Preparing for Hormone Therapy

Understanding Hormone Therapy

Hormone therapy for cancer can continue for a while, which is why it helps to be medically, physically, and emotionally prepared for it before commencing(1). This article will help you to understand your treatment plan, manage your expectations around side effects, maintain a good emotional state and understand how your fertility or menopause may be affected. Healthy habits, nutrition, adequate physical activity, and support systems can help you feel more prepared before your treatment begins.

Understanding Hormone Therapy Before Starting Treatment

Hormone therapy is used to treat cancers that rely on hormones to grow [2]. It typically works by reducing the levels of hormones in the body or stopping hormones from reaching cancer cells. It can be given as tablets, injections, or other medications, depending on the type of cancer and what your doctor aims to achieve [3]. Some people receive only hormone therapy, while others receive hormone therapy alongside surgery, chemotherapy, or radiation therapy. Treatment with hormone therapy is typically taken for a long time. So, it is important to understand how it can impact you in the long term before starting. Side effects of hormone therapy vary from person to person and, of course, depend on the treatment type and hormones being targeted [4].

What to Discuss with your Healthcare Team Before Starting Hormone Therapy

Before starting hormone therapy, you should understand why the treatment is being recommended and what the goals of the treatment are.

Hormone therapy may be used to:

• Lower the risk of your cancer returning after it has been treated with some other treatment type.
• Slow or stop the growth of hormone-sensitive cancers.
• Help manage advanced stages of cancer, or cancers that have spread to other parts.
• Lower hormone levels or block hormones from reaching cancer cells. 

You may wish to discuss:

• How long your treatment is expected to last
• Which type of hormone therapy will be used
• Possible side effects and how it will affect your day-to-day life
• Whether or not treatment can affect your fertility, menopause, your sexual or hormonal health [5,6].
• How your treatment will be measured over time.

Preparing for Hormone Therapy Treatment

Hormone therapy may be given in different ways, depending on the type of cancer and the plan your doctor believes is right for you [7]. Sometimes, it's combined with other forms of cancer treatment. Preparation is usually medical, physical, and emotional [8].

Understanding the Type of Hormone Therapy You Receive

The most common methods of receiving hormone therapy include: [9]

• Tablets or capsules taken by mouth every day
• Injections given monthly or once every few months
• Surgery to remove organs that produce hormones

Medical Preparations for Hormone Therapy

Before starting hormone therapy, you may need to undergo one or more of the following:

• Blood tests to check the hormone levels and your overall health
• Bone density scans, especially if you’re being treated for breast cancer or prostate cancer. 
• Discussions around your current medications and possible interactions.
• Discussions about fertility or menopause

Because hormone therapy lasts a while, you need to prepare for how it impacts your daily life and how it impacts your emotional well-being, energy levels, and physical health. 

Emotional and Lifestyle Preparation Before Hormone Therapy

Starting a form of cancer treatment that lasts a while can be very demanding on your emotions. You may feel overwhelmed and out of place. You would benefit from discussing your concerns with your family members, your caregivers, your support groups, or even healthcare professionals. Preparing routines and sticking to work schedules, developing good exercise habits, and leaning into support from your support system in advance, even before starting this therapy, can help you adjust more comfortably when the treatment itself begins. You'll have to get enough sleep, perform enough physical activity, eat healthy meals, and learn to manage your stress. You should also not hesitate to report any emotional changes such as anxiety, low mood, or difficulty coping to your doctor or caregivers.

What to Expect During Hormone Therapy

Since hormone therapy is taken for a long time, sometimes for several years depending on the type of cancer, you should expect some side effects. Although you can keep up with your normal daily activities during treatment, side effects can happen that affect your sleep, mood, or physical well-being. Common ones include: [10,11]

• Fatigue
• Bone density loss
• Lean muscle mass loss
• Hot flushes or sweating
• Joint and muscle pain
• Mood changes
• Abdominal fat gain
• Changes related to menopause or low hormone levels

Regular follow-up appointments, blood tests, or scans are usually used to monitor progress and manage your side effects.

It's normal for you to feel a bit of uncertainty before or during your treatment, particularly when hormone therapy is expected to last a while. Healthcare professionals will give you personalised guidance on what to expect and how to cope.

When to Speak with Your Medical Team

Speak to your medical team about:

• How and when your treatment will be taken
• How your side effects will be monitored
• Recommended lifestyle changes that may help you cope during treatment.

Contact them if you notice any new or severe symptoms and concerns.

Supporting Your Body During Hormone Therapy

The side effects of hormone therapy, such as fatigue, appetite changes, weight changes, or digestive symptoms, can affect your well-being and, as such, it is important that you be in good shape [12]. Maintaining good nutrition, drinking enough water, and getting just the right amount of physical activity to maintain bone health can support you throughout your treatment. You may benefit from additional nutritional support if your side effects keep you from getting enough nutrients. If side effects make it difficult to meet your nutritional needs through food alone, your healthcare team or dietitian may recommend oral nutritional supplements.

Speak to your healthcare team before you make significant changes to your diet or supplements.

Key Takeaways

Hormone therapy can last a while. You need to be medically, physically, and emotionally prepared before you begin. You should not hesitate to get support from your family and your healthcare team. Speak to someone when you feel overwhelmed, and be open to asking questions.