Hot flashes last post-prostate cancer treatment

» I’m a 76-yearold man who was treated for prostate cancer starting in summer 2017. Following radiation therapy, I was given Lupron injections every six months for two years. It’s been two years since my last injection, but I still experience hot flashes. Will these hot flashes stay with me for the rest of my life?

— D.T.

DEAR READER » Leuprolide (Lupron) is a medicine that prevents the body from making testosterone. Back in 1941, depleting testosterone was proven to slow prostate cancer growth, but even in the first group of subjects, there were men with severe hot flashes. The sudden drop in testosterone causes “vasomotor instability,” meaning that the blood vessels in the skin suddenly dilate, causing an intense heat sensation. The whole body can cool down with this, leading sufferers to feel cold afterward.

Given the symptoms seem quite bothersome, ask your urologist or oncologist about treatment. Just as with menopausal women who have hot flashes, there are treatments that can reduce, though perhaps not eliminate, the number of hot flashes you get per day.

DEAR DR. ROACH » I just got my COVID-19 vaccination with the Moderna

vaccine. I will have a booster in 28 days. Am I protected from the “new strain”? Or will I need yet another vaccination?

— J.P.

DEAR READER » At the time of this writing, most experts agree that both the Pfizer and Moderna vaccines provide a high degree of protection against the currently predominant strains. There is less protection against the South African variant.

Some variants, such as the UK B.1.1.7, seem to be more likely to transmit from person to person compared with those that have previously been circulating, and may even be more likely to cause serious disease or death.

It is possible that future mutations in the virus could lead to a large enough structural change in the spike protein that the vaccine will be significantly less effective.

The best way to prevent this is to get control over the pandemic as fast as possible. The more people that are infected with COVID-19, the more chances the virus has of developing a resistant variant. If that happens, a new vaccine would be needed, although vaccine development would be much easier due to the amount of work already done.

It is not clear whether yearly boosters will be required. Immunity might wear off, or new variants may continue to emerge. This is speculative until we have more information.