Your cancer

Living with the disease

Hormone Therapy

What is it ?

Hormone therapy is used to treat and help prevent recurrence of hormone-sensitive types of cancer, namely breast, uterine and prostate cancer.

How it works

The term ‘hormone therapy’ a bit of a misnomer. As hormone therapy’s aim is to prevent hormone stimulation of cancer cells, a more accurate name might be ‘anti-hormone’ therapy.

Breast cancer

The majority of breast cancer tumors have estrogen and/or progesterone receptors on the surface of their cells. When these hormones attach to the surface of the tumor cells, they stimulate the proliferation of the cancer cells. There are three types of hormone therapy for breast cancer:

  • Antithe: degrades and/or replaces the tumor cells’ estrogen receptors.
  • LH-RH analogues: suppress the production of female hormones by the ovaries in pre-menopausal women.
  • Anti-aromatases: prevent the production estrogen in post-menopausal women.

Prostate cancer

Prostate cancer’s development is linked to androgen metabolism, particularly how testosterone binds to the tumor cells’ androgen receptors. All types of prostate cancer are initially hormone-sensitive, and are referred to as castrate-sensitive. The molecules prescribed are called LH-RH agonists or LH-RH antagonists. These drugs are mainly prescribed in injectable form (subcutaneously) on a monthly, quarterly, or even semi-annual basis. This treatment can also be supplemented with oral medication.

When the cancer is metastatic or becomes resistant to castration, ‘next-generation hormone therapy’ may be prescribed. It is generally a combination of oral and injectable hormone therapy.

Treatment is monitored by measuring the level of testosterone in the blood in relation to PSA (prostate-specific antigen) levels.

Endometrial cancer

As with breasts, endometrial tissue growth is influenced by female hormones. Hormone therapy is often used to stop tumor growth.

An alternative hormone therapy, albeit less frequently used,
is the surgical removal of the ovaries (double oophorectomy) or testicles (double orchiectomy.)

Side Effects

The frequency and severity of side effects can vary greatly from patient to patient. Discuss your symptoms with your oncologist.

Side effects of hormone therapy include:

Osteoporosis or loss of bone density

Bone density will be measured at the on-set and throughout treatment.

Increased risk of cardiovascular disease

Which requires monitoring, particularly in the event of pre-existing conditions.

Weight gain

Sexual disorders

Including decreased libido and erectile dysfunction.

Hot flashes

Irritability

Breast pain

Decrease in size
of the penis and testicles

Risk of deep vein thrombosis (phlebitis)

In the case
of estrogen-targeting drugs

Indications

Breast cancer:Hormone therapy can be used at all stages

At the localized stage : Prescribed for a duration of 5 years or more, following radical treatment

In the metastatic stage : Used alone or in combination with other systemic treatments, hormone therapy can slow down or even stop cancer growth.

Endometrial cancer:Hormone therapy is recommended at metastatic stages. It can be prescribed on its own if the cancer is in a ‘slow growth’ (indolent) state, or for fragile patients who cannot tolerate chemotherapy.

Prostate cancer: Hormone therapy is a primary treatment strategy. It is typically continued indefinitely, even in instances where resistance to castration occurs.

At the localized stagehormone therapy is prescribed when there is an intermediate or high risk of recurrence. The treatment duration varies, most often lasting between six months and three years.

At the metastatic stage or if there is resistance to secondary castration: hormonal treatment should be continued, and your oncologist may decide to include ‘new generation’ hormone therapy (pills or +/-chemotherapy).

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