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Fever, Sweats, and Hot Flashes (PDQ®)

Patient Version
Last Modified: 02/24/2012

Treatment of Sweats and Hot Flashes in Patients with Cancer

Key Points for This Section


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 1 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:

  • 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 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:

  • Wear loose-fitting clothes made of cotton.

  • Use fans and open windows to keep air moving.

  • Practice relaxation training and slow, deep breathing.

  • Learn and practice self-hypnosis.

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 2 section in the PDQ summary on Acupuncture for more information.)



Glossary Terms

acupuncture (AK-yoo-PUNK-cher)
The technique of inserting thin needles through the skin at specific points on the body to control pain and other symptoms. It is a type of complementary and alternative medicine.
anticonvulsant (AN-tee-kun-VUL-sunt)
A drug or other substance used to prevent or stop seizures or convulsions. Also called antiepileptic.
antidepressant (AN-tee-dee-PREH-sunt)
A drug used to treat depression.
appetite (A-peh-tite)
A desire to satisfy a physical or mental need, such as for food, sex, or adventure.
black cohosh (blak KOH-osh)
An eastern North American perennial herb. A substance obtained from the root of the plant has been used in some cultures to treat a number of medical problems. It is being studied in the treatment of hot flashes and other symptoms of menopause. The scientific name is Cimicifuga racemosa. Also called black snakeroot, bugbane, bugwort, and rattlesnake root.
breast cancer (brest KAN-ser)
Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
chaste tree berry (chayst ... BAYR-ee)
An extract made from the fruit of the chaste tree (Vitex agnus-castus) found in parts of Asia and Europe. It is claimed to treat infertility and to lessen symptoms that may occur before or during a woman’s menstrual period, such as headaches and irregular bleeding. Chaste tree berry may affect levels of reproductive hormones in the blood. It is a type of phytomedicine. Also called monk’s pepper and Vitex.
clinical trial (KLIH-nih-kul TRY-ul)
A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.
clonidine (KLOH-nih-deen)
The active ingredient in a drug used to treat high blood pressure. It is also being studied in the treatment of certain types of cancer pain. It blocks the release of chemicals from nerve endings that make blood vessels constrict (get narrower). Clonidine is a type of antihypertensive agent and a type of alpha-adrenergic agonist.
constipation (KON-stih-PAY-shun)
A condition in which stool becomes hard, dry, and difficult to pass, and bowel movements don’t happen very often. Other symptoms may include painful bowel movements, and feeling bloated, uncomfortable, and sluggish.
dietary supplement (DY-uh-TAYR-ee SUH-pleh-ment)
A product that is added to the diet. A dietary supplement is taken by mouth, and usually contains one or more dietary ingredient (such as vitamin, mineral, herb, amino acid, and enzyme). Also called nutritional supplement.
dong quai (dong kwye)
An herb native to China. A substance taken from the roots has been used in traditional Chinese medicine to treat menstrual and menopausal problems. Dong quai may increase the effect of the drug warfarin (a blood-thinner). The scientific name is Angelica sinensis.
drug (drug)
Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.
drug therapy (… THAYR-uh-pee)
Treatment with any substance, other than food, that is used to prevent, diagnose, treat, or relieve symptoms of a disease or abnormal condition.
estrogen (ES-truh-jin)
A type of hormone made by the body that helps develop and maintain female sex characteristics and the growth of long bones. Estrogens can also be made in the laboratory. They may be used as a type of birth control and to treat symptoms of menopause, menstrual disorders, osteoporosis, and other conditions.
estrogen replacement therapy (ES-truh-jin reh-PLAYS-ment THAYR-uh-pee)
Hormones given to postmenopausal women or to women who have had their ovaries surgically removed. Hormones are given to replace the estrogen no longer produced by the ovaries. Also called ERT.
fever (FEE-ver)
An increase in body temperature above normal (98.6 degrees F), usually caused by disease.
flaxseed (FLAX-seed)
The seed of the flax plant. It is a rich source of omega-3 fatty acid, fiber, and a compound called lignin. It is being studied in the prevention of several types of cancer. Also called linseed.
healthcare provider (HELTH-kayr proh-VY-der)
A licensed person or organization that provides healthcare services.
herbal (ER-bul)
Having to do with plants.
high blood pressure (hy blud PREH-sher)
A blood pressure of 140/90 or higher. High blood pressure usually has no symptoms. It can harm the arteries and cause an increase in the risk of stroke, heart attack, kidney failure, and blindness. Also called hypertension.
hormone (HOR-mone)
One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.
hormone replacement therapy (HOR-mone reh-PLAYS-ment THAYR-uh-pee)
Hormones (estrogen, progesterone, or both) given to women after menopause to replace the hormones no longer produced by the ovaries. Also called HRT and menopausal hormone therapy.
hot flash (hot flash)
A sudden, temporary onset of body warmth, flushing, and sweating (often associated with menopause).
hypnosis (hip-NOH-sis)
A trance-like state in which a person becomes more aware and focused and is more open to suggestion.
insomnia (in-SOM-nee-uh)
Difficulty in going to sleep or getting enough sleep.
licorice root extract (LIH-kuh-rish … EK-strakt)
A substance prepared from dried roots of the plant Glycyrrhiza glabra. It is used as a flavoring in medicines, drinks, and sweets, and it is being studied in the treatment of cancer. Licorice root extract contains several compounds that reduce inflammation, kill certain bacteria and viruses, act like estrogen and other hormones, and may cause cancer cells to die. It is a type of antioxidant.
medicine (MEH-dih-sin)
Refers to the practices and procedures used for the prevention, treatment, or relief of symptoms of a diseases or abnormal conditions. This term may also refer to a legal drug used for the same purpose.
megestrol (meh-JES-trol)
A drug used to block estrogen and suppress the effects of estrogen and androgens. It is used to treat breast and endometrial cancer, and is being studied in the treatment of other types of cancer. It is also used to improve appetite in patients with cancer. Megestrol belongs to the group of hormones called progestins. Also called Megace.
menopause (MEH-nuh-pawz)
The time of life when a woman’s ovaries stop producing hormones and menstrual periods stop. Natural menopause usually occurs around age 50. A woman is said to be in menopause when she hasn’t had a period for 12 months in a row. Symptoms of menopause include hot flashes, mood swings, night sweats, vaginal dryness, trouble concentrating, and infertility.
milk thistle (milk THIH-sul)
A plant that has been used in some cultures to treat certain medical problems, including stomach, liver, and gallbladder disorders. The active extract of milk thistle seeds is called silymarin. It is being studied in the prevention of liver damage caused by some cancer treatments. Also called Silybum marianum.
nausea (NAW-zee-uh)
A feeling of sickness or discomfort in the stomach that may come with an urge to vomit. Nausea is a side effect of some types of cancer therapy.
PDQ
PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.
placebo (pluh-SEE-boh)
An inactive substance or treatment that looks the same as, and is given the same way as, an active drug or treatment being tested. The effects of the active drug or treatment are compared to the effects of the placebo.
progesterone (proh-JES-teh-rone)
A type of hormone made by the body that plays a role in the menstrual cycle and pregnancy. Progesterone can also be made in the laboratory. It may be used as a type of birth control and to treat menstrual disorders, infertility, symptoms of menopause, and other conditions.
progestin (proh-JES-tin)
Any natural or laboratory-made substance that has some or all of the biologic effects of progesterone, a female hormone.
prostate cancer (PROS-tayt KAN-ser)
Cancer that forms in tissues of the prostate (a gland in the male reproductive system found below the bladder and in front of the rectum). Prostate cancer usually occurs in older men.
recurrence (ree-KER-ents)
Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrent cancer.
red clover (red KLOH-ver)
Trifolium pratense. A plant with flowers that has been used in some cultures to treat certain medical problems. It is being studied in the relief of menopausal symptoms and may have anticancer effects. Also called purple clover, Trifolium pratense, and wild clover.
relaxation technique (ree-lak-SAY-shun tek-NEEK)
A method used to help reduce muscle tension and stress, lower blood pressure, and control pain. Examples of relaxation techniques include tensing and relaxing muscles throughout the body, guided imagery (focusing the mind on positive images), meditation (focusing thoughts), and deep breathing exercises.
response (reh-SPONTS)
In medicine, an improvement related to treatment.
side effect (side eh-FEKT)
A problem that occurs when treatment affects healthy tissues or organs. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.
soy (soy)
A product from a plant of Asian origin that produces beans used in many food products. Soy contains isoflavones (estrogen-like substances) that are being studied for the prevention of cancer, hot flashes that occur with menopause, and osteoporosis (loss of bone density). Soy in the diet may lower cholesterol levels and reduce the risk of heart disease. Also called Glycine max, soya, and soybean.
symptom (SIMP-tum)
An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.
tamoxifen (tuh-MOK-sih-FEN)
A drug used to treat certain types of breast cancer in women and men. It is also used to prevent breast cancer in women who have had ductal carcinoma in situ (abnormal cells in the ducts of the breast) and in women who are at a high risk of developing breast cancer. Tamoxifen is also being studied in the treatment of other types of cancer. It blocks the effects of the hormone estrogen in the breast. Tamoxifen is a type of antiestrogen. Also called tamoxifen citrate.
tumor (TOO-mer)
An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.
vitamin E (VY-tuh-min ...)
A nutrient that the body needs in small amounts to stay healthy and work the way it should. It is fat-soluble (can dissolve in fats and oils) and is found in seeds, nuts, leafy green vegetables, and vegetable oils. Vitamin E boosts the immune system and helps keep blood clots from forming. It also helps prevent cell damage caused by free radicals (highly reactive chemicals). Vitamin E is being studied in the prevention and treatment of some types of cancer. It is a type of antioxidant. Also called alpha-tocopherol.

Table of Links

1http://www.cancer.gov/cancertopics/pdq/supportivecare/fever/Patient/Page3#Secti
on_16
2http://www.cancer.gov/cancertopics/pdq/cam/acupuncture/healthprofessional/Page5
#Section_153