Hot flushes associated with hormonal therapies for breast or prostate cancer
Hot flushes in patients with breast cancer or prostate cancer may be associated with hormonal antineoplastic drugs or hormone ablation treatment. Venlafaxine or gabapentin may be helpfulBordeleau, 2010; use:
1venlafaxine modified-release 37.5 mg orally, daily initially; increase to twice daily after 7 days, then as tolerated and according to response at 7-day intervals. Maximum daily dose 150 mg venlafaxine
OR
2gabapentin 100 to 300 mg orally, daily; increase as tolerated and according to response at 3-to 7-day intervals to twice daily, then 3 times daily, up to a maximum of 900 mg daily. For patients who are frail or older than 70 years, use the lower end of the dose range initially, and titrate more slowlyLoprinzi, 2009Porzio, 2006. gabapentin
Assess the effectiveness of drug therapy and consider stopping if no benefit is apparent after 1 to 2 weeks, or sooner if the patient experiences undesirable adverse effects.
It may be appropriate to stop the causative anticancer drug or trial hormone replacement therapyNational Cancer Institute (NIH), depending on the patient’s prognosis, preferences and their goals of care, balance of benefit and harm, and impact of sweating on quality of life. This should be discussed with the patient’s treating oncologist.