You finish breast cancer treatment expecting life to settle down again. Then one day, you're sitting at work or trying to sleep when a sudden wave of heat takes over. Your face turns red, you're sweating within seconds, and just as quickly as it starts, it's gone.
This may happen often if you are on hormone therapy after breast cancer. Tamoxifen and aromatase inhibitors may have many side effects, including hot flashes. They are not toxic, but can cause irritation and interfere with your sleep, energy, and life. Hot flashes are not an issue anymore as three years ago, and there are more options for women these days.
Why do hot flashes happen
Hormone therapy helps to lower or stop estrogen, which decreases the risk of breast cancer returning. While that's an important part of treatment, estrogen also helps your brain regulate body temperature.
As the level of estrogen decreases, the body temperature may be confused with overheating. That results in a hot flash. Suddenly you may feel hot, sweat, hear your heart racing, or feel cold afterward. Some women go through hot flashes several times a day or at night; others, several times a week.
They can be managed now
Until recently, treatment choices were fairly limited. Doctors may suggest lifestyle changes or prescribe drugs that are normally prescribed for depression or nerve pain.
Now, there is a new alternative with newer non-hormonal drugs. One of these is fezolinetant, a substance that acts on the signals in the brain that regulate body temperature, rather than replacing estrogen. Initial research indicates that it may be beneficial for many women in reducing the frequency of hot flashes and enhancing sleep.
Another medicine, elinzanetant, is also showing promising results in clinical trials. Researchers are continuing to study how well it works for women receiving hormone therapy for breast cancer. These medicines aren't suitable for everyone, so it's important to speak with your oncologist before considering them.
Small changes
Medication isn't always the first step. Many women notice that a few everyday habits help make hot flashes more manageable.
You can try:
Keeping your bedroom cool at night.
Wearing lightweight, breathable clothing.
Using a fan when needed.
Limiting caffeine, alcohol, or spicy foods if they seem to trigger symptoms.
Staying physically active.
Practising relaxation techniques such as deep breathing.
If hot flashes are affecting your sleep or making daily life difficult, your doctor may also recommend non-hormonal medicines such as gabapentin or certain antidepressants that have been shown to reduce symptoms in some women.
You don't have to just live with it
Some women do not report hot flashes on subsequent visits since they believe they are a side effect of treatment. But no need to suffer in silence. There are more options, like making a few changes to your lifestyle or seeking newer treatment options. Discuss your hot flashes with your doctor if they are disturbing your sleep schedule, work, and life.