Flushing. Long-term side effect of orchiectomy in treatment of prostatic carcinoma.

Orchiectomy is considered a safe and simple procedure, free from serious side effects, in the treatment of prostatic carcinoma. We have found that 76 percent of patients experienced postorchiectomy flushes, and 30 percent believed their symptoms warranted treatment. The flushing started at between one and twelve months (average 2.7 months) postoperatively and lasted an average of thirty months or, in some cases, up to the time of death (average 33 months). No single precipitating factor was found, and no single hormone seemed to be responsible. Special attention was given to the nonflushers to see whether or not it was of prognostic significance, and it appears that the slight elevation in the testosterone level sufficient to prevent flushing may indicate a nontesticular source of androgen. Medroxyprogesterone acetate (Provera), 5 mg twice daily, appeared to be an effective agent for controlling the flushes.