Cancer Treatment-Related Hot Flashes in Women With Breast Cancer and Men With Prostate Cance
Recommendations
Pharmacologic recommendations for women with breast cancer
For women with breast cancer who are experiencing drug- or surgery-induced hot flashes, the ONS Guidelines panel suggests using venlafaxine, paroxetine, or clonidine rather than no treatment for the management of symptoms or
- The panel suggests using sertraline, fluoxetine, escitalopram, or duloxetine rather than no treatment for the management of symptoms.a
Among these pharmaceuticals, the panel suggests using venlafaxine, paroxetine, or clonidine rather than sertraline, fluoxetine, escitalopram, or duloxetine for the management of symptoms.a
( Conditional , Very low)Among venlafaxine, paroxetine, or clonidine, the panel suggests using venlafaxine or paroxetine rather than clonidine for the management of symptoms.a
( Conditional , Low)Remarks: Patients who have not responded to treatment with venlafaxine or paroxetine may wish to try clonidine to manage hot flash symptoms. Patients who have not responded to venlafaxine, paroxetine, or clonidine may wish to try these antidepressants: sertraline, fluoxetine, escitalopram, or duloxetine.a
a Paroxetine and fluoxetine are strong CYP2D6 inhibitors and may significantly interfere with tamoxifen metabolism and, therefore, are contraindicated in women taking tamoxifen.
Pharmacologic recommendations for men with prostate cancer
For men with prostate cancer who are experiencing drug- or surgery-induced hot flashes, the panel suggests paroxetine or clonidine rather than no treatment for the management of symptoms or
- The panel suggests sertraline, fluoxetine, escitalopram, or duloxetine rather than no treatment for the management of symptoms.
(Low/Very low)
Among these pharmaceuticals, the panel suggests paroxetine or clonidine rather than sertraline, fluoxetine, escitalopram, or duloxetine for the management of symptoms.
( Conditional , Very low)Remarks: Patients who have not responded to treatment with paroxetine or clonidine may wish to try the following antidepressants: sertraline, fluoxetine, escitalopram, or duloxetine.
For men with cancer who are experiencing drug- or surgery-induced hot flashes, the panel recommends venlafaxine for the management of symptoms only in the context of a clinical trial.
(No recommendation; knowledge gap, )Pharmacologic recommendations for women with breast or men with prostate cancer
For patients with cancer who are experiencing drug- or surgery-induced hot flashes, the panel suggests against gabapentin or pregabalin (gabapentinoids) for the management of symptoms.
( Conditional , Very low)Nonpharmacologic recommendations for women with breast or men with prostate cancer
For patients with cancer who are experiencing drug- or surgery-induced hot flashes, the panel suggests against herbal or dietary supplements (soy, black cohosh, St. John’s wort, melatonin, vitamin E) for the management of symptoms.
( Conditional , Very low)Among patients with cancer experiencing drug- or surgery-induced hot flashes, the panel recommends hypnosis or relaxation therapy only in the context of a clinical trial.
(No recommendation; knowledge gap, )Among patients with cancer experiencing drug- or surgery-induced hot flashes, the panel recommends cognitive behavioral therapy only in the context of a clinical trial.
(No recommendation; knowledge gap, )Recommendation Grading
Overview
Title
Cancer Treatment-Related Hot Flashes in Women With Breast Cancer and Men With Prostate Cancer
Authoring Organization
Oncology Nursing Society
Publication Month/Year
July 1, 2020
Last Updated Month/Year
February 6, 2024
Supplemental Implementation Tools
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adult, Older adult
Health Care Settings
Ambulatory, Hospital
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Treatment
Diseases/Conditions (MeSH)
D019584 - Hot Flashes
Keywords
breast cancer, prostate cancer, Hot flashes/drug therapy
Source Citation
Kaplan, M., Ginex, P., Michaud, L., Fernández-Ortega, P., Grimmer, D., Leibelt, J., Mahon, S., Rapoport, B., Robinson, V., Maloney, C., Moriarty, K., Vrabel, M., & Morgan, R. (2020). ONS GuidelinesTM for Cancer Treatment–Related Hot Flashes in Women With Breast Cancer and Men With Prostate Cancer. Oncology Nursing Forum, 47(4), 374–399. https://doi.org/10.1188/20.onf.374-399