Hormone therapy for breast cancer

Hormone therapy for breast cancer

Hormone therapy (also known as hormonal therapy, or endocrine therapy) hold the body's ability to produce hormones or by disrupting the action of hormones to slow or stop the growth of tumors sensitive to hormones.



     Hormone therapy for breast cancer is not the same as menopausal hormone therapy or hormone replacement therapy for women, where hormones are given to reduce the symptoms of menopause. Hormone therapy is most often used as therapeutic adjuvants to help reduce the risk of cancer coming back after surgery and neoadjuvant treatment. It is also used to treat cancer that relapses after treatment or has spread.

Several strategies have been developed to treat hormone-sensitive breast cancer, including the following:

  • Blocking the function of the ovaries. Examples of ovarian suppression medication is goserelin (Zoladex®) and leuprolide (Lupron®).
  • Blocking the production of estrogen: drugs called aromatase inhibitors can be used to block the activity of an enzyme called aromatase, which the body uses to make estrogen in the ovaries and other tissues. Examples of aromatase inhibitors anastrozole (Arimidex®) and letrozole (Femara®), both of which temporarily disable aromatase, and exemestane (Aromasin®), which permanently stops the enzyme activity.
  • Blocking the effects of estrogen: some types of drugs interfere with the ability of estrogen to stimulate the growth of breast cancer cells: Selective estrogen receptor modulator (SERM) binds to estrogen receptors, prevents estrogen from binding. Examples of SERMS is tamoxifen (Nolvadex®), raloxifene (Evista), and toremifene (Fareston®). Tamoxifen has been used for more than 30 years to treat hormone receptor-positive breast cancer. Others, such as antiestrogen drug fulvestrant (Faslodex®), works in a manner that is somewhat different for blocking the effects of estrogen.

How does hormone therapy?

     Most of the estrogen in a woman's body is made by the ovaries. After menopause, a smaller number are still made in the fatty tissues of the body, in which a hormone made by the adrenal gland is converted into estrogen.

     Estrogen receptor positive breast cancer makes against the hormone grows. About 2 out of 3 different types of breast cancer hormone receptor positive Hormone receptors containing estrogen (ER-positive cancers) and/or progesterone (PR-positive cancers). So, this reduces the amount of estrogen or hinder his work can reduce the risk of recurrence of breast cancer in early stage after the operation. Hormonal therapy drugs can also be used to help shrink or slow the growth of an advanced stage or metastatic breast cancer hormone receptor positive. This type of treatment is beneficial to the hormone receptor-positive breast cancer, but it did not help patients with hormone receptor negative tumors (both ER-and PR-negative).

      Hormone therapy prevents cancer cells get the hormones they need to grow and slow or stop the tumor growth hormone receptor positive. This is done in several ways.

     Some medications, such as hormone therapy, tamoxifen, attaches to receptors on cancer cells and block the estrogen so as not to attach to the receptors. Other therapies, such as aromatase inhibitors, lower estrogen levels in the body so that the cancer cells can't get that they need estrogen to grow.

What are the side effects of hormone therapy?

     Side effects of hormone therapy depends on the particular remedy or types of treatment. Your doctor will consider the benefits and risks of hormone therapy use and choose the best treatment for you.

     The taste is hot, night sweats, and vaginal dryness are common side effects of hormone therapy. Hormone therapy also disrupts the menstrual cycle in premenopausal women.

     Rare but serious side effect is of hormone therapy may include:

Tamoxifen
  • The risk of blood clots, especially in the lungs and legs
  • Stroke
  • Cataracts
  • Endometrial and uterine cancer
  • Pengeroposan bone in Premenopausal woman
  • Mood swings, depression, and loss of libido
  • In men: headache, nausea, vomiting, skin rashes, impotence, and a decrease in sexual interest
Raloxifene
  • The risk of blood clots, especially in the lungs and legs
  • The stroke in a specific subgroup
Ovarian suppression
  • Bone loss
  • Mood swings, depression, and loss of libido

Aromatase inhibitors

  • The risk of heart attack, angina, heart failure, and hiperkolesterolemia
  • Bone loss
  • Joint pain
  • Mood swings and depression
Fulvestrant
  • Gastrointestinal symptoms
  • Loss of power
  • Pain
    General changes strategy, in which patients using tamoxifen for 2 or 3 years, followed by aromatase inhibitors for 2 or 3 years, could provide a balance between the benefits and the dangers of both types of hormone therapy.

What should be feared?

      Certain drugs, including some prescription antidepressants, inhibits an enzyme called CYP2D6. This enzyme plays an important role in the use of tamoxifen by the body because it metabolizes, or divide, tamoxifen became the molecules, or metabolites, that are much more active than tamoxifen itself.

     The possibility that the SSRIS, inhibits the CYP2D6 tamoxifen metabolism, slow down and reduce its potential be a concern given that as much as a quarter of breast cancer sufferers experiencing clinical depression and can be treated with SSRIS. In addition, SSRIS are sometimes used to treat burn caused by hormone therapy. Other drugs which inhibit CYP2D6 include the following:

  • Quinidine, which is used to treat abnormal heart rhythms
  • Diphenhydramine, which is an antihistamine
  • Cimetidine, which is used to reduce stomach acid
      If you are prescribed tamoxifen, you should discuss the use of all other medications with your doctor. Consult your doctor if you have any issues.

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