Hormone Therapy

Hormone Therapy

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1. What is Hormone Therapy?

Hormonal therapy is effective only on hormone-receptor-positive breast cancers. These medicines are able to treat the cancers with the help of a two way approach. The first is by reducing the levels of estrogen hormone in the body and secondly by interfering with or blocking of estrogen action on the cancer cells.

Ovaries in women’s body are responsible producing most of the estrogen. This estrogen helps in growth stimulation of cancer in hormone-receptor-positive breast cancers. Thus interfering the amount of estrogen available in the body can result in recurrence risk reduction of the early-stage hormone-receptor-positive breast cancers post surgery. Hormonal therapy medicines are also effective in advanced-stage or metastatic hormone-receptor-positive breast cancers by aiding in their shrinking or slow growth of cancerous tissue.

It is obvious that hormonal therapy medicines do not work against hormone-receptor-negative breast cancers.

As a preventive course for hormone-receptor-positive breast cancer in some cases, there may be surgical removal of ovaries and fallopian tubes especially for high risk women, also in certain cases a temporary shutdown of the ovaries may be done using medication.

It is essential that patient understands that there is a difference between hormonal therapy and hormone replacement therapy (HRT).

Hormone Replacement Therapy

HRT is used in treatment of menopausal side effects which are quite troublesome. Side effects like swings in moods and hot flashes. Post menopause, there is a reduction in estrogen levels of the body, HRT raises these levels. Thus therapy is a combination of estrogen and can contain progesterone and other hormones. It should be notes that it is actually the opposite of hormone therapy and is not used to treat breast cancer.

2. When is hormone therapy prescribed?

Breast cancer is different in different women. For some patients exit from hospital is the end of breast treatment but for some it continues in the form of hormone therapy. Women discharged from home have been known to be on hormone therapy for breast cancer for as long as five years.

This therapy is only advised if on testing the breast cancer is known to be hormone receptor positive. Such cancerous cells have on its surface receptors which positively react to female hormone estrogen, stimulating cell growth. In hormone therapy this positive stimulation is prevented. This hormone therapy is applicable on various breast cancer conditions and situations like post surgery, or administration of hormone therapy post radiotherapy or chemotherapy and such. Post any other treatment it is primarily aimed at reduction of recurrence risk and is then termed as adjunct therapy. Prior to any surgical intervention it is aimed at shrinking of cancerous cells or reducing the size of the growth, also to control cancer growth in other parts of the body.

  • Hormones used in a therapy are different from one patient to another as factors like age; menopause and side effects of the therapy are specific to individual cases.
  • Hormone therapy does not work on breast cancers which are not hormone receptor sensitive or estrogen receptor negative.
  • Hormonal therapy has the “Carry – Over” effect, which basically means that for a number of years (upto5) the effects of this therapy will remain even its course is complete. Thus the benefits will last longer than the actual stop of medication intake.
  • Hormonal therapy , drug tamoxifen has shown to slowing of the bone loss process and even reduction in osteoporosis risk in post menopausal women.
  • Hormonal therapy usually has a course of 2 – 5 years with the doctors discretion for an extension if necessary.

3. Is Hormonal Therapy Right for You?

  • Hormonal therapy is right in following conditions:
    • Utilization in reducing the recurrence risk of early stage, hormone-receptor-positive post surgery
    • Treatment of advanced-stage/metastatic hormone-receptor-positive breast cancer
    • Can be utilized on both pre- and postmenopausal women and men
  • This hormonal therapy is not effective on hormone-receptor-negative cancers.
  • Hormone therapy is useful in women whom cancer has not been detected but is at high risk of developing a hormone-receptor-positive breast cancer.
  • This therapy can be administered in combination with or before or after any other breast cancer treatments.
  • Every medication in hormonal therapy is subject to every patient’s medical condition and cancer type.
  • Pregnant women are advised against taking hormonal therapy as it is unsafe during pregnancy.
  • Hormonal therapy medication is aimed at hormone-receptor-positive breast cancer, thus in addition to taking a hormonal therapy medicine, it is suggested that such premenopausal women consider ovarian shutdown (possible with medication) or alternatively get the ovaries surgically removed. Before menopause as estrogen is primarily produced by the ovaries, estrogen production is ceased with ovarian shutdown or removal.
  • The various factors which help in prescribing the hormonal therapy for a patient are specific to patients. These factors include the menopausal status, breast cancer stage, medical history( if any) of blood clots, the bone density, arthritis history (if any) and individual risk of uterine and ovarian cancer.
  • Depending upon the type stage and other pathology of the breast cancer one hormonal medication may suit the patient better than some other combination of hormonal medication.
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