Endometrial Cancer: Hormone Therapy
What is hormone therapy?
Hormone therapy is a type of cancer treatment that changes the levels of certain hormones in your body. This can help to control endometrial cancer. It's not the same as the hormone therapy that may be used to manage symptoms of menopause. The treatment is often done by a gynecologic oncologist. This is a specialist who diagnoses and treats female cancer. It may also be done by a medical oncologist, a specialist in the treatment of cancer using medicines (chemotherapy).
How hormone therapy works
Hormones are chemicals in your blood. They control how cells grow. Hormones such as estrogen and progesterone can cause cancer cells in the uterus to grow. The goal of hormone therapy for cancer is to stop cancer cells from getting the hormones they need to grow. The cancer cells may then shrink and die.
The therapy uses medicines to keep certain hormones from being made. Or the medicines used may stop the hormones from helping cancer cells grow. For endometrial cancer, the hormones affected are estrogen and progesterone. You take the medicines by mouth or as a shot (injection). The medicines control the cancer cells both inside and outside the uterus. For endometrial cancer, hormone therapy may help to shrink or kill the cancer. In some cases, the cancer may respond to the treatment for some time. But the response may not last.
Is hormone therapy right for you?
Your doctor may advise hormone therapy for you in any of these cases:
Surgery and radiation are not good choices for you. This may be because your health is not good. Or it may be because the cancer has spread to other parts of your body.
You have already been treated for endometrial cancer, and it has come back
You’re young and want to get pregnant, and your cancer hasn’t spread. Surgery would be delayed to give you a chance to become pregnant.
Your doctor will test cancer cell samples of the cancer cells from your biopsy or surgery. They will be tested to see how they respond to the hormones. This helps your doctor know if hormone therapy may work for you.
Hormone therapy medicines for endometrial cancer
Progestins. These are the most common hormone treatment used. They slow the growth of endometrial cancer cells.
Tamoxifen. This medicine stops estrogen from causing the cancer cells to grow.
Lutenizing hormone releasing hormone agonists. These medicines slow the growth of endometrial cancer cells by keeping the ovaries from making estrogen.
Aromatase inhibitors. These medicines stop estrogen production in fat tissue after the ovaries have been removed. They are still being studied as treatment for endometrial cancer.
How is hormone therapy given?
Most hormone therapy medicines are pills that you simply take at home. A few are shots (injections).
Very small (early) endometrial cancers may be treated with an intrauterine device that contains a progestin hormone called levonorgestrel along with pills.
Possible side effects of hormone therapy
Side effects are similar for all types of hormone therapy. But there are some differences with different types of medicines. Many of these are a lot like the symptoms of menopause. Side effects vary from woman to woman and can include:
Muscle and joint aches
Weakened bones (osteoporosis)
Fluids building up inside the body (fluid retention)
Coping with side effects
Talk with your healthcare provider about what to expect from your type of hormone treatment. Some of the side effects can be prevented or treated. For example:
Weight-bearing exercise and medicine can help decrease bone loss.
Vaginal moisturizers and lubricants can help overall vaginal health and comfort during sex.
Regular exercise can help prevent weight gain and muscle loss. It can also help prevent depression.
Medicine and counseling can help treat depression.
Ease hot flashes by wearing layers of clothing that you can easily remove, taking care not to get overheated, and stay away from your hot flash triggers.
Talk with your healthcare team about any side effects you have.
Working with your healthcare team
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 cause. Make sure you know what number to call with questions. Is there a different number for evenings and weekends?
Tell your healthcare team about any side effects, even those that seem minor. Your treatment may be adjusted to reduce these effects.
It may be helpful to keep a diary of your side effects. Write down physical, thinking, and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage your side effects.
Also talk with your doctor about any other therapies you may want to try. Some alternative therapies can affect hormone therapy.
June 15, 2018
Clinical Practice Guidelines in Oncology: Uterine Neoplasms, National Comprehensive Cancer Network
Goodman, Howard, MD,Stump-Sutliff, Kim, RN, MSN, AOCNS