Types Of Hormone Therapy For Cancer

How Do You Treat A Tumor

Hormonal therapy is often given in conjunction with other treatments. The timing varies depending on the tumor, its stage and its location, among other factors: 1 Neoadjuvant hormonal therapy is when hormones are given before surgery or radiotherapy. The goal is to make a tumor shrink, so its smaller, which can make it easier to treat. 2 Adjuvant hormonal therapy is given after the patient has received surgery, radiation therapy or chemotherapy. Given after treatment, hormones decrease the risk of cancer recurring or spreading.

Types Of Hormone Therapy

The table at the right provides an overview of three commonly used types of hormone therapy. These and others are discussed below. While hormone therapy is commonly used, side effects of the treatment are reported as well. They range from erectile dysfunction, hot flashes, weight gain and loss of bone density.

How Is Hormone Therapy Given

Hormone therapy can be given in different ways. They include:

Oral hormone therapy. You can take some types of hormone therapy by mouth in a pill, capsule, or liquid form. Many oral hormone therapies can be prescribed by a doctor, picked up from a pharmacy, and then taken at home on a regular schedule. Talk with your health care team if you have any questions about the instructions for taking your medication at home.

Injected hormone therapy. This is when you receive hormone therapy as a shot. You may receive these shots in your arm, leg, hip, or belly. They may be given in a muscle or injected under the skin. Hormone injections may be given at a clinic or doctor’s office. Your health care team may also teach you to do the injections at home.

Surgical ablation. Surgery to remove an organ that makes certain hormones is sometimes recommended. For example, the testicles may need to be removed to reduce testosterone levels as part of prostate cancer treatment. This procedure is called a bilateral orchiectomy. Another example is when the ovaries are surgically removed to stop estrogen production as part of breast cancer treatment. This is called ovarian ablation. Surgical ablation is done in a hospital or a specialized medical center.

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Breast Cancer Incidence By Type And Age Over Time

Between 2002 and 2014, a total of 14,085 breast cancer cases were identified among MHS female members age20. These cases included 12,354 patients with invasive breast cancer and 1731 patients with in-situ breast cancer . The median age at diagnosis for those with invasive breast cancer was 56.0 and 54.0 for those diagnosed with in-situ breast cancer. The age-adjusted incidence rate of invasive breast cancer peaked in 2005 and decreased thereafter . The decline for overall breast cancer and for invasive breast cancer was significant for the 20022014 period. EAPC was 0.88 overall, 0.94 for invasive breast cancer and 0.36 for in situ breast cancer. Age is a risk factor for breast cancer overall , and for invasive and in situ breast cancer separately . In women age 5074, for whom biennial mammography tests are routinely performed at a subsidized price, as part of the national screening program for breast cancer, the invasive breast cancer incidence peaked around 2005, consistent with the mammography increase that year , and declined thereafter . In patients, age75 years, for whom mammography screening is not routinely performed, no such peak was observed .

Breast cancer incidence 20022014. Age-adjusted annual incidence rate of breast cancer by type and overall. Age-specific annual incidence rates of breast cancer overall .

Hormone Therapy Side Effects

Hormone therapy either blocks your bodys ability to produce hormones or interferes with how hormones behave. This means that it can also cause some side effects. The side effects of hormone therapy will depend on the type of treatment you receive and how your body responds to it. These side effects are similar to what women may experience at menopause.

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Treatments For Vaginal Dryness

Vaginal dryness and discomfort can be bothersome menopausal symptoms for some women.

Devices that use lasers or other forms of energy to rejuvenate vaginal tissue are now being studied as well, although its not yet clear how helpful they might be. Its important to discuss the possible risks and benefits of these treatments with your doctor before deciding if one is right for you.

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Benefits Of Hormone Therapies In Early And Locally Advanced Breast Cancer Treatment

Treatment with the hormone therapies tamoxifen and/or an aromatase inhibitor lowers the risk of :

• Breast cancer recurrence
• Breast cancer in the opposite breast
• Death from breast cancer

Premenopausal women who get ovarian suppression plus tamoxifen or an aromatase inhibitor may lower these risks more than premenopausal women who get tamoxifen or an aromatase inhibitor alone .

Learn more about tamoxifen.

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Early Versus Delayed Treatment

For men who need hormone therapy, such as men whose PSA levels are rising after surgery or radiation or men with advanced prostate cancer who dont yet have symptoms, its not always clear when it is best to start hormone treatment. Some doctors think that hormone therapy works better if its started as soon as possible, even if a man feels well and is not having any symptoms. Some studies have shown that hormone treatment may slow the disease down and perhaps even help men live longer.

But not all doctors agree with this approach. Some are waiting for more evidence of benefit. They feel that because of the side effects of hormone therapy and the chance that the cancer could become resistant to therapy sooner, treatment shouldnt be started until a man has symptoms from the cancer. This issue is being studied.

Menopausal Hormone Therapy And Cancer Risk

For decades, women have used hormone therapy to ease symptoms of menopause, such as hot flashes and sweating. This is called menopausal hormone therapy, and you may see it abbreviated as HT or MHT. You may also hear it described as hormone replacement therapy , postmenopausal hormone therapy , or postmenopausal hormones .

In the past, many doctors and their patients believed that MHT didnt just help with hot flashes and other symptoms it had important health benefits. But well-conducted studies have led many doctors to conclude that the risks of MHT often outweigh the benefits.

This information covers only how MHT can affect a womans risk of getting certain cancers. It does not cover other possible risks of MHT such as heart disease or stroke.

You can use this information when you talk to your doctor about whether MHT is right for you.

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Exogenous Hormone Induction Of Spawning In Female Frogs

If the female anuran has a mature cohort of eggs to ovulate, the final ovulatory dose of hCG/LHRHa typically stimulates egg laying 12â48 hours post administration of hormone. In many of the ranid species, the females may be stripped of eggs by carefully stroking from cranial to caudal to push eggs from the oviducts into the cloaca and then externally for collection.31,37 In other species, such as the Panamanian golden frog, the eggs enter the oviducts just hours before laying, and these frogs cannot be stripped easily or at all.4 Female anurans that do not spawn will eventually resorb the egg mass partially or entirely before the next season, but this condition may lead to additional health problems due to the increased metabolic demands on the female.

How Hormone Therapy Is Used Against Cancer

Hormone therapy is used for two main reasons.

• Treat cancer. Hormone therapy can stop or slow cancer’s growth and reduce the chance it will return.
• Ease cancer symptoms. Hormone therapy may be used to reduce or prevent symptoms in men with prostate cancer who are not able to have surgery or radiation therapy.

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What Is Hormonal Therapy

Hormonal therapy is often given in conjunction with other treatments. The timing varies depending on the tumor, its stage and its location, among other factors: Neoadjuvant hormonal therapy is when hormones are given before surgery or radiotherapy. The goal is to make a tumor shrink, so its smaller, which can make it easier to treat.

Breast Cancer Hormone Therapy

The female hormones oestrogen and progesterone affect some breast cancers. Doctors describe these cancers as 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.

You may have more than one type of hormone therapy to treat breast cancer. For early breast cancer, it aims to stop the cancer coming back.

Tamoxifen

Tamoxifen works by blocking the oestrogen receptors. It stops oestrogen from telling the cancer cells to grow.

Tamoxifen is one of most common hormone therapies for breast cancer. Women who are still having periods and women who have had their menopause can take tamoxifen.

Hormone therapy might be offered to people at high risk of breast cancer. This is called chemoprevention. This is not suitable for everyone.

Speak to your doctor if you think you are at high risk of breast cancer.

Aromatase Inhibitors

You might have an aromatase inhibitor 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 into oestrogen. Aromatase is the enzyme that makes this change happen. Aromatase inhibitors block aromatase so that it cant change androgens into oestrogen.

There are a few different types of aromatase inhibitor. We have detailed information about aromatase inhibitors, including anastrozole , exemestane and letrozole .

Fulvestrant

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Learn More About How Hormone Therapy Is Used To Target Cancer Cells

Hormone therapy may also be called endocrine therapy or hormone-blocking therapy.

Some cancers grow in response to particular hormones. These cancers are known as hormone-dependent cancers. They include some types of breast, uterine and prostate cancers. The aim of hormone therapy is the slow or stop the growth of hormone receptor positive cells.

What Type Of Breast Cancer Is Treated With Hormones

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 inhibitors anastrozole, letrozole, and exemestane are approved for this use in postmenopausal women.

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Types Of Cancer Treatment

There are many types of cancer treatment. The types of treatment that you receive will depend on the type of cancer you have and how advanced it is.

Some people with cancer will have only one treatment. But most people have a combination of treatments, such as surgery with chemotherapy and radiation therapy. When you need treatment for cancer, you have a lot to learn and think about. It is normal to feel overwhelmed and confused. But, talking with your doctor and learning about the types of treatment you may have can help you feel more in control. Our list of Questions to Ask Your Doctor About Treatment may help.

Hormone Therapy To Treat Cancer

Hormones are chemical substances produced by glands in the body that enter the bloodstream and cause effects in other tissues. For example, the hormone testosterone is made in the testicles and is responsible for male characteristics such as deepening voice and increased body hair. The use of hormone therapy to treat cancer is based on the observation that receptors for specific hormones that are needed for cell growth are on the surface of some tumor cells. Hormone therapy can work by stopping the production of a certain hormone, blocking hormone receptors, or substituting chemically similar agents for the active hormone, which cannot be used by the tumor cell. The different hormone therapy types are categorized by their function and/or the type of hormone that is affected.

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Hormone Therapy For Reducing The Risk Of Breast Cancer

Women at moderate or high risk of breast cancer because of their family history may be offered hormone therapy to reduce their risk of developing breast cancer.

Drugs used to reduce the risk of breast cancer in women who have not had breast cancer include:

These drugs are usually taken for five years.

How To Tell If Hormone Therapy Is Working

If you are taking hormone therapy for prostate cancer, you will have regular PSA tests. If hormone therapy is working, your PSA levels will stay the same or may even go down. But, if your PSA levels go up, this may be a sign that the treatment is no longer working. If this happens, your doctor will discuss treatment options with you.

If you are taking hormone therapy for breast cancer, you will have regular check-ups. Checkups usually include an exam of the neck, underarm, chest, and breast areas. You will have regular mammograms, though you probably wont need a mammogram of a reconstructed breast. Your doctor may also order other imaging procedures or lab tests.

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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.

Possible Side Effects Of Ais

The most common side effects of AIs are:

• Bone and joint pain

AIs tend to have side effects different from tamoxifen. They don’t cause uterine cancers and very rarely cause blood clots. They can, however, cause muscle pain and joint stiffness and/or pain. The joint pain may be similar to a feeling of having arthritis in many different joints at one time. Options for treating this side effect include, stopping the AI and then switching to a different AI, taking a medicine called duloxetine , or routine exercise with nonsteroidal anti-inflammatory drugs . But the muscle and joint pain has led some women to stop treatment. If this happens, most doctors recommend using tamoxifen to complete 5 to 10 years of hormone treatment.

Because AIs drastically lower the estrogen level in women after menopause, they can also cause bone thinning, sometimes leading to osteoporosis and even fractures. If you are taking an AI, your bone density may be tested regularly and you may also be given bisphosphonates or denosumab , to strengthen your bones.

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Advances In Hormonal Therapy

Hormonal therapy applies to cancers that are either sensitive or hormone-dependent for development. There are three major types of the hormonal therapy based on the type of cancer http://www.cancerresearchuk.org/

2.

Prostate cancer hormonal therapy: Prostate cancer is the most reported male cancer that depends on the male hormone testosterone for its growth. The LH blocker, antiandrogen, and gonadotrophic release hormone blockers have been used for hormonal therapy in prostate cancer to lower the level of serum testosterone. Interestingly, low level of testosterone has also been linked to prostate cancer. Among all hormonal therapies, GnRH blockers have been widely accepted. GnRH blockers render the signal in the hypothalamus of the brain to stop the production of LH, which controls the production of androgens . The list of the agents approved by FDA has been summarized in Table 16.7.

Table 16.7. The Hormonal Therapy Approved by FDA for Prostate Cancer

Stage of Prostate Cancer
2012â14

3.

Ovarian and womb cancer hormonal therapy: ER receptors have been found overexpressed in some ovarian cancer. Tamoxifen is the preferred choice for hormonal therapy in ovarian cancer. In the case of womb cancer, both ER and PR affect the growth and the activity of the cell lining of the womb. Doctors preferred to advise the analog of PR, medroxyprogesterone acetate and megestrol to reduce womb cancer .

Leslie E. Fox, … Jeffrey N. Bryan, in, 2010

What Are Hormone Inhibitors And How Do They Work

Hormone inhibitors also target breast cancer cells with hormone receptors, but unlike hormone blockers, they work by reducing the bodys hormone production. When breast cancer cells are cut off from the food supply the tumor begins to starve and die.Generally, the benefits of using hormone therapy and chemotherapy together have a much greater combined effect than using either alone. If your breast cancer is positive for hormone receptors, your doctor may recommend both therapies.

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Can I Take Menopausal Hormone Therapy After Breast Cancer

When women reach menopause, some choose to take PHT, which is made up of female hormones to help reduce menopause symptoms. But there have been concerns about women who have had breast cancer using PHT, because of the known link between estrogen levels and breast cancer growth.

A well-designed clinical trial found that breast cancer survivors taking PHT were much more likely to develop a new or recurrent breast cancer than women who were not taking these hormones. Because of this, doctors generally do not recommend PHT if a woman was previously treated for breast cancer.