Is there a correlation between gastric cancer and nocturnal diaphoresis (night sweats)?

From the Guidelines

Night sweats can be a symptom of gastric cancer, and if experienced alongside other concerning symptoms, prompt medical evaluation is necessary to rule out this condition. According to the British Sarcoma Group clinical practice guidelines 1, night sweats are listed among non-specific systemic symptoms that some patients with gastrointestinal stromal tumors (GISTs) may experience, which can also be applicable to gastric cancer. These symptoms, including weight loss and fever, are not specific to gastric cancer but warrant investigation, especially in individuals with risk factors such as family history, H. pylori infection, or certain dietary patterns.

Key points to consider in the evaluation of night sweats in the context of potential gastric cancer include:

• The presence of other alarming symptoms like unexplained weight loss, persistent abdominal pain, difficulty swallowing, feeling full quickly, nausea, vomiting (especially with blood), or black tarry stools.
• The importance of early detection, which significantly improves treatment outcomes for gastric cancer.
• The role of diagnostic tools such as endoscopy with biopsy, imaging studies, and blood tests in confirming the presence of gastric cancer.
• The consideration of paraneoplastic syndromes or the body's immune response to the cancer as potential causes of night sweats in gastric cancer patients.

Given the potential severity of gastric cancer and the importance of early intervention, it is crucial for individuals experiencing night sweats along with other concerning symptoms to seek medical attention promptly. The guidelines 1 emphasize the importance of obtaining a pre-operative diagnosis for suspected GISTs, which can also apply to the diagnostic approach for gastric cancer, highlighting the need for a thorough evaluation when symptoms suggestive of gastric cancer are present.

From the Research

Gastric Cancer and Night Sweats

• Gastric cancer is a disease with different management approaches in different regions, especially between Western and Asian countries 2.
• The main treatment for early gastric cancer is endoscopic resection, while non-early operable gastric cancer is treated with surgery, which should include D2 lymphadenectomy 3.
• Advanced gastric cancer is treated with sequential lines of chemotherapy, starting with a platinum and fluoropyrimidine doublet in the first line; median survival is less than 1 year 3.
• Night sweats are a symptom linked to menopause, malignancies, autoimmune diseases, and infections, but in primary care settings, night sweats are commonly reported by persons without these conditions 4.
• The prevalence of night sweats ranges from 10% among older primary care patients to 60% among women on an obstetrics inpatient unit 4.
• There is no direct evidence linking gastric cancer to night sweats, but night sweats can be a symptom of various conditions, including malignancies 4.
• Trastuzumab, a recombinant humanized anti-HER-2 monoclonal antibody, is a treatment option for patients with HER2-positive advanced gastric cancer 2, 5.
• Chemotherapy remains the mainstay of treatment for advanced gastric cancer, with combination chemotherapy extending overall survival slightly compared to single-agent chemotherapy 6.

Treatment Options for Gastric Cancer

• Trastuzumab in combination with chemotherapy is a treatment option for patients with HER2-positive advanced gastric cancer 2, 5.
• Chemotherapy improves survival in comparison to best supportive care, and combination chemotherapy improves survival compared to single-agent chemotherapy 6.
• Irinotecan-containing combinations and docetaxel-containing combinations show significant survival benefits in the comparisons studied 6.
• Oxaliplatin-containing regimens demonstrated a benefit in overall survival as compared to the same regimen containing cisplatin 6.
• S-1 regimens improve overall survival slightly compared to 5-FU-containing regimens, but the applicability of this finding to individual populations is uncertain 6.

Night Sweats in Gastric Cancer Patients

• There is no direct evidence linking gastric cancer to night sweats, but night sweats can be a symptom of various conditions, including malignancies 4.
• The symptom, night sweats, appears to be nonspecific, and many questions about causation, evaluation, and management remain unanswered 4.
• Alpha adrenergic blockers may reduce night sweats in patients taking serotonin reuptake inhibitors, and thalidomide and thioridazine may benefit some terminal cancer patients with night sweats 4.