Hormone treatments are treatments using natural body chemicals called hormones, or drugs that block hormones. Hormones are chemicals made in one part of the body, that travel in the bloodstream to make something happen in another part of the body. Some cancer cells need hormones to grow, or are encouraged to grow more quickly by hormones. These cancers are said to be 'hormone sensitive' or 'hormone dependent'.
They include : -
Breast cancer
Prostate cancer
Uterine (womb) cancer
Ovarian cancer
Hormone treatments are also sometimes used for kidney cancer, thyroid cancer or melanoma.
What hormone therapy is ?
What hormones are : -
Hormones are natural substances made by glands in our bodies. The network of glands that make hormones is called the endocrine system. Hormones are carried in our bloodstream and act as messengers between one part of our body and another. They control the growth and activity of certain cells and organs.
What hormone therapy is : -
Hormone treatments use the sex hormones produced by our bodies, or drugs that block them, to treat cancer. Not all cancers respond to hormone therapy. Doctors might use hormone therapy for people with cancers that are 'hormone sensitive' or 'hormone dependent'. This means that the cancer needs the hormone to grow.
Cancers that can be hormone sensitive are : -
Breast cancer
Prostate cancer
Womb cancer (uterine)
How hormone therapy works : -
Cancers that are hormone sensitive or hormone dependent need hormones to grow. So stopping the hormone reaching the cancer cells may either slow down or stop the growth of the cancer.
Hormone therapies can work by either
Stopping hormones being made
Preventing the hormone reaching the cancer cell
Types of hormone therapy : -
There are a number of different types of hormone therapy. Which one you have depends on a number of factors, including your type of cancer.
There is information below on
Breast cancer hormone therapy
Prostate cancer hormone therapy
Womb cancer hormone therapy
Breast cancer hormone therapy
The female hormones oestrogen and progesterone affect some breast cancers. Doctors say these cancers are either oestrogen receptor positive or progesterone receptor positive, or both. Hormone treatment for breast cancer works by stopping these hormones getting to the breast cancer cells.
There are different types of hormone therapies that doctors use to treat breast cancer
Tamoxifen
Aromatase inhibitors
Pituitary down regulators
Tamoxifen
Tamoxifen is one of the most common hormone therapies used for breast cancer. Both pre and postmenopausal women can take tamoxifen. It works by stopping the hormone oestrogen from reaching cancer cells.
Aromatase inhibitors
These are a relatively new type of hormone therapy. You can only take them if you have been through the menopause. After menopause, your ovaries stop producing oestrogen. But your body still makes a small amount by changing other hormones (called androgens) into oestrogen. You need an enzyme called aromatase to make this change happen. Aromatase inhibitors block this enzyme so it can't convert androgen into oestrogen.
There are a few different types of aromatase inhibitor, including : -
Anastrozole (Arimidex®)
Exemestane (Aromasin®)
Letrozole (Femara®)
Pituitary down regulators
A gland in the brain, called the pituitary gland, controls the amount of sex hormones made by the ovaries. Pituitary down regulators are drugs that prevent the ovaries making oestrogen or progesterone. They do this by blocking the signal from the pituitary gland to the ovaries.
You will only have this treatment if you haven't yet had your menopause. After menopause, your ovaries don't produce hormones so this type of drug won't help. Pituitary down regulators include goserelin for breast cancer (Zoladex) and leuprorelin.
Prostate cancer hormone therapy
Prostate cancer depends on the male hormone testosterone for its growth. Hormone therapy aims to reduce or stop the body making testosterone and slow down or stop the growth of the cancer.
There are different types of hormone therapy
Pituitary down regulators
Anti-androgens
Pituitary down regulators : -
A gland in the brain, called the pituitary gland, controls the amount of testosterone made by the testicles. Pituitary down regulators are drugs that prevent the testicles making testosterone. They do this by blocking the signal from the pituitary gland to the testicles.
Pituitary down regulators include : -
Goserelin for prostate cancer (Zoladex)
Leuprorelin (Prostap)
Triptorelin (Decapetyl)
Anti-androgens : -
Prostate cancer cells have receptors on them that take up testosterone. Anti-androgen drugs work by attaching themselves to these receptors. This stops the testosterone reaching the prostate cancer cell.
There are a few different types including : -
Bicalutamide (Casodex)
Cyproterone acetate (Cyprostat)
Flutamide (Drogenil)
Womb cancer hormone therapy
The female hormones oestrogen and progesterone affect the growth and activity of the cells that line the womb. Doctors give the hormone progesterone to help shrink larger womb cancers, or to treat womb cancers that have come back. There are different types of progesterone treatment, including medroxyprogesterone acetate (Provera) or megestrol (Megace).
General side effects of hormone therapy
We all react differently to treatment and you won't necessarily have all the side effects that we have listed below.
Side effects of hormone therapy for women
The side effects you might get depend on the type of hormone therapy you are on. Remember the side effects we have listed are general. You can find more information about side effects of specific hormone therapies in this section of CancerHelp UK.
General side effects include : -
Tiredness
Stomach upset and other effects on your digestion
Menopausal symptoms
Effects on your muscles and bones
Other effects
Tiredness or fatigue
You may feel more tired when you are taking hormone therapy. For more information about coping with fatigue see the section on cancer fatigue.
Digestive system
Hormonal therapies can affect your digestive system in different ways
You may feel sick. This is usually mild and settles down after a few days to weeks. Your doctor can prescribe anti-sickness tablets, which should help
You might have constipation or diarrhoea - this is usually mild and easily controlled with diet or drugs
You may lose your appetite a bit, or have an increased appetite - this might lead to weight changes
There is more information about coping with sickness, bowel problems and eating problems in the symptoms and side effects section of CancerHelp UK.
Menopausal symptoms
If you haven't already been through your menopause, it may start when you begin hormone therapy. This could be either temporary or permanent. If you are taking a pituitary down regulator, your periods will stop. If you are taking tamoxifen, and are still having periods, they may stop or become lighter. You might also get other menopause symptoms, even if you've already been through it, for example hot flushes and sweating, decreased interest in sex and vaginal dryness. There is information about dealing with sweating in our symptoms and side effects section.
Muscle and bone changes
You may develop pains in your joints. This often settles down after a few weeks. You can take a mild painkiller to help control any pain you have.
Some hormonal therapy can cause thinning of your bones. Weight bearing exercise can help to protect your bones, such as walking, running, cycling or exercise in the gym. But check with your doctor before starting any new form of exercise, especially if you have not exercised for a while.
Tamoxifen doesn't cause bone thinning and can have some protective effect on your bones.
Other general side effects
Other side effects women may have when on hormone treatments include hair thinning, headaches and mood changes.
General side effects of hormone therapy for men
The side effects you might have will depend on the type of hormone therapy you are taking. Remember the side effects we have listed are general side effects. You can find information about side effects of specific hormone therapies in this section of CancerHelp UK.
> Problems getting an erection
> Hot flushes and sweating
> Breast tenderness
> Pain from tumour flare
> Weight gain
> Memory problems
> Bone thinning
> You may feel more tired when you are taking hormonal therapy.
Individual hormone therapies
Anastrozole (Arimidex)
Bicalutamide (Casodex)
Exemestane (Aromasin)
Flutamide (Drogenil)
Goserelin (Zoladex) for breast cancer
Goserelin (Zoladex) for prostate cancer
Letrozole (Femara)
Tamoxifen (Novaldex)
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