Night sweats can be a side effect of cancer treatment or a symptom of certain cancers. Night sweats are part of a variety of symptoms referred to as vasomotor. Vasomotor symptoms stem from the body's thermoregulatory center, which is affected by circulating hormones.
Women may undergo oophorectomy (the surgical removal of one or both ovaries), either for ovarian cancer or when accompanied by hysterectomy for endometrial cancer or uterine sarcoma, as part of their cancer treatment. Pelvic radiation may also damage the ovaries. Removal or permanent damage to the ovaries results in
immediate menopause. Many women with ovarian cancer have already gone through menopause, as a function of their age. However, when ovarian or reproductive tract cancer strikes a pre-menopausal woman, the immediate, versus gradual, loss of circulating hormones is dramatic, and is a concern in the immediate post-operative period. In an American Cancer Society News Today of January 29, 2001 the ACS reported on a study that found women undergoing systemic treatment for breast cancer, especially those on tamoxifen, reported a higher frequency and intensity of menopausal symptoms such as night sweats, hot flashes, and fatigue. Men may also experience vasomotor symptoms with metastatic adenocarcinoma of the prostate, or following removal of the prostate for prostate cancer.
Vasomotor symptoms such as night sweats add to the existing stress for individuals undergoing cancer treatment, as they can reduce the quality of sleep, make daily life very uncomfortable, and decrease the quality of life.
Night sweats can be a sign of infection in the immuno-compromised cancer patient, as well as being a symptom of undiagnosed cancer and early AIDS. Drenching night sweats may be a sign of Hodgkin's or non-Hodgkin's lymphoma, both in children as well as in adults. Night sweats may also be present with liver hemangiomatumors. Generalized symptoms such as night sweats, fever, chills and sweating are sometimes referred to as B symptoms. Night sweats have also been associated with malignant melanoma and with metastatic compression of the optic nerve. Children who are ultimately diagnosed with a malignancy may present to a rheumatologist with a variety of symptoms, including night sweats. Night sweats in the absence of explained fever or perimenopause should be brought to the attention of one's health care provider for evaluation.
Causes
The ovary produces the hormone estrogen. When the ovary is removed, there is a dramatic termination of circulating estrogen, with symptoms such as night sweats, hot flashes, and vaginal dryness. Estrogen replacement therapy (ERT) can relieve these symptoms. However, the use of ERT is controversial with some cancers, because of the association with estrogen-receptor positive cancers. Women who are approaching menopause at the time of chemotherapy may lose ovarian function as a result of treatment, thus undergoing significant menopausal symptoms. The use of tamoxifen in postmenopausal women has been associated with an increase in vasomotor symptoms.
Hodgkin's and non-Hodgkin's lymphomas are cancers of the lymphatic system. Symptoms include night
sweats, painless swelling in the lymph nodes, especially in the neck, underarm or groin, unexplained weight loss, recurrent fevers, and itchy skin. The night sweats in Hodgkin's disease appears to be related to an instability in the thermoregulatory center of the hypothalamus. Risk factors for Hodgkin's and non-Hodgkin's lymphomas include reduced immune function, transplant surgery, occupational exposure to herbicides and other toxic chemicals, Sjögren's syndrome, and Epstein-Barr virus.
Treatments
Some research has been conducted using estrogenandrogen replacement therapy. The concerns about ERT and estrogen-sensitive cancers remains the same. The androgen component assists in the healing process, as well as in a sense of well-being, sexual desire and arousal, and increased energy level. The use of androgens can result in hirsutism (growth of male-pattern hair), which may be dose-dependent.
Successful diagnosis of the cause of the night sweats can lead to proper treatment for the condition. Successful treatment of Hodgkin's or non-Hodgkin's lymphoma resolves the night sweats.
Alternative and complementary therapies
Acupuncture has been effective for both men and women. Individuals considering herbal remedies or supplements for reproductive-related night sweats associated with cancer treatment should seek the counsel of a
knowledgeable practitioner. Substances that function through mimicking estrogenic properties could have an adverse effect in estrogen-sensitive tumors.
Resources
BOOKS
Dollinger, Malin, Ernest H. Rosenbaum, and Greg Cable. Everyone's Guide to Cancer Therapy, Rev. 3rd ed. Kansas City, MO: Somerville House Books Limited, 1997.
National Cancer Institute. Building 31, Room 10A31, 31 Center Drive, MSC 2580, Bethesda, MD 20892-2580. 301-435-3848. <http://www.nci.nih.gov>.
National Center for Complementary and Alternative Medicine. NCCAM Clearinghouse, P.O. Box 8218, Silver Spring, MD 20907-8218. (888) 644-6226. <http://nccam.nih.gov.>
Natural Health Village. 18 July 2001 <http://www.naturalhealthvillage.com>.
Esther Csapo Rastegari, R.N., B.S.N., Ed.M.
Hirsutism
—The development of male-pattern hair growth as a result of the use of male hormones.
Lymphatic system
—The lymphatic system is a complex network of vessels, ducts, nodes, and organs that produce, filter, and carry lymph throughout the body. It is part of the body's immune system.
—The time period prior to menopause that may last 10 to 15 years, even beginning in one's 30s. It is associated with decreased ovarian function and decreasing estrogen levels.
Vasomotor symptoms
—Vasomotor symptoms include night sweats, hot flashes, and sweating.
