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.
Because cannabinoid receptors, unlike opioid receptors, are not located in the brainstem areas controlling respiration, lethal overdoses from Cannabis and cannabinoids do not occur.[1,2,3,4] However, cannabinoid receptors are present in other tissues throughout the body, not just in the central nervous system, and adverse effects include tachycardia, hypotension, conjunctival injection, bronchodilation, muscle relaxation, and decreased gastrointestinal motility.
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.