Would you use fezolinetant for hot flashes for men on ADT?

Topics: Radiation Oncology • Genitourinary Cancers • Medical Oncology

Many options for vasomotor symptoms of menopause do not work well for men on ADT. However, fezolinetant is a neurokinin B blocker, so theoretically, should be effective in this population?

Answer from: Radiation Oncologist at Academic Institution

I might consider it after trying the usual agents that will at least partially relieve symptoms in the majority of patients, such as low-dose megestrol or venlafaxine (there are others, but these are the ones with which I have had the most experience and success). Fezolinetant is expensive and requ...

Comments

Radiation Oncologist at Community Health Network
I have used oxybutynin with good success. It also ...

Radiation Oncologist at Weatherby Health Care
What dose of oxybutynin and frequency of dosing?

Medical Oncologist at Clinical Instructor
Dr. @James G. Pelton, we also have an extensive Q&...

Answer from: Radiation Oncologist at Community Practice

Presently, I would not use Fezolinetant. First I try Effexor. It can be helpful. But in my experience, this works in a minority of men's bothersome hot flashes.The next step, which is much more effective is low-dose estrogen patches. This has been studied in randomized clinical trials - Russell et a...

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Radiation Oncologist at Ashland Radiation Oncology, Inc.
I agree, particularly since the discounted price f...

Answer from: Radiation Oncologist at Community Practice

Start with medroxyprogesterone 20 mg daily. “Medroxyprogesterone could be considered to be the standard treatment for hot flushes in men undergoing androgen suppression for prostate cancer.”Reference: Irani et al., PMID 19963436

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