Hormones are like little messengers that coordinate various activities in our body. Imagine, these hormones are added to our blood by the glands in our body. Then, these hormones travel through the blood and give messages to each organ, such as "do this" and "stop this". In fact, our body cannot function properly without hormones. But sometimes, these good messengers also help some cancerous cells "grow well and divide quickly". That's when hormone therapy becomes important for us.
So how does this hormone treatment work?
Simply put, hormone therapy works by blocking the way cancer cells get the hormones they need to grow. This can be done in several ways. Your doctor will decide which method to use based on your condition.
- Stopping hormone production: Some cancer cells are able to stop producing hormones that help them grow. In some cases, the glands that produce these hormones may even need to be surgically removed.
- Blocking the action of hormones: In this method, even though the body produces hormones, the cancer cells are prevented from 'using' those hormones. Think of the cancer cell as a house, and the hormone as a key. This treatment is like closing the keyhole that fits the key. Then, even if the key is there, the door cannot be opened.
- Hormone replacement therapy: Sometimes, instead of the natural hormones in our bodies, we give our bodies a type of synthetic hormone made in a laboratory (Bioidentical hormones). These synthetic hormones cannot be used by cancer cells to grow. In other words, instead of the hormone that the cancer cells need, they give them a 'fake' hormone that they cannot use, but looks the same.
The important thing is that hormone therapy works by cutting off the 'fuel' supply to cancer cells. This can be done alone or in combination with other treatments such as surgery, chemotherapy, or radiation therapy.
What types of cancer is this treatment used for?
Hormone therapy is not used for all types of cancer. It is mainly used for hormone-dependent cancers. Some of them include:
- Prostate Cancer
- Breast Cancer
- Ovarian Cancer
- Uterine Cancer
Let's look at how hormone therapy affects each of these cancer types separately.
Hormone therapy for prostate cancer
Prostate cancer cells often need male hormones, especially testosterone, to grow. So the main goal of this treatment is to reduce the levels of these hormones or stop them from working. In some cases, surgical removal of one or both testicles, which produce testosterone, (orchiectomy) is even performed as part of this treatment.
If medications are used, the following medications can mainly be used.
| Drug type | How it works |
|---|---|
| Abiraterone acetate | This drug stops the production of male hormones (androgens) within prostate cancer cells. It is often prescribed for men who do not respond to other hormonal treatments. |
| LHRH agonists | These drugs signal the pituitary gland in our brain to stop releasing the hormone that tells the testicles to produce testosterone. Therefore, when the supply of testosterone stops, the cancer cells stop growing. |
| Antiandrogens | These work by preventing the testosterone produced in the body from binding to cancer cells. This means that even if the hormone is present, the cancer cell cannot benefit from it. |
Possible side effects
Some side effects may occur when taking this treatment. However, these do not occur in everyone and some people may not experience any side effects. It is best to talk to your doctor about this.
- Weight gain.
- Decreased or loss of sexual desire.
- Erectile dysfunction.
- Decreased bone density (Osteoporosis).
Hormone therapy for breast cancer
About eight out of ten breast cancers are hormone-dependent. Simply put, estrogen, a female hormone, helps these cancer cells grow. Think of the cancer cells as having little 'antennas' on their surface that can attach to hormones. We call these hormone receptors. When estrogen binds to these antennas, the cancer cell receives a signal to grow. We call these 'hormone receptor-positive' cancers.
Hormone therapy works by either lowering the body's estrogen levels or preventing the hormone estrogen from binding to cancer cells. This treatment is often given after surgery to reduce the risk of the cancer coming back.
| Drug type | How it works |
|---|---|
| Aromatase inhibitors | These drugs reduce estrogen levels in the body by blocking an enzyme called aromatase, which converts other hormones into estrogen. They are usually prescribed to women who have gone through menopause. |
| SERMs (Selective estrogen receptor modulators) | These drugs prevent the hormone estrogen from binding to receptors on breast cancer cells, so the cancer cells don't receive the signal to grow. |
| ERDs (Estrogen receptor down regulators) | These block the action of estrogen and reduce the number of estrogen receptors on cancer cells, making them less likely to bind to estrogen. |
Possible side effects
- Joint pain or stiffness.
- Fatigue.
- Nausea and vomiting.
- Weight gain.
- Decreased sexual desire.
- Hot flashes.
- Breast pain or swelling.
Hormonal treatments for ovarian and uterine cancer
Hormone therapy is used for some rare types of ovarian cancer and uterine cancer. In uterine cancer, a drug called progestin, which acts like the hormone progesterone, is most commonly used. This slows the growth of cancer cells.
Drugs such as LHRH agonists, tamoxifen, and aromatase inhibitors can also be used to treat both types of cancer.
Possible side effects
- Hot flashes.
- Vaginal dryness.
- Decreased bone density (Osteoporosis).
- Joint and muscle pain.
- Weight gain.
- Night sweats.
What are the treatment methods and risks?
Hormone therapy is given in two main ways. One is by taking pills or capsules by mouth (oral medications) . The other is by giving injections . This method varies depending on the type of treatment you are prescribed.
Like any cancer treatment, hormone therapy carries a risk of side effects. However, these vary greatly from person to person. Many factors affect this, including your overall health and the type of hormone therapy you receive.
The most important thing is to talk openly with your doctor about possible side effects and how to manage them before starting treatment. He or she will explain everything to you.
What are the benefits and success rates of hormone therapy?
The main benefit of hormone therapy is that it helps stop or slow down the growth of cancer. It is especially effective when used in combination with other treatments. Sometimes, it can be used to shrink a tumor before surgery and to prevent the cancer from coming back after surgery.
It's hard to say exactly how effective this treatment is. It depends on many factors, including the type of cancer you have, how far it has spread, your age, and your overall health. The best information about your condition can only be obtained from your treating doctor. So don't be afraid to ask him or her about this.
If you are receiving hormone therapy, it is very important to attend clinics and undergo tests on time as instructed by your doctor.
Take-Home Message
- Hormones are chemical messengers that control various functions in our body.
- Some types of cancer, such as prostate and breast, depend on hormones to grow.
- Hormone therapy works by cutting off the supply of hormones needed by cancer cells or blocking their function.
- This treatment is given as pills or injections.
- Side effects are possible, but they vary from person to person and can be managed.
- It is very important to talk openly with your doctor about any questions or concerns you have.
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