Hormone Therapies For Breast Cancer Treatment
Several treatment options are available for treating hormone-sensitive breast cancers. Some drugs block the effects of estrogen on the cancer cells in the breast, while others prevent estrogen production altogether.
Common hormone therapy drugs include Tamoxifen , Arimidex® , and Femara® , along with Faslodex® for recurrent breast cancer.
Breast cancer in males may also be treated with tamoxifen. Tamoxifen is currently being studied as hormone therapy for the treatment of other types of cancer.
How Is Fulvestrant Given
Fulvestrant is given by two injections, one in each buttock. These are known as intramuscular injections.
You may be asked to hold the fulvestrant to warm it up before you have the injections. This is to reduce discomfort when it is given.
Each injection takes one to two minutes as fulvestrant is oily and needs to be given slowly.
Its usually given at hospital every two weeks for the first three doses, then once a month.
You will usually be given fulvestrant for as long as it keeps your breast cancer under control and any side effects can be managed.
The Latest In Breast Cancer Treatments Are Available In Portland And Vancouver
Understanding the molecular makeup of each patients breast cancer allows the oncologist to select the most appropriate and proven treatments available today. At Compass Oncology, our comprehensive treatment team includes breast cancer specialists, breast surgeons, specialists in genetics, pathologists, and diagnostic imaging.
Compass Oncologys care team focuses on helping each patient through their individual cancer journey with treatments and support throughout. If you or a loved one in the Portland, Oregon, or Vancouver, Washington area have been diagnosed with breast cancer, schedule a consultation today to learn if targeted or hormone therapies can help you.
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How Hormone Therapy Is Given
Hormone therapy may be given in many ways:
- Oral. Hormone therapy comes in pills that you swallow.
- Injection. The hormone therapy is given by a shot in a muscle in your arm, thigh, or hip, or right under the skin in the fatty part of your arm, leg, or belly.
- Surgery. You may have surgery to remove organs that produce hormones. In women, the ovaries are removed. In men, the testicles are removed.
If You Cant Have Surgery
Surgery is the main treatment for breast cancer, but some women have health problems that mean they cant have surgery. Some women choose not to have surgery.
In this case, if your breast cancer is oestrogen receptor positive, your doctor might recommend hormone therapy. This treatment won’t get rid of the cancer but can stop it growing or shrink it.
The treatment can often control the cancer for some time. Your doctor might change you to a different type of hormone treatment if your cancer starts growing again.
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Hormone Therapies For Prostate Cancer Treatment
Male hormones cause prostate cancer cells to grow. Androgens support a healthy prostate gland however, they can also promote the growth of cancerous prostate cells.
When using hormone therapy for prostate cancer, the treatment can block the production or use of androgens in one of the following ways:
Is Hormone Replacement Safe After Breast Cancer Maybe Not
Arguments have persisted for many years regarding the safety of using hormone replacement during or after the treatment for early-stage breast cancer. Several clinical trials suggested that post-treatment hormone therapy increased the risk of breast cancer recurrence whereas others did not see any adverse impact. To make things more confusing, there are two types of hormone replacement. One is systemic therapy with patches injections or pills , and the other is using vaginal tablets or suppositories for replacement needs. In fact, a large analysis of many studies from the Collaborative Group on Hormone Factors in Breast Cancer noted an increase in the risk of new primary cancers in women who have never had breast cancer treated with systemic hormones but not with vaginal hormones. This most recent study published by Cold et.al., published in the Journal of the National Cancer Institute studied a very large group of Danish postmenopausal women with estrogen receptor-positive breast cancer. All patients in this study received five years of tamoxifen, an aromatase inhibitor , or both in sequence, or received no hormone therapy.
The initiation of hormone therapy initiated during adjuvant treatment with aromatase inhibitors
Dr. Alan Stolier, MD, FACS, clinical breast oncologist, shares his expert medical perspective with a series of educational and scientific articles.
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Can Birth Control Affect Breast Size
While we dont have hard scientific proof that birth control makes your boobs bigger, many people do report an increase in size, says Amy Roskin, MD, OB-GYN and Chief Medical Officer of womens telehealth provider Favor.
Hormonal birth control contains the hormones estrogen and progesterone, which can cause water retention, leading to increased tenderness and fullness of the breasts, says Alice Sutton, MD, OB-GYN and assistant clinical professor of gynecology and reproductive science at UC San Diego.
But just how big and full are we talking about? Theres no research on the matter, however, the increase is most likely small: Anecdotally, most people dont find that they need to change their bra size, for example, but some do report this, says Roskin.
Moreover, if you do happen to experience an increase in breast size from birth control, the change likely isnt permanent.
Breasts may return to their prior size when the individual discontinues birth control, says Sutton.
Tamoxifen And Breast Cancer Prevention
A large study by the National Cancer Institute looked at whether tamoxifen lowered cases of breast cancer in healthy women who were known to be likely to get the disease. The results of the trial showed a 50% reduction in breast cancer in the women who took the drug.
Studies have also shown that tamoxifen lessens the risk of breast cancer returning in women who have had the earliest form of the disease, ductal carcinoma in situ .
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How Is Hormone Therapy Used To Treat Breast Cancer
There are three main ways that hormone therapy is used to treat hormone-sensitive breast cancer:
Adjuvant therapy for early-stage breast cancer:Tamoxifen is FDA approved for adjuvant hormone treatment of premenopausal and postmenopausal women with ER-positive early-stage breast cancer, and the aromatase inhibitorsanastrozole, letrozole, and exemestane are approved for this use in postmenopausal women.
Research has shown that women who receive at least 5 years of adjuvant therapy with tamoxifen after having surgery for early-stage ER-positive breast cancer have reduced risks of breast cancer recurrence, including a new breast cancer in the other breast, and reduced risk of death at 15 years .
Until recently, most women who received adjuvant hormone therapy to reduce the chance of a breast cancer recurrence took tamoxifen every day for 5 years. However, with the introduction of newer hormone therapies , some of which have been compared with tamoxifen in clinical trials, additional approaches to hormone therapy have become common .
Some premenopausal women with early-stage ER-positive breast cancer may have ovarian suppression plus an aromatase inhibitor, which was found to have higher rates of freedom from recurrence than ovarian suppression plus tamoxifen or tamoxifen alone .
Men with early-stage ER-positive breast cancer who receive adjuvant therapy are usually treated first with tamoxifen. Those treated with an aromatase inhibitor usually also take a GnRH agonist.
Hormone Therapy Available At Willamette Valley Cancer Institute
Some cancers grow because of hormones present in the body. Usually, there is too much of a hormone that is fueling the cancers growth. A cancer treatment that slows or stops the growth of cancers that use hormones to grow is called hormone therapy. Prostate and breast cancers are commonly treated with hormone therapies.
Hormone therapy, also called hormonal therapy or endocrine therapy, is commonly used in addition to other cancer treatments. The types of treatment you are prescribed are based on the type of cancer, if it has spread, and how far, if it uses hormones to grow, and if you have other health problems.
What Happens During Breast Development
The first sign of breast development is slight swelling under the nipple, a stage of development called breast buds.
As your breasts first start to grow, they can be very tender and sore. They may also itch as your skin gets stretched. Buying a first bra can help protect new breast growth and minimize pain. If the breasts grow rapidly, stretch marks may occur in the skin. These will fade over time.
The breasts will continue to grow as the girls body fat increases during puberty. They become rounder and fuller. The areola may get darker and larger and the nipple may become erect, or stick out.
Its common for one breast to develop faster than the other. Over time it should even out, however many adult women find their breasts differ very slightly in size. This is completely normal.
How Is Hormone Therapy Used To Treat Cancer
Doctors often use hormone therapy along with other types of cancer treatment, such as radiation therapy, chemotherapy, or surgery. If a person cannot have those treatments because of other health problems, hormone therapy may be used alone.
Hormone therapy can be used in different ways at different times. These include:
Before surgery or radiation therapy to shrink a tumor. This is called neoadjuvant therapy.
After other cancer treatments to reduce the risk that cancer will come back. This is called adjuvant therapy.
For cancer that comes back after treatment, called recurrent cancer.
For cancer that has spread to other parts of the body, called metastatic cancer.
The goal of hormone therapy depends on the type of cancer and how far it has spread. Sometimes, the goal is to keep cancer from coming back after treatment. Or the goal may be to stop or slow cancer growth.
Hormone therapy may also be used to help prevent or manage cancer symptoms. Relieving side effects is an important part of cancer care and treatment. This is called palliative care or supportive care. Be sure to ask your doctor why a specific hormone therapy is being recommended for you and how the therapy will contribute to your cancer treatment plan.
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Hormone Therapy Versus Menopausal Hormone Therapy
Hormone therapy for breast cancer treatment is different than menopausal hormone therapy .
- Hormone therapies used in breast cancer treatment act as anti-hormone or anti-estrogen therapies. They block hormone actions or lower hormone levels in the body.
- MHT is used to increase hormone levels in the body to treat menopausal symptoms.
MHT increases the risk of breast cancer. Its not usually recommended for women with breast cancer. For other women, its only recommended at the lowest dose, for the shortest time needed, to ease symptoms .
MHT is also called postmenopausal hormone use or hormone replacement therapy .
Learn more about talking with your healthcare provider.
If youve been recently diagnosed with breast cancer or feel too overwhelmed to know where to begin to gather information, Susan G. Komen® has a Questions to Ask Your Doctor About Hormone Therapy and Side Effects resource that might help.
You can download, print and write on the resource at your next doctors appointment. Or you can download, type and save it on your computer, tablet or phone during a telehealth visit using an app such as Adobe. Plenty of space and a notes section are provided to jot down answers to the questions.
There are other Questions to Ask Your Doctor resources on many different breast cancer topics you may wish to download.
What Cyclical Changes Happen To The Breasts During The Menstrual Cycle
Each month, women go through changes in the hormones that make up the normal menstrual cycle. The hormone estrogen is produced by the ovaries in the first half of the menstrual cycle. It stimulates the growth of milk ducts in the breasts. The increasing level of estrogen leads to ovulation halfway through the cycle. Next, the hormone progesterone takes over in the second half of the cycle. It stimulates the formation of the milk glands. These hormones are believed to be responsible for the cyclical changes that many women feel in their breasts just before menstruation. These include swelling, pain, and soreness.
During menstruation, many women also have changes in breast texture. Their breasts may feel very lumpy. This is because the glands in the breast are enlarging to get ready for a possible pregnancy. If pregnancy does not happen, the breasts go back to normal size. Once menstruation starts, the cycle begins again.
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Types Of Hormone Therapy For Prostate Cancer
Hormone therapy may be part of prostate cancer treatment if the cancer has spread and cant be cured by surgery or radiation therapyor if the patient isnt a candidate for these other types of treatment. It may also be recommended if cancer remains or returns after surgery or radiation therapy, or to shrink the cancer before radiation therapy.
Additionally, hormone therapy may be combined with radiation therapy initially if theres a high risk of cancer recurrence. It can also be given before radiation therapy to shrink the cancer and make other treatments more effective. Other types of hormone therapy for prostate cancer include:
Stopping The Ovaries Working
In premenopausal women, doctors might use a type of hormone treatment to stop the ovaries from producing oestrogen. This type of drug is called a luteinising hormone releasing hormone . For example, goserelin and leuprorelin . You might have this on its own or with other hormone therapy drugs.
LHRH drugs work by blocking a hormone made in the pituitary gland that stimulates your ovaries to make and release oestrogen. This stops your ovaries from working. So you won’t have periods or release eggs while you are having the injections.
When you stop taking the drug, your ovaries should start working again. But, if you’re close to the age at which your menopause would naturally start, your periods might not start again.
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What Is Hormonal Therapy
Hormones help control how cells grow and what they do in the body. The hormones oestrogen and progesterone, particularly oestrogen, can encourage some breast cancers to grow.
Hormonal therapies reduce the amount of oestrogen in the body or stop it attaching to the cancer cells. They only work for women with oestrogen-receptor positive cancers.
Your cancer doctor will advise you to take hormonal therapy to reduce the risk of the breast cancer coming back. It also helps reduce the risk of getting a new breast cancer in your other breast. Sometimes hormonal therapy drugs are given before surgery to shrink a cancer and avoid a mastectomy.
You usually take hormonal therapy drugs for a number of years. For some women, this could be up to 10 years. You usually start taking them after surgery or chemotherapy.
The type of hormonal therapy you have depends on:
- whether you have been through the menopause or not
- the risk of the cancer coming back
- how the side effects are likely to affect you.
What Types Of Hormone Therapy Are Used For Breast Cancer
Several strategies are used to treat hormone-sensitive breast cancer:
Blocking ovarian function: Because the ovaries are the main source of estrogen in premenopausal women, estrogen levels in these women can be reduced by eliminating or suppressing ovarian function. Blocking ovarian function is called ovarian ablation.
Ovarian ablation can be done surgically in an operation to remove the ovaries or by treatment with radiation. This type of ovarian ablation is usually permanent.
Alternatively, ovarian function can be suppressed temporarily by treatment with drugs called gonadotropin-releasing hormone agonists, which are also known as luteinizing hormone-releasing hormone agonists. By mimicking GnRH, these medicines interfere with signals that stimulate the ovaries to produce estrogen.
Estrogen and progesterone production in premenopausal women. Drawing shows that in premenopausal women, estrogen and progesterone production by the ovaries is regulated by luteinizing hormone and luteinizing hormone-releasing hormone . The hypothalamus releases LHRH, which then causes the pituitary gland to make and secrete LH and follicle-stimulating hormone . LH and FSH cause the ovaries to make estrogen and progesterone, which act on the endometrium .
Blocking estrogens effects: Several types of drugs interfere with estrogens ability to stimulate the growth of breast cancer cells:
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Possible Side Effects Of Hormone Therapy
Some side effects are common to all methods of hormone therapy and are due to the reduced levels of oestrogen.
Tamoxifen and aromatase inhibitors also produce some different side effects. You may experience some of the side effects listed, but are unlikely to experience them all.
For most people who are recommended to take hormone therapy for breast cancer, the risks of treatment are outweighed by the benefits.
Here is a list of possible side effects that might be experienced on tamoxifen and aromatase inhibitors:
Cancers Treated With Hormone Therapy
Hormone therapy is used to treat prostate and breast cancers that use hormones to grow. Hormone therapy is most often used along with other cancer treatments. The types of treatment that you need depend on the type of cancer, if it has spread and how far, if it uses hormones to grow, and if you have other health problems.
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How Do Hormone Therapies Work
Hormone therapy drugs slow or stop the growth of hormone receptor-positive breast cancers in a couple of ways:
- Some hormone therapies, such as tamoxifen, attach to the hormone receptor in the cancer cell and block estrogen from attaching to the receptor.
- Others, such as aromatase inhibitors and ovarian suppression, lower the level of estrogen in the body so the cancer cells cant get the estrogen they need to grow.