Hormone Therapy For Breast Cancer
Tamoxifen And Other Drugs
Hormone Therapy For Breast Cancer |
Hormone Therapy For Breast CancerContents • What Is Hormonal Therapy? |
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What Is Hormonal Therapy?
As female hormones appear to play such a major role in causing breast cancer, one treatment strategy is to shift the body's hormone balance in order to discourage the growth of cancer. It is important to note at this point that hormonal therapy (HT) is not the same as hormone replacement therapy (HRT) or estrogen replacement therapy (ERT). HRT and ERT are used for treating symptoms of menopause such as hot flashes and menopausal depression. Neither HRT nor ERT are used as breast cancer treatments. Where HRT increases the amount of the estrogen in the body which tends to drop after menopause, HT does the opposite. It blocks or lowers estrogen levels in the body which is why it is considered an anti-estrogen therapy. In fact, for women with a breast cancer diagnosis, HRT is considered unsafe. Historically, the first attempts at HT involved removing the ovaries from young women with virulent forms of breast cancer so that the ovaries could no longer produce estrogen to 'feed' the cancer cells. This type of surgery is used less often these days, although it is making some sort of comeback in Europe. The procedure is less invasive than it used to be and can now be carried out with a laparoscope. Studies show that the operation seems to show similar results to those women who undergo chemo instead. The main issue however is that it causes premature menopause and the woman enters menopause overnight (read about the effects of menopause on the body). Today in the U.S., HT is more commonly performed with the use of drugs, in particular tamoxifen (Nolvadex).
HT, like chemotherapy, is a systemic treatment. That means it treats the whole body, and not just one specific area (like radiation therapy). Systemic therapies are normally recommended where the oncologist suspects that cancer cells have escaped the breast area. HT may be a recommended form of treatment after a lumpectomy or mastectomy - particularly if a breast biopsy of the tissue removed shows cancer at the margins and the cancer is estrogen receptor positive (see below). HT also helps to:
HT is used to treat what is known as hormone receptor positive breast cancers. These receptors are like little ears on a breast cell which listen for signals and instructions from hormones - such as when to grow or multiply. • 80 percent of breast cancers are estrogen receptor positive. If a cancer is either estrogen or progesterone receptor positive, it is considered hormone-receptor-positive. If it has neither receptor it is considered negative and HT as a treatment cannot help. Additionally as HT affects the action of estrogen only, the value of the treatment is less clear to patients who are progesterone receptor positive and estrogen receptor negative. These 2 percent of cases will need to discuss the pros and cons of therapy with their oncologist. There are 3 different types of HT medications. These are: Selective Estrogen Receptor Modulators (SERMs), Aromatase Inhibitors and Estrogen Receptor Downregulators (ERDs). SERMs Aromatase Inhibitors ERDs Which Drug Will I Be Prescribed? This depends on a number of factors: 1. Your stage of breast cancer. Early Stage Cancer After Menopause Early Stage Cancer Before Menopause Advanced Cancer How Long Do I Need To Take HT? This depends on whether or not you are taking it before or after cancer surgery, the stage of your cancer and the side effects it causes. Postmenopause women who take HT after surgery usually do so for 5 years. Sometimes a different medication may extend this timeframe. For example, sometimes doctors recommend an aromatase inhibitor for another 5 years after 5 years of tamoxifen. Postmenopause women taking HT before surgery may need to take it for 3 to 6 months, just to shrink the tumor. This is known as neoadjuvant hormonal therapy. Women of all ages with advanced receptor positive breast cancer usually keep taking HT indefinitely as long it keeps working. This may require switching medications every so often. All the HT treatments, except Faslodex, are taken as a pill once a day. Faslodex is a liquid which needs to be injected by a doctor once a month. SERMs Side Effects Abnormal vaginal bleeding or discharges Aromatase Inhibitors Side Effects ERDs Side Effects Women Just Diagnosed With Receptor Positive Breast Cancer Women Who Have Been Taking Tamoxifen For 2 or 3 Years 1. Do you think I should switch to an aromatase inhibitor? If not, why not? Women Who Have Taken 5 Years Of Any HT Drug 1. Is there any reason for me to continue with HT?
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For more information, see the following: • Cancer guide: Treatment, causes and clinical trials. Back to Homepage: Womens Health Advice |
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