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Fever, Sweats, and Hot Flashes

Treatment of Sweats and Hot Flashes in Patients with Cancer

Sweats are controlled by treating their cause.

Sweats caused by fever are controlled by treating the cause of the fever. (See the Treatments to Relieve Fever in Patients with Cancer section for more information.) 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 estrogen replacement (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, progesterone, antidepressants, and anticonvulsants. Certain hormones (such as estrogen) can make some cancers grow.

Other drug therapy 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 have side effects. Megestrol (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:

Patients may respond in different ways to drug therapy. It is important that the patient's health care providers know about all medicines, dietary 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.

Comfort measures may help relieve sweats related to cancer.

Comfort measures may be used to treat sweats related to cancer. Since body temperature goes up before a hot flash, doing the following may control body temperature and help control symptoms:

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. The use of ground flaxseed to treat hot flashes is being studied.

Claims are made about several other plant-based and natural products as remedies for hot flashes. These include dong quai, milk thistle, red clover, licorice 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 may be used to treat hot flashes.

Several studies have looked at the use of acupuncture to treat hot flashes. Results are not clear and more studies are needed. (See the Vasomotor symptoms section in the PDQ summary on Acupuncture for more information.)