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 “The goal of any therapy is to help patients feel better, and we
don’t want them to needlessly suffer and think there are no
treatments available,” said Dr. Arjun Gupta of the University of
Texas Southwestern Medical Center in Dallas, the author of a
one-page patient-information sheet available for free online in JAMA
Oncology.
Hot flashes are unpleasant episodes of heat that start in the upper
body and spread, causing sweating and anxiety. They can occur
infrequently, daily or several times a day. At night, they can cause
sleep disturbances.
“It’s important to let your physician know so we can talk about it
and what’s really causing these troubling symptoms,” Gupta said in a
phone interview. “They affect quality of life, and we want to help
patients if this is really bothering them.”
Some cancers, particularly some types of breast and prostate cancer,
depend on sex hormones for growth. Whereas in menopause, the goal of
hormone therapy is to boost hormone levels, the goal of hormone
therapy for cancer is to reduce hormone levels. And when levels
drop, hot flashes can result.
For cancer patients, hot flashes could be related to the cancer
itself, infection, hormone therapy or other medications such as
steroids, so it’s important to report them to a doctor, Gupta
writes. His recommendations are drawn from the American Society of
Clinical Oncology’s patient information resource, Cancer.net.
Management of hot flashes includes both prevention and treatment.
Nonmedication-based techniques are usually tried first.
Gupta recommends documenting the number, intensity and duration of
hot flashes, which can help identify triggers to avoid. Taking a hot
bath or eating spicy food may spark a hot flash, for example.
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He also recommends lifestyle changes such as avoiding excessive
caffeine and alcohol, and quitting smoking. A cool environment
during the day and while sleeping, with cotton clothing and sheets
and cool showers, can help. Relaxation activities such as yoga,
meditation and breathing exercises may help as well.
Dr. Charles Loprinzi of the Mayo Clinic in Rochester, Minnesota, who
has researched cancer symptoms for more than 25 years, told Reuters
Health by phone, “One patient told me that in the winter, she’d get
in her car, put on her seat belt and then put her coat on backwards
so she could easily pull the coat off if she had a hot flash while
driving.”
In gold-standard trials, Loprinzi’s team has found that for both men
and women, hot flashes can be managed with low doses of certain
antidepressants, such as venlafaxine, citalopram, clonidine,
gabapentin and oxybutynin.
“In our studies, we’ve found that the treatment of hot flashes in
women who have breast cancer is largely unrelated to the fact that
they have breast cancer,” Loprinzi told Reuters Health by phone.
“The nonhormonal treatments seem to have the same efficacy for
everyone.”
Rarely, hot flashes related to cancer treatment may require a change
in the dose or discontinuation of hormone therapy, Gupta said.
Alternative therapies like herbal products, soy and acupuncture
haven’t been extensively studied for treating hot flashes in cancer
patients. Patients who are interested in these options should talk
to their doctor, Gupta advises.
SOURCE: http://bit.ly/2ADluJp JAMA Oncology, online December 28,
2017.
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