VERIFIED CONTENTAuthor: Karolina Karabin, MD, PhD, molecular biologist, laboratory diagnostician, nutrition and lifestyle consultant

Hormone therapy together with surgery, radiotherapy and chemotherapy plays an important role in the treatment of certain types of cancer, such as breast cancer. In selected cases, hormone therapy is a better and cheaper method of treatment than chemotherapy. When exactly do we use hormone therapy? What are the side effects of hormone therapy?

Hormones are signaling molecules that control virtually every process in our body. They work through special receptors located outside or inside the cell. Hormones which, after binding to the receptors, activate them are called agonists, while those that block the action of the receptors are called antagonists.

Examples of hormones are estrogens, progesterone, testosterone, insulin, and cortisol. It turns out that in some cases, when the tissue is overstimulated with a specific hormone, cancer may develop. They are called hormone-dependent tumors, such as breast cancer, which develops through stimulation by estrogens.

Hormonotherapy - what is it?

In the case of hormone-dependent tumors, hormone therapy, otherwise known as hormone therapy, turns out to be effective. Currently, hormone therapy is used in the treatment of early-stage cancer, palliative treatment and as supportive care.

The advantage of hormone therapy is that it is much less toxic than chemotherapy and is therefore often used as a palliative treatment. Another important advantage is that the cost of hormone therapy is much lower than that of chemotherapy. However, the disadvantage is that hormone therapy, compared to other methods of cancer treatment, requires a longer time until the effects of treatment are obtained.

Hormone therapy - how does it work?

Hormone therapy is a systemic treatment because hormones circulate throughout the body and can affect many tissues and organs. This distinguishes hormone therapy from topical treatments that only affect a specific part of the body, such as most types of surgery and radiotherapy.

Cancer hormone therapy is aimed at removing the source of hormones or preventing their effect on cancer cells,which allows to inhibit the growth of hormone-dependent neoplasms.

The mechanism of hormone therapy in cancer may be:

  • ablative- its purpose is to inhibit or limit the production of a certain hormone, and this is achieved by surgical removal or radiotherapy of a hormone-producing gland, e.g. the ovaries
  • additive- its purpose is to increase the concentration of a specific hormone by administering it and, as a result, inhibit the growth of neoplasms, e.g. glucocorticosteroids, progestogens
  • antagonistic- its purpose is to block the action of receptors, e.g. antiestrogens
  • inhibition- its goals are to inhibit hormone converting enzymes, e.g. aromatase inhibitors

Hormone therapy - when is it used?

In oncology, hormone therapy can be used in:

  • treatment of hormone-dependent tumors,
  • to reduce the effects of inappropriate hormone secretion,
  • Adjunctive therapy to relieve symptoms related to cancer (e.g. wasting syndrome) or following anti-cancer treatment (nausea, vomiting).

Hormone therapy is used in the treatment of:

  • breast cancer,
  • endometrial cancer,
  • prostate cancer,
  • ovarian cancer,
  • endometrial cancer,
  • thyroid cancer,
  • bone tumors.

Hormone therapy is one of the basic methods of treating breast and prostate cancer. An indication for hormone therapy in breast cancer and at the same time an indicator allowing to determine the probability of obtaining a response to treatment is the determination of the level of estrogen receptors (ER) and progesterone receptors (PgR).

The main drug used in the hormone therapy of breast cancer is Tamoxifen, which inhibits the binding of estrogens to receptors and therefore blocks the stimulation of cancer cells by oestrogens.

It is worth mentioning that the prevention of breast cancer in high-risk women through the use of tamoxifen reduces the risk by up to about 50%.

Hormone therapy - drugs

Drugs used in the treatment of breast cancer (supportive and palliative treatment):

  • antiestrogens (tamoxifen, toremifene),
  • aromatase inhibitors (anastrozole, letrozole),
  • gonadoliberin analogs (goserelin, buserelin),
  • progestogens (megestrol, medroxyprogesterone).

Drugs used in the treatment of prostate cancer (palliative treatment):

  • antiandrogens (flutamide, bicalutamide),
  • gonadoliberin analogs (goserelin,leuprorelin),
  • estrogens (diethylstylbestrol).

Drugs used in the treatment of endometrial cancer (palliative treatment):

  • progestogens (megestrol acetate),
  • antiestrogens (tamoxifen).

Drugs used in the treatment of thyroid cancer (complementary and palliative treatment):

  • thyroxine

Drugs used in the treatment of ovarian cancer (palliative treatment):

  • antiestrogens (tamoxifen)

Hormone therapy - side effects

Although hormone therapy is better tolerated by the body than chemotherapy and has fewer side effects, it is not completely free from them. Very often, patients undergoing hormone therapy may complain of:

  • nausea,
  • water retention,
  • skin rashes,
  • hot flashes,
  • fatigue.

Other common symptoms include:

  • anemia,
  • allergic reactions,
  • muscle spasms,
  • headache,
  • light-headedness,
  • hair loss,
  • vomiting,
  • diarrhea,
  • constipation,
  • muscle pains,
  • increased risk of thrombosis.

Good to know …

In addition to its use in oncology, hormone therapy is also used in the treatment of diseases such as hypothyroidism, diabetes, or as hormone replacement therapy in women.

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