I took Xtandi for 26 months. Excellent drug. Had fatigue, hot flashes and edema of extremities. Side effects are expected. Remember that your testosterone levels need to be at castration range (less than 50) to help control the cancer and that is what is likely causing your hot flushes. Fatigue is a common side effect of Xtandi. Expect a major drop in your PSA with this treatment. Wish you the best. Stay strong.