Onkologie. 2026:20(4):213-218 | DOI: 10.36290/xon.2026.038

Treatment-induced hot flushes in breast and prostate cancer: a review of pathophysiology and management options

Tomáš Büchler, Eva Strecková, Michaela Klimeš Lipánová

Onkologická klinika, 2. LF UK a Fakultní nemocnice Motol a Homolka, Praha

Hot flashes and night sweats are common and clinically significant adverse effects of adjuvant endocrine therapy for breast cancer and androgen deprivation therapy for prostate cancer. They affect the majority of patients treated with tamoxifen or aromatase inhibitors and up to 80 % of men receiving androgen-deprivation therapy (ADT), substantially impairing sleep, mood, cognitive and sexual function, and overall quality of life. Severe vasomotor symptoms are an important cause of non-adherence or premature discontinuation of endocrine therapy, which may adversely affect oncologic outcomes. Because hormone replacement therapy is generally contraindicated in hormone-dependent malignancies, management relies on non-pharmacological approaches and non-hormonal pharmacotherapy. In breast cancer, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) with particular attention to safety in patients receiving tamoxifen and avoidance of strong CYP2D6 inhibitors, and gabapentin are most commonly used. Treatment selection is guided by the adverse-effect profile, potential drug interactions, and the pattern of symptoms (daytime vs. nocturnal). A major innovation is represented by neurokinin receptor antagonists (NK3 and dual NK1/3 antagonists). In men receiving ADT, hormonal interventions (progestins or estradiol) are the most effective, but their use is limited by safety concerns; non-hormonal options (SSRIs/SNRIs, gabapentin, oxybutynin) represent safer alternatives with generally moderate efficacy. Overall, effective management of vasomotor symptoms is crucial not only for quality of life but also for maintaining adherence to oncologic therapy.

Keywords: vasomotor symptoms, breast cancer, androgen deprivation therapy, endocrine therapy, NK3 receptor antagonist.

Accepted: September 21, 2026; Published: October 9, 2026  Show citation