Uterine Sarcoma: Hormone Therapy
What is hormone therapy?
Hormone therapy is a type of cancer treatment that works to change the levels of some hormones in your body. It may be used to treat some types of uterine sarcoma. It's not the same as the hormone therapy that's can be used to help manage the symptoms of menopause. The treatment is done by a gynecologic oncologist. This is a specialist who diagnoses and treats female cancer. You may have hormone therapy along with radiation or 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 the cancer cells from having the hormones they need to grow. The cancer cells may then shrink and die. Because hormones travel through your blood and affect your whole body, this is called a systemic treatment.
Estrogen and progesterone are the 2 main types of female hormones that affect uterine cancer. Different types of cancer cells respond differently to them. Your doctor may test samples of the cancer cells from your biopsy or surgery to see how they respond. Certain types of uterine sarcoma, such as endometrial stromal sarcoma (ESS), respond better to hormone therapy. ESS is cancer that starts in the stromal tissue. This tissue connects the lining of the uterus (endometrium) to the wall of the uterus. Hormone therapy can help shrink or kill the cancer.
You may have hormone therapy:
After you've had surgery. In this case, the goal is to help ensure that all the cancer cells have been killed. Treatment after surgery is called adjuvant hormone therapy.
If your cancer has come back. Hormone therapy may be used if you have already been treated for uterine sarcoma, and it has come back.
Hormone therapy medicines for uterine sarcoma
You may take a progesterone-like medicine to help work against the effects of estrogen. Or you may take a medicine with anti-estrogen effects. These are the some of the hormone-influencing medicines used to treat uterine sarcoma. Your gynecologic oncologist will talk to you about the kind of hormone therapy that would be best for you:
Progestins. These include megestrol acetate and medroxyprogesterone. These progesterone-like medicines may be used to treat ESS.
Aromatase Inhibitors. These include letrozole, anastrozole, and exemestane. These medicines prevent estrogen from forming in the body's fatty tissue. They may be used to treat ESS in women who have had their ovaries removed. The ovaries are the main source of estrogen. They may be used to treat ESS in women who have been through menopause.
Gonadotropin-releasing hormone agonists. These include goserelin and leuprolide. These medicines are used to lower estrogen levels in women who have not gone through menopause.
Common side effects of hormone therapy
If you are taking medicines for hormone therapy, you will need to know what they are and the common side effects you should watch for. Your doctor and nurse will give you the details on your treatment.
Some women have only a few side effects. They usually get better with time. The kind you have depends on which medicines are used and how the medicine is given.
The side effects vary from woman to woman. The side effects most often seen are a lot like symptoms of menopause. They may include:
Joint and/or muscle pain
Weakened bones (osteoporosis), if certain types of hormone therapy are used for years
Working with your healthcare team
Ask your doctor what side effects to expect. Tell your healthcare team about any side effects, even those that seem minor. Your treatment may be adjusted to reduce these effects.
Also talk with your doctor about any other therapies you may want to try. Some alternative therapies can affect hormone therapy, so be sure to talk to your doctor first.
March 21, 2017
Reichardt, P. The treatment of uterine sarcomas, Annals of Oncology (2012) 23(10); pp. x151-x157
Cunningham, Louise, RN,Stump-Sutliff, Kim, RN, MSN, AOCNS