Night Sweats: Are They Common in Cancer, Why They Happen, and How to Manage Them

Night sweats can occur with cancer, but they are not the most common cancer symptom overall; lymphoma is the cancer most often linked to night sweats, and night sweats are also frequent side effects of cancer treatments such as hormone therapy, chemotherapy, radiation, or surgeries that trigger menopause or lower sex hormones. ^[1] Night sweats can also happen in people without cancer due to many other conditions, so the context of other symptoms matters. ^[2]

How cancer is linked to night sweats

• Lymphoma association: Lymphoma is the cancer most commonly known to cause night sweats. ^[1]
• Treatment-related sweats: Hot flashes and night sweats are common during or after cancer treatments especially breast cancer (estrogen-blocking therapy) and prostate cancer (androgen deprivation). ^[3] These can also follow radiation, chemotherapy, hormone treatments, or surgeries that remove ovaries or testicles, because they abruptly change hormone levels. ^[1]
• Persistence after therapy: Some people continue to have night sweats even after finishing treatment. ^[4]

Common non-cancer causes

• Menopause and perimenopause: Hot flashes and night sweats are very common due to natural hormonal shifts. ^[3]
• Environmental/physiologic factors: A warm bedroom or heavy bedding can cause sweating that isn’t considered true “night sweats.” ^[2]
• Other medical causes: Night sweats are often linked with other symptoms like fever, weight loss, localized pain, cough, or diarrhea, suggesting infections, autoimmune disease, endocrine issues, or hematologic disorders. ^[5]

Red flags: When to seek care

• Regular, sleep-disrupting episodes or night sweats plus symptoms such as fever, unexplained weight loss, persistent pain, cough, or diarrhea should prompt a medical visit. ^{[6] [7]}
• New night sweats long after menopause warrant evaluation. ^[8]

Why night sweats happen (mechanisms)

• Cytokine and immune activity: Some cancers (like lymphomas) can raise inflammatory cytokines, disturbing body temperature regulation and causing sweating at night. [PM20]
• Hormone withdrawal: Cancer therapies that block estrogen or androgens trigger thermoregulatory instability, leading to hot flashes and night sweats. ^[3]
• Medication effects: Certain drugs used in oncology and supportive care can affect sweat and heat control. ^[9]

How night sweats are evaluated

• History and exam: Your clinician will review timing, severity (soaking clothes/bedding), triggers, and accompanying symptoms (fever, weight loss), and assess recent treatments. ^[10]
• Targeted tests: Based on findings, tests may include blood counts, inflammatory markers, infection workups, thyroid function, and imaging when indicated. ^[11]

Management strategies

Lifestyle and environment

• Keep the bedroom cool, use breathable bedding, and layer clothing to adjust quickly; these practical steps can reduce sweat burden and improve sleep. ^[12]
• Limit alcohol and spicy foods at night, and consider stress-reduction techniques, which may help stabilize hot flashes/night sweats. ^[12]

Treat underlying causes

• Address infections or endocrine issues if identified; fixing the root cause often improves night sweats. ^[11]
• Cancer-related sweats: If due to cancer activity, optimizing cancer treatment may help; if due to therapy, symptom-focused care is key. ^[9]

Symptom-specific options in cancer care

• Breast and prostate cancer therapies: Nonhormonal options (for example, certain antidepressants or gabapentin) are commonly used to ease hot flashes and night sweats and can improve sleep and quality of life. [PM23]
• Menopause-related sweats after cancer treatment: A variety of nonhormonal approaches are typically tried first in those for whom hormone therapy isn’t appropriate. ^[3]
• Complementary approaches: Limited evidence suggests some benefit from modalities like acupuncture for paraneoplastic night sweats in select cases, though data are not definitive. [PM19]
• Cannabinoid therapy (dronabinol): Small case series report improvement for refractory paraneoplastic night sweats, but larger studies are needed and clinician guidance is essential. [PM21]

Practical step-by-step plan

1. Confirm true night sweats: Are you soaking clothes or bedding despite a cool room and light covers? If yes, they are more likely clinically significant. ^[2]
2. Check for red flags: Note fever, weight loss, persistent pain, cough, diarrhea, or new night sweats long after menopause; if present, book a medical visit. ^{[6] [8]}
3. Review treatments: If you’re on or recently completed cancer therapy (especially hormone-blocking therapies), night sweats may be a side effect; ask about nonhormonal symptom treatments. ^{[3] [4]}
4. Optimize sleep environment: Cool room, breathable fabrics, avoid triggers, and use layered bedding for quick adjustments. Small changes can make a big difference. ^[12]
5. Discuss medications: If sweats are severe or persistent, clinicians may suggest evidence-based nonhormonal medicines to reduce hot flashes/night sweats. [PM23]
6. Consider supportive therapies: For difficult cases, complementary options may be explored under medical supervision. [PM19] [PM21]

Key takeaways

• Night sweats can be linked to cancer most notably lymphoma and to cancer treatments that change hormone levels. ^{[1] [3]}
• Many non-cancer causes exist, and the presence of other symptoms guides urgency and testing. ^[5]
• Management focuses on treating underlying causes and using practical lifestyle changes plus nonhormonal therapies to control symptoms. ^[12] [PM23]