other tests that I should be doing?


dixiedad and ROLL TIDE!

38 Replies
GP24 profile image

Wikipedia writes: "The exact cause and pathogenesis, or causes, of vasomotor symptoms (VMS)—the clinical name for hot flashes—has not yet been fully studied.[11][12]"

If the PSA is undetectable it can also mean that ADT has stopped the mets growing further.

As long as your PSA is undetecteable I would observe and not try to find metastases.

dixiedad profile image
dixiedad in reply to GP24

Thank you

Tall_Allen profile image

It's the thermoregulation mechanism in your brain. It seems to be highly estrogen dependent.

PSa is a pretty good guide, but it isn't 100%.

mintlatte profile image
mintlatte in reply to Tall_Allen

Welp I will credit you when I tell my husband that….hubby and I are suffering together 😀 and often asked ourselves why - now I can answer him. 😂

dixiedad profile image
dixiedad in reply to Tall_Allen

Many thanks. I had the same feeling about PSA. It seems to be good enough for my uro.

I was diagnosed 10/12/20; Gleason was 4/4. last ADT (Trelstar) was on 12/12/21.

HikerWife profile image
HikerWife in reply to dixiedad

If only your uro is treating you, I would urge you to get a consult with a medical oncologist, especially one specializing in prostate cancer. The are the knowledgeable quarterbacks.

addicted2cycling profile image
addicted2cycling in reply to Tall_Allen

Tall_Allen wrote -- "It's the thermoregulation mechanism in your brain .... "

DANG, I guess my Orchiectomy back in 2015 has caused another part of my 72yo brain to stop functioning. NO hot flashes, NO sweats, NO irritability in addition to the NO *T* 😅

dixiedad profile image
dixiedad in reply to addicted2cycling

I've thought about that, tooo. Kinda hate to be cut though.

maley2711 profile image
maley2711 in reply to dixiedad

IMO an ochiectomy does not eliminate the possibility of hot flashes. Some men are luckier than others evidently.

dixiedad profile image
dixiedad in reply to maley2711

Yeah, I'm OK with the status quo.

Tall_Allen profile image
Tall_Allen in reply to addicted2cycling

One's brain adapts over time. Hot flashes usually become less frequent.

CAMPSOUPS profile image
CAMPSOUPS in reply to Tall_Allen

Any consensus that short anxiety like attacks can occur immediately preceding hot flashes. I have this since starting Xtandi a couple months ago.

Tall_Allen profile image
Tall_Allen in reply to CAMPSOUPS

I never heard that before. I wonder if that's something Mindfulness can help with?

runtrails profile image
runtrails in reply to CAMPSOUPS

I always get a naseau roller coaster ride type thing. I never could explain it. But the anxiety statement might. Stronger that feeling, stronger my hot flash. Change in blood pressure? Because my veins on hand and feet pop out a bunch at that time. Get 15 to 20 plus a day..

CAMPSOUPS profile image
CAMPSOUPS in reply to runtrails

Yea I get that " I can't breathe " feeling and mental anguish and yep the stronger that is the more intense the hot flash.

ARIES29 profile image

Hot Flushes obviously caused by lack of T in body due to ADT, I never had them before & are a dam nuisance, also rash on legs if I forget to take hay fever treatment.

Thankful for ongoing life however🙂

EdBar profile image

it’s my understanding that in men some testosterone gets converted to estrogen so when testosterone is virtually eliminated from ADT the lack of estrogen causes hot flashes just like it does in women.


dixiedad profile image
dixiedad in reply to EdBar

Oh, yeah...permanent menopause.

Benkaymel profile image
Benkaymel in reply to EdBar

Yes, I believe you're right. Some use low dose oestrogen patches to alleviate but that can increase gyno problems.

EdBar profile image
EdBar in reply to Benkaymel

Yep I’ve been using them for years now, my man boobs probably not much worse than other guys my age. Couldn’t deal with the intense hot flashes that I used to get.


runtrails profile image
runtrails in reply to EdBar

Is that a prescription from your primary or RO/MO? I would be willing to try

EdBar profile image
EdBar in reply to runtrails

originally prescribed by Snuffy Myers and my local MO as well as Dr. Sartor are fine with it. Sartor replaced Snuffy as my PCa specialist. Both feel it is good for bone health as well as hot flashes. The patches don’t pose a cardiovascular risk since they are absorbed through the skin and not the liver. Snuffy has some vids on YouTube that you can watch regarding estradiol patches.


EdinBmore profile image

Whatever the cause, they are annoying, irritating, embarrassing, tiring, and not very much fun. If there's any plus, it's that one knows that the ADT is working. Ugh.


dixiedad profile image
dixiedad in reply to EdinBmore

I seem to have more at night, not so much during the day except during workouts.

Weights & stationary recumbent bike.

runtrails profile image
runtrails in reply to dixiedad


Seebs9 profile image
Seebs9 in reply to EdinBmore

...but Dr's call it bothersome, get with it my Brother!

“as long as you PSA is 'unmeasurable', does that, in itself, mean that your cancer has NOT metastasized?”First, everything I know about this process was shared by a Research Professor of Genitourinary Diseases who treated me from 2004 until several years ago when he passed away. He researched and taught at three different medical schools during his career. 

The short answer to your question is, no. ADT will kill only about 80% of existing bone metastatic lesions. I have no idea about metastatic lesions in soft tissue.

In addition there are several concepts that enter into the equation. First there is micro-metastasis. Second, there is cancer cellular dormancy. It is very complicated and frankly over the heads of many physicians; especially those who are not well-read and on top of their game. Almost all rely on current standards of practices as the best chance of success for their patients. 

Always the Professor, he explained a lot of what was going on with my cancer spread and spinal metastasis. Two and half hours on the first consultation; then weekly for two years, followed by quarterly thereafter. Always at least thirty minutes including comparisons of whole body nuclear bone scans as he marked the active metastatic lesions killed and replacement with new bone growth. For example, as a clinical trial volunteer, I had 22 nuclear bone and soft tissue CT scans from 2004 to 2010. Then one in 2016 and again in 2022. 

I remember the day he came in and stated that it mattered not which primary treatment I had for PCa, it was too late. I most likely had micro-metastasis prior to my original DX in early 2003. I learned a new term that day - that in 2004 was foreign to many physicians. I remember the day that he drew a cell on the board and explained how total systemic treatment with Lupron/Eligard enabled cellular suicide whereby the walls of a cancer cell (the weakest point) collapses effectively killing an individual cell. 

Dormancy is another term. Sometimes, even after twenty years dormant cancer cells awaken and start to grow. Why, is unknown. However, that suspected process is being explored by my current Professor of Genitourinary Diseases.

I am sorry that I wrote so much for a not so simple question. I have posted many times in this forum since I joined in 2016 after ten years in an Advance Prostate Cancer Usenet group. Please forgive what some say is antidotal. What I do know that after 20 years with this bastard disease, 19 of which was metastatic, I have been most fortunate. 

I wish you the best in killing the little bastards....

Gourd Dancer

dixiedad profile image
dixiedad in reply to

Many thanks

London441 profile image

That’s good. There is no data for this but I believe fitness, strength and good body composition tends to minimize hot flashes as it does all the other ADT side effects.

As usual I was dedicated to both cardiovascular and strength training throughout and only occasionally had what I called ‘warm moments’. Maybe I was just lucky but I doubt it.

Of course there’s a kaleidoscope of reasons to exercise anyway, its importance greatly magnified by ADT.

carbide profile image
carbide in reply to London441

I was so sick I have no desire or ability to exercise. I do try to keep active.

London441 profile image
London441 in reply to carbide

Not sure what you’re saying. You didn’t exercise but do now, or the other way around?

carbide profile image
carbide in reply to London441

No formal exercise. Do walk and stay busy around the house. Thx.

j-o-h-n profile image

When I was a teen my hot flashes were from good looking girls with hot asses.....

No longer in my horny teens, they're now from my sorley genes.....

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 03/24/2023 11:55 AM DST

Scout4answers profile image

Timely... I woke up with soaking wet shirt last two nights, 16 months into Lupron.

I have noticed that I am cold most of the time, could be more than Chicago winters😎

dixiedad profile image
dixiedad in reply to Scout4answers

Thankfully I never have sweats.

carbide profile image
carbide in reply to dixiedad

U R Lucky. 😁

FortyWinks profile image

Really fed up with my hot flashes. Soaking clothing/bedding, irritability, then cold. Would be better in a hot climate I think. I have mets and PSA undetectable. Scans show no new spread. Can’t have scans constantly but quarterly bloods give me reassurance.

runtrails profile image

Headed to Playa del Carmen in a few weeks. Probably be a week long "man"opause hot flash, but hours of snorkeling will distract me

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