A 70-year-old man with prostate cancer on androgen deprivation therapy (GnRH agonist plus anti-androgen) presents with hot flashes. The hot flashes are primarily caused by which mechanism?
- A Altered hypothalamic thermoregulatory set point due to androgen deprivation ✓
- B Estrogen deficiency from aromatase inhibition
- C Histamine release as a side effect of the anti-androgen medication
- D Autonomic neuropathy from paraneoplastic involvement
Correct answer: A. Altered hypothalamic thermoregulatory set point due to androgen deprivation
Explanation
Hot flashes in men on androgen deprivation therapy for prostate cancer result from androgen deprivation altering the hypothalamic thermoregulatory center (narrowing of the thermoneutral zone). This is analogous to hot flashes in menopausal women caused by estrogen deficiency. It is not due to histamine release, paraneoplastic neuropathy, or aromatase inhibition. Management options include venlafaxine, gabapentin, or megestrol acetate. This is a well-recognized quality-of-life issue in prostate cancer treatment.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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