Hot Flashes and Prostate Cancer: How Common, Why They Happen, and What Helps

Hot flashes are very common in men receiving hormone therapy (androgen deprivation therapy) for prostate cancer, and less commonly linked to the cancer itself. ^[1] When prostate cancer is treated with hormone therapy, hot flashes often occur due to lowered testosterone and changes in the body's temperature control. ^{[2] [3]}

---

How Common Are Hot Flashes?

• During prostate cancer hormone therapy, hot flashes are among the most frequent side effects reported. ^[2]
• For example, men taking anti‑androgen medicines with LHRH (GnRH) therapy experienced hot flashes in over half of cases in clinical trials. ^[4]
• Outside of hormone therapy, hot flashes are less typical, but cancer treatments and certain medicines can still trigger them. ^[3]

---

Why Hot Flashes Happen

• Lowering testosterone shifts your brain’s thermostat (the hypothalamus), making it over‑react to small temperature changes and triggering a flush to cool the body. ^[3]
• Hormone therapy for prostate cancer is designed to shrink or slow the cancer by suppressing androgens, and this suppression drives vasomotor symptoms like hot flashes. ^{[1] [2]}
• Other contributors can include medicines, thyroid problems, or side effects of broader cancer treatments. ^[3]

---

What They Feel Like

• Sudden warmth, sweating, flushing of the face or torso, sometimes with palpitations or anxiety, and often night sweats that disturb sleep. ^[3]
• Symptoms may start soon after beginning hormone therapy and can persist for months, sometimes continuing after treatment ends. ^[5]

---

Evidence‑Based Management Options

Lifestyle and Non‑Drug Strategies

• Keep cool: dress in layers, use fans, lower room temperature, and choose breathable fabrics. ^[6]
• Limit triggers: consider reducing spicy foods, caffeine, alcohol, and stress where possible. ^[6]
• Stress reduction: relaxation breathing, mindfulness, or similar techniques can help some people. ^[7]
• Acupuncture may help some, though results are mixed; discuss with your clinician if interested. ^[8]

Non‑Hormonal Medicines

• SSRIs/SNRIs (examples: paroxetine, venlafaxine) can reduce frequency and severity of hot flashes. ^[7]
• Gabapentin or pregabalin can be effective, especially for night sweats and sleep disruption. ^{[7] [9]}
• Clonidine (a blood pressure medicine) is another option when others aren’t suitable. ^{[7] [9]}
• Oxybutynin, often used for overactive bladder, has shown benefit for hot flashes. ^[7]

Hormonal Approaches (Selected Cases)

• Progestins (such as medroxyprogesterone) or similar agents can help severe, persistent hot flashes, but are generally reserved for those informed of risks and when non‑hormonal options are insufficient. [PM9]

---

Practical Tips for Daily Life

• Bedtime routine: keep the bedroom cool, use light bedding, and consider cooling pillows or gel packs to reduce night sweats. ^[8]
• Hydration and pacing activities: drink water and schedule exertion when it’s cooler to lower episodes. ^[6]
• Track symptoms: journaling triggers and timing helps tailor interventions and guide discussions with your care team. ^[6]

---

When to Call Your Clinician

• If hot flashes are severe, disrupt sleep, or come with weight loss, fever, palpitations, or other new symptoms, it’s reasonable to be evaluated to rule out other causes (such as thyroid issues or medication effects). ^[3]
• Your oncology team can adjust prostate cancer treatment plans and offer targeted therapies to reduce side effects while keeping cancer control on track. ^[2]

---

Key Takeaways

• Hot flashes are common with androgen‑lowering treatments for prostate cancer and stem from changes in the body’s temperature regulation due to reduced testosterone. ^{[1] [2] [3]}
• Many effective, non‑hormonal options exist SSRIs/SNRIs, gabapentin, clonidine, and oxybutynin along with practical cooling and stress‑reduction strategies. ^{[7] [9]}
• Work with your clinician to personalize management, balancing symptom relief with ongoing cancer care. ^[2]