Botanicals such as soy and black cohosh are promoted to reduce treatment-related hot flashes in cancer patients. However, evidence suggests that they are not effective. Randomized, placebo-controlled trials show no benefit for black cohosh118 or soy119,120 in reducing the frequency of hot flashes in breast cancer patients. Vitamin E decreases hot flashes only minimally,121 but its low cost and lack of toxicity have led at least some authorities to recommend its use.122
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