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 done by a gynecologic oncologist. This is a specialist who diagnoses and treats female cancer.
How hormone therapy works
The therapy uses medicines to keep certain hormones from being made. Or, the medicines 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. 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, either because your health is poor or 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 postponed to try to give you a chance to become pregnant.
If you are at high risk for endometrial cancer because you have endometrial hyperplasia, your doctor may suggest using hormones before cancer appears. This may be done with an intrauterine device that contains a hormone called levonorgestrel.
Your doctor will test samples of the cancer cells from your biopsy or surgery 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.
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. The symptoms can include:
Muscle and joint aches
Weakened bones (osteoporosis)
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 shed, taking care not to overheat yourself, and avoiding your hot flash triggers.
Talk with your healthcare team about any side effects you have.
March 21, 2017
Practice Bulletin Clinical Management Guidelines for Obstetrician Gynecologists Endometrial Cancer, The American College of Obstetricians and Gynecologists, Treatment of recurrent or metastatic endometrial cancer, Up To Date, Up To Date. Treatment of Low-Risk Endometrial Cancer
Cunningham, Louise, RN,Stump-Sutliff, Kim, RN, MSN, AOCNS