martes, 30 de julio de 2019

Hot Flashes and Night Sweats - National Cancer Institute

Hot Flashes and Night Sweats - National Cancer Institute

National Cancer Institute



Hot Flashes and Night Sweats (PDQ®)–Patient Version

Overview

KEY POINTS

  • Hot flashes and night sweats may be side effects of cancer or its treatment.
  • Hot flashes and night sweats affect quality of life in many patients with cancer.

Hot flashes and night sweats may be side effects of cancer or its treatment.

Sweating is the body's way of lowering body temperature by causing heat loss through the skin. In patients with cancer, sweating may be caused by fever, a tumor, or cancer treatment.
Hot flashes can also cause too much sweating. They may occur in natural menopause or in patients who have been treated for breast cancer or prostate cancer.
Hot flashes combined with sweats that happen while sleeping are often called night sweatsor hot flushes.

Hot flashes and night sweats affect quality of life in many patients with cancer.

A treatment plan to help manage hot flashes and night sweats is based on the patient's condition and goals of care. For some patients, relieving symptoms and improving quality of life is the most important goal.
This summary describes the causes and treatment of hot flashes and night sweats in cancer patients.

Causes of Hot Flashes and Night Sweats in Patients with Cancer

KEY POINTS

  • In patients with cancer, hot flashes and night sweats may be caused by the tumor, its treatment, or other conditions.
  • Many patients treated for breast cancer and prostate cancer have hot flashes.
  • Certain types of drugs can cause night sweats.

In patients with cancer, hot flashes and night sweats may be caused by the tumor, its treatment, or other conditions.

Sweating happens with disease conditions such as fever and may occur without disease in warm climates, during exercise, and during hot flashes in menopause. Sweating helps balance body temperature by allowing heat to evaporate through the skin.
Hot flashes and night sweats are common in patients with cancer and in cancer survivors. They are more common in women but can also occur in men.

Many patients treated for breast cancer and prostate cancer have hot flashes.

Menopause in women can have natural, surgical, or chemical causes. Chemical menopause in women with cancer is caused by certain types of chemotherapyradiation, or hormone therapy with androgen (a male hormone).
"Male menopause" in men with cancer can be caused by orchiectomy (surgery to remove one or both testicles) or hormone therapy with gonadotropin-releasing hormone or estrogen.
Treatment for breast cancer and prostate cancer can cause menopause or menopause-like effects, including severe hot flashes.

Certain types of drugs can cause night sweats.

Drugs that may cause night sweats include the following:

Drug Treatment for Hot Flashes and Night Sweats in Patients with Cancer

KEY POINTS

  • Sweats are controlled by treating their cause.
  • Hot flashes may be controlled with estrogen replacement therapy.
  • Other drugs may be useful in some patients.

Sweats are controlled by treating their cause.

Sweats caused by fever are controlled by treating the cause of the fever. Sweats caused by a tumor are usually controlled by treatment of the tumor.

Hot flashes may be controlled with estrogen replacement therapy.

Hot flashes during natural or treatment-related menopause can be controlled with estrogen replacement therapy. However, many women are not able to take estrogenreplacement (for example, women who have or had breast cancer). Hormone replacement therapy that combines estrogen with progestin may increase the risk of breast cancer or breast cancer recurrence.
Treatment of hot flashes in men who have been treated for prostate cancer may include estrogens, progestin, antidepressants, and anticonvulsants. Certain hormones (such as estrogen) can make some cancers grow.

Other drugs may be useful in some patients.

Studies of non-estrogen drugs to treat hot flashes in women with a history of breast cancer have reported that many of them do not work as well as estrogen replacement or haveside effectsMegestrol (a drug like progesterone), certain antidepressants, anticonvulsants, and clonidine (a drug used to treat high blood pressure) are non-estrogen drugs used to control hot flashes. Some antidepressants may change how other drugs, such as tamoxifen, work in the body. Side effects of drug therapy may include the following:
  • Antidepressants used to treat hot flashes over a short period of time may cause nausea, drowsiness, dry mouth, and changes in appetite.
  • Anticonvulsants used to treat hot flashes may cause drowsiness, dizziness, and trouble concentrating.
  • Clonidine may cause dry mouth, drowsiness, constipation, and insomnia.
Patients may respond in different ways to drug therapy. It is important that the patient's health care providers know about all medicinesdietary supplements, and herbs the patient is taking.
Drugs that may relieve nighttime hot flashes or night sweats and improve sleep at the same time are being studied in clinical trials.
If one medicine does not improve symptoms, switching to another medicine may help.

Non-Drug Treatment for Hot Flashes and Night Sweats in Patients with Cancer

KEY POINTS

  • Treatments that help patients cope with stress and anxiety may help manage hot flashes.
  • Hypnosis may help relieve hot flashes.
  • Comfort measures may help relieve night sweats related to cancer.
  • Herbs and dietary supplements should be used with caution.
  • Acupuncture has been studied in the treatment of hot flashes.

Treatments that help patients cope with stress and anxiety may help manage hot flashes.

Treatments that change how patients deal with stressanxiety, and negative emotions may help manage hot flashes. These are called psychological interventions. Psychological interventions help patients gain a sense of control and develop coping skills to manage symptoms. Staying calm and managing stress may lower levels of a hormone called serotonin that can trigger hot flashes.
Psychological interventions may help hot flashes and related problems when used together with drug treatment.

Hypnosis may help relieve hot flashes.

Hypnosis is a trance-like state that allows a person to be more aware, focused, and open to suggestion. Under hypnosis, the person can concentrate more clearly on a specific thought, feeling, or sensation without becoming distracted.
Hypnosis is a newer treatment for hot flashes that has been shown to be helpful. In hypnosis, a therapist helps the patient to deeply relax and focus on cooling thoughts. This may lower stress levels, balance body temperature, and calm the heart rate and breathing rate.

Comfort measures may help relieve night sweats related to cancer.

Comfort measures may be used to treat night sweats related to cancer. Since body temperature goes up before a hot flash, doing the following may control body temperature and help control symptoms:
  • Wear loose-fitting clothes made of cotton.
  • Use fans and open windows to keep air moving.
  • Practice relaxation training and slow, deep breathing.

Herbs and dietary supplements should be used with caution.

Studies of vitamin E for the relief of hot flashes show that it is only slightly better than a placebo (pill that has no effect). Most studies of soy and black cohosh show they are no better than a placebo in reducing hot flashes. Soy contains estrogen-like substances; the effect of soy on the risk of breast cancer growth or recurrence is not clear. Studies of ground flaxseed to treat hot flashes have shown mixed results.
Claims are made about several other plant-based and natural products as remedies for hot flashes. These include dong quaimilk thistlered cloverlicorice root extract, and chaste tree berry. Since little is known about how these products work or whether they affect the risk of breast cancer, women should be cautious about using them.

Acupuncture has been studied in the treatment of hot flashes.

Pilot studies of acupuncture and randomized clinical trials that compare true acupuncture and sham (inactive) treatment have been done in patients with hot flashes and results are mixed. A review of many studies combined showed that acupuncture had slight or no effects in breast cancer patients with hot flashes. (See the Vasomotor symptoms section in the PDQ health professional summary on Acupuncture for more information.)

Current Clinical Trials

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

About This PDQ Summary

About PDQ

Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.
PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

Purpose of This Summary

This PDQ cancer information summary has current information about the causes and treatment of hot flashes and night sweats. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Reviewers and Updates

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.
The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Supportive and Palliative Care Editorial Board.

Clinical Trial Information

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).

Permission to Use This Summary

PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
The best way to cite this PDQ summary is:
PDQ® Supportive and Palliative Care Editorial Board. PDQ Hot Flashes and Night Sweats. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/about-cancer/treatment/side-effects/hot-flashes-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389162]
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Disclaimer

The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.

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