Dr Tamás Martin
Medical Oncologist
Some cancers, like breast and prostate cancer, need hormones to grow and spread (1). If you have a cancer like this, your care team may consider placing you on hormone therapy. Hormone therapy may be used on its own, or used alongside surgery, chemotherapy, radiation therapy, or other targeted therapies (2). This article aims to help you understand what hormone therapy really is and how it may be useful during your cancer treatment.
Hormone therapy is an approach to cancer treatment that works by reducing the level of hormones in your blood that cancers require to grow. Hormone therapy is commonly used for cancers that show sensitivity to hormones. Different types of hormone therapies target different hormones, depending on the type of cancer you have. Hormone therapy can continue for months, years or lifelong depending on your treatment plan.
Hormone therapy is most commonly used to treat prostate and breast cancer. But it can also be used for other hormone-sensitive cancers like endometrial cancer, ovarian cancer, and rarely for thyroid cancer, among others (3). You would usually have to be tested before hormone therapy is commenced to determine if your cancer is hormone-receptor positive. If your cancer is hormone-receptor positive, it means hormone therapy is likely to work for controlling it.
Hormone therapy typically falls into two broad groups: those that block the production of a hormone that drives a cancer completely, and those that change or influence how a hormone acts in the body (4).
Different hormone therapy approaches include:
Hormone therapy is used to treat hormone-receptor-positive breast cancers by reducing the effect of estrogen on cancer cells (5). Many hormone receptor-positive breast cancer cells rely on estrogen signalling to grow. Reducing estrogen activity can slow or stop the growth of these cancers. Some drugs used in hormone therapy for breast cancer include tamoxifen and aromatase inhibitors. Tamoxifen works differently from aromatase inhibitors and may be used in different patient groups depending on factors such as menopause and the stage of the cancer.
Tamoxifen works by blocking estrogen receptors on breast cancer cells, preventing estrogen from stimulating their growth. Aromatase inhibitors work differently by reducing the body's production of estrogen, mainly in tissues outside the ovaries after menopause (6, 7).
Hormone therapy medication for breast cancer can be taken for several years as a part of a long-term treatment and as a way to prevent the cancer from returning.
Hormone therapy for prostate cancer aims at reducing the levels of testosterone across the body or the hormone’s effect on cancer cells, so that they stop growing (8).
Androgen deprivation therapy (ADT) is a common hormone therapy approach for prostate cancer.
It can be given as injections, implants, tablets, or by removing both testes, depending on the treatment plan (9).
It can be used alone or alongside other treatment plans like chemotherapy and radiation therapy or a new type of anti-androgen regimen.
Hormone therapy may be given as tablets, capsules, or injections. Some treatments are taken daily (like tablets), while others are taken monthly or once every few months. Your treatment plan can vary between you and other people, depending on your cancer type and stage.
Hormone therapy has some side effects. Not everyone experiences these effects the same way. You may experience side effects while someone else does not or vice versa. Side effects of hormone therapy generally vary between people and their treatment types. The most common ones include:(10)
Because hormone therapy is often taken for a long period, you may feel affected physically and emotionally by it (11). Your relationships may also be strained, and your daily routines may experience some changes. Consider receiving follow-up care and discuss any ongoing symptoms or concerns with your healthcare team.
Side effects of hormone therapy, such as fatigue, changes in your appetite, or digestive symptoms, can affect your well-being. You need to stay properly hydrated, get enough nutrition, and achieve just the right amount of physical activity, which improves bone health. This can support overall health during treatment. Some people may benefit from nutritional support like oral nutritional supplements; this is especially true if your treatment affects your appetite, energy levels, and food intake more than you can keep up with.
Hormone therapy is used to treat cancers that depend on hormones to grow. It includes drugs and injections that can block the hormones from being produced, block the hormones from reaching cancer cells, or change how cancer cells interact with these hormones. It's taken for a very long time and, as such, has a toll on your physical, emotional, and mental well-being. You should speak to your doctor concerning any side effects, especially those that bother you.
References:
This information is provided for educational purposes only. It is general in nature and is not intended to replace professional medical advice, diagnosis, or treatment. Always consult your healthcare team regarding any questions or concerns about your health or care.
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