Key notes on symptom control issues in Palliative Care



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tarix25.12.2016
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Sweating




Step one

Diagnose the cause and treat if possible

Fans, open windows and cotton sheets

Step two

NSAIDs

Paracetamol if pyrexial

Step three

Ask for help




Sweating can be viewed as severe when a patient needs to change clothing and/or bed linen on a regular basis. In some cancer patients it is a paraneoplastic syndrome, although it is also associated with pyrexia, exercise, a high ambient temperature and/or emotion.

  • Practical measures such as using fans, opening windows and using cotton bed linen and clothes may help.

  • If there is a fever, paracetamol 1g orally or rectally every 6 hours may help. Consider using an antibiotic if there is infection.

  • NSAIDs can help with sweating which is persistent and due to a paraneoplastic syndrome. Their impact on the sweating will take at least two weeks and up to one month.

  • If the sweating is secondary to hormone manipulation as in breast or prostate cancer, consider trying megesterol acetate 20-40mg daily or clonidine 50 micrograms twice daily increasing to 100microgrammes twice daily after two weeks. Both these interventions will take at least two weeks and up to a month to reduce the sweating.



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