Can immunotherapy cause hot flashes?

Short answer: Hot flashes are more commonly linked to hormone therapies (like tamoxifen or aromatase inhibitors), chemotherapy, radiation, or surgeries affecting hormones, rather than immunotherapy itself. ^[1] Hot flashes and night sweats can occur during or after cancer treatment, especially when treatments trigger menopause-like changes or involve hormonal pathways. ^{[2] [3]}

What we know about hot flashes in cancer care

• Common causes: Hormone treatments for breast or prostate cancer, chemotherapy, radiation, and surgeries that alter hormone levels (e.g., ovary removal) frequently lead to hot flashes and night sweats. ^[3] These symptoms are also common during natural menopause and may persist after treatment. ^[4]
• Medicines associated with hot flashes: Tamoxifen and aromatase inhibitors are well-known triggers; opioids and certain antidepressants (tricyclics) can also contribute. ^[1]
• Immunotherapy context: Immunotherapy side effects are typically immune‑related (inflammation of organs, endocrine changes like thyroid/hypophysis/adrenal disorders), and while hot flashes are not a classic hallmark, endocrine dysfunction from immunotherapy could theoretically alter temperature perception or sweating. ^[5] General guidance emphasizes monitoring and managing diverse immunotherapy side effects promptly. ^{[6] [7]}

Could your hot flashes be related to immunotherapy?

It’s possible but less likely directly; hot flashes are rarely listed as a primary immunotherapy side effect compared with hormone treatments. ^[1] If you’re receiving immunotherapy and develop new sweating, heat intolerance, fatigue, weight changes, or feeling unusually cold, clinicians often evaluate for thyroid or other endocrine issues caused by immune checkpoint inhibitors. ^[5] Immunotherapy programs highlight close monitoring and tailored management for side effects, including endocrine problems. ^{[6] [7]}

Practical ways to cope with hot flashes

• Track triggers: Keep a diary of episodes (time, foods, stress, room temperature) to identify patterns that you can modify. Hot flashes can persist after treatment in some people, so tracking helps target solutions. ^[2]
• Lifestyle adjustments:
  • Dress in breathable layers and use cooling bedding; keep a fan nearby. ^[2]
  • Limit hot drinks, spicy foods, alcohol, and caffeine if they seem to trigger episodes. ^[2]
  • Practice paced breathing or mindfulness to lower sympathetic arousal during a flash. ^[2]
• Nonhormonal medications: For treatment‑related hot flashes, clinicians commonly use nonhormonal options such as certain antidepressants (e.g., SSRIs/SNRIs), gabapentin, or clonidine; these are standard approaches when hormone therapy is not appropriate. ^[2]
• Address underlying causes: If you are on tamoxifen or aromatase inhibitors, discuss dose timing changes or alternative agents with your oncology team; these medicines are recognized causes of hot flashes. ^[1] If you are on opioids or tricyclic antidepressants, review necessity and dose, as they may worsen symptoms. ^[1]
• Evaluate endocrine function during immunotherapy: If hot flashes coincide with fatigue, mood changes, weight shifts, hair loss, constipation, or feeling cold, ask your team about thyroid and pituitary/adrenal testing, since immunotherapy can affect these glands and requires prompt management. ^[5] Immunotherapy care teams are trained to manage such side effects and may adjust treatment or add steroids if immune‑related issues arise. ^{[6] [7]}

When to contact your care team

• Urgent symptoms: Night sweats with fever, weight loss, or persistent severe fatigue warrant prompt evaluation to rule out infection, endocrine problems, or disease‑related causes. Care teams encourage early reporting and will guide testing and treatment. ^{[6] [7]}
• Persistent or disruptive hot flashes: Even if not dangerous, frequent episodes affecting sleep and quality of life should be discussed effective treatments and coping strategies are available. ^{[2] [4]}

Key takeaways

• Hot flashes are common with hormone therapies and some other cancer treatments, and may continue after treatment. ^{[2] [4] [3] [1]}
• Immunotherapy does not typically cause hot flashes directly, but it can affect endocrine glands, which may indirectly influence temperature regulation and sweating. ^{[5] [6] [7]}
• Practical coping strategies and nonhormonal medications can help reduce symptoms, and your oncology team can tailor management to your specific treatment plan. ^{[2] [1] [6] [7]}