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JAMA Oncology Patient Page
April 2018

Hormone Therapy–Related Hot Flashes and Their Management

JAMA Oncol. 2018;4(4):595. doi:10.1001/jamaoncol.2017.4439

Hormone therapy for cancer may be associated with hot flashes in some patients.

What Is Hormone Therapy?

Certain cancers, such as some subtypes of breast and prostate cancer, are dependent on sex hormones for growth. Reducing the level and activity of sex hormones is one strategy used to treat them. This is achieved through surgical removal of the ovaries or testes, or more commonly through the administration of certain drugs. By depriving cancers of sex hormones, these drugs act as antihormones, but this treatment is nonetheless called hormone therapy.

This hormone therapy is different from the more commonly prescribed hormone therapy used to treat symptoms of menopause.

What Are Hot Flashes?

These are uncomfortable episodes of a sudden sensation of heat originating in the upper part of the body and spreading throughout. They typically last a few minutes and can be accompanied and followed by sweating and anxiety. They may occur infrequently or several times a day, and even during sleep leading to sleep disturbances. These are similar to the hot flashes experienced by women undergoing menopause.

What If Hot Flashes Occur?

Let your physician know if you experience hot flashes. In some cases, the cancer itself, infection, or other medications can cause sweating, which might be confused with hot flashes. Management of hot flashes includes both prevention and treatment; nonmedication-based techniques can be tried first.

Maintain a Symptom Diary

Document the number, intensity, and duration of hot flashes. This may help identify triggers or patterns. If you identify triggers, such as taking a hot bath or eating spicy food, avoid them.

Lifestyle Changes

Avoid excessive caffeine, smoking, and alcohol use. Maintain a relatively cool environment (cotton clothing and sheets, taking cool showers, using a fan or air conditioner). Perform activities such as yoga, meditation, or breathing exercises to relax.

Are There Medications to Treat Hot Flashes?

If these techniques are unsuccessful, your doctor may prescribe medications. Unlike hot flashes associated with menopause, hormone therapy–related hot flashes are typically not treated with added hormones (estrogen and/or progesterone), since that may make the cancer grow. Nonhormonal medications used to treat hormone therapy–related hot flashes include antidepressant medications, such as venlafaxine or citalopram; and clonidine, gabapentin, or oxybutynin.

Men with prostate cancer can sometimes be treated with additional drugs, such as megestrol acetate. These drugs may have adverse effects of their own and can have significant interactions with hormone therapy. Rarely, refractory hot flashes may require a change in the dose or discontinuation of hormone therapy.

Are There Alternative Therapies Available?

Safety and effectiveness information is lacking for herbal products, soy, and acupuncture. Speak to your doctor about them if you are interested.

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Section Editor: Howard (Jack) West, MD.
The JAMA Oncology Patient Page is a public service of JAMA Oncology. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA Oncology suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call (312) 464-0776.
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Article Information

Published Online: December 28, 2017. doi:10.1001/jamaoncol.2017.4439

Conflict of Interest Disclosures: None reported.

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