Hormone Therapy for Breast Cancer
Estrogen is one of the female hormones. Sometimes breast cancer cells grow and multiply when exposed to estrogen. A hormone receptor test is done to measure the amount of certain proteins (called hormone receptors) in a person's breast cancer tissue. If the test is positive, it means that the hormone is probably helping the cancer cells to grow. Hormone therapy is a way to reduce the action of estrogen on these cells.
How the therapy works
Hormone therapy is only used on the types of cancer that have the proteins that estrogen can attach to. The therapy can help keep estrogen from attaching to these cells. Hormone therapy can make breast cancer less likely to come back (recur). It is the usual first-line treatment for hormone receptor-positive breast cancer that has spread. It is done in addition to other treatments such as surgery, radiation, or chemotherapy. The type of hormone therapy to be used depends on factors such as your gender, your age, and whether the cancer has spread.
How the therapy is done
Hormone therapy can be done in several ways. These include:
Estrogen-receptor blockers. These medicines stop estrogen from working on cancer cells. They come in pill form and as an injection. They may be given for early breast cancer, or breast cancer that has spread. These medicines can help keep breast cancer from coming back after treatment and help lower the risk of breast cancer in the other breast. They may be given to reduce the risk of breast cancer in some women.
Aromatase inhibitors (AIs). These medicines stop the body from making estrogen. Or they may stop estrogen from working in the body. They can be used to treat breast cancer that has spread and to help keep cancer from coming back after treatment. They are only given to women who are past menopause. AIs come in pill form.
LHRH and GnRH agonists. These medicines stop the body from making estrogen and other hormones that are similar to estrogens. These hormones can also cause breast cancer cells to grow. The medicines may be injected into a muscle or just under the skin. Or they may come in pill form and be taken by mouth.
Surgery. Estrogen is mostly made in the ovaries. Surgery to remove the ovaries (ovarian ablation) may be done. This is only done in women who have not gone through menopause. It takes away the main source of estrogen in the body. This may help other hormone therapies to work better.
Possible side effects of hormone therapy for breast cancer
All forms of hormone therapy cause similar side effects that are like the symptoms of menopause, such as:
Sudden increase in body heat (hot flashes)
Menstrual period stops
Extreme tiredness (fatigue)
Reduced interest in sex
Vaginal dryness or discharge
Nausea or vomiting
Other side effects of some types of hormone therapy include:
Loss of bone mass (osteoporosis)
Higher cholesterol levels
Cancer of the lining of the uterus (endometrial cancer)
Increased risk for blood clots, heart attacks, and stroke
It's important to know which medicines you're taking and what side effects they might cause. Talk with your healthcare providers about what signs to look for and when to call them. Make sure you know what number to call with questions, even on evenings and weekends.
Coping with side effects
Side effects vary from person to person. Some of the side effects of hormone therapy are short-term (temporary). Others are more long-lasting. This depends on the type of treatment used, and how it affects your body. Your doctor can tell you more. To help cope with side effects, try the tips below.
Talk with your doctor about your symptoms. He or she may prescribe medicines that can help you feel better and reduce problems.
Avoid hot tubs, saunas, and hot showers if you notice these increase your symptoms.
Don't have spicy food, alcohol, and caffeine if you notice these increase your symptoms.
Exercise and do other physical activity to help prevent weight gain and muscle loss.
Keep mentally active.
Work with your partner to manage sexual changes. Vaginal moisturizers and lubricants can help overall vaginal health and comfort during sex.
Try counseling or support groups.
Checking your progress
It's important to know which medicines you're taking. Write your medicines down, and ask your healthcare team how they work and what side effects they might have. Talk with your healthcare providers about what signs to look for and when to call them. Make sure you know what number to call with questions. Is there a different number for evenings and weekends?
During the course of your treatment, you’ll have routine visits with your doctor. You may also have tests. These allow your doctor to check your health and response to the treatment. After treatment ends, you and your doctor will discuss your treatment results. You’ll also discuss whether you need additional cancer treatments.
November 03, 2017
Levy, Adam S, MD,Stump-Sutliff, Kim, RN, MSN, AOCNS