We understand the fear, shock, and many questions that arise when you find out you have breast cancer. But the most important thing at this time is to be properly informed. Because, not all breast cancers are the same. There are treatments specifically targeted for some types of cancer. Well, one treatment that has been used successfully for many people is hormone therapy . Let's talk about it simply today.
What is hormone therapy? Is it right for everyone?
Simply put, certain hormones in our bodies help some breast cancer cells grow. Specifically, two hormones called estrogen and progesterone.
Think of cancer cells as little houses. Some cancer cells have special 'doors' (receptors) that allow these hormones to enter. We call cancers that have these doors hormone receptor-positive . Doctors, you may have noted this in your report as ER-positive (estrogen-doors) or PR-positive (progesterone-doors).
Hormone therapy works for cancers that have these hormone gates. These treatments either close those gates or reduce the production of those hormones in the body. This deprives the cancer cells of the "nutrition" they need, causing them to stop growing or die.
The important thing is, if your cancer cells don't have these hormone receptors, that is, if they are hormone receptor-negative , these hormone treatments won't work. Doctors recommend other treatments for such people.
What are the main types of hormone therapy?
There are several main types of hormone therapy used for breast cancer. Your doctor will choose the most suitable medication for you based on many factors, including your age, the type of cancer, and whether you have gone through menopause. Let's look at two main types.
| Type of treatment | Who is it mainly given to? | Side effects to know |
|---|---|---|
| Tamoxifen | For women of any age (pre and post menopause). A remedy that has been used successfully for decades. | A slightly increased risk of uterine cancer, blood clots in the legs and lungs, stroke, cataracts, and hot flashes. |
| Aromatase Inhibitors (AIs) Ex: Anastrozole, Letrozole | Mainly for women after menopause. | Weakening of bones (Osteoporosis) and risk of fractures, joint and muscle pain, memory problems, and a slightly increased risk of heart disease. |
A little more about Tamoxifen
This is a pill that you take daily. Research has shown that taking it for several years, usually about 5 years, significantly reduces the risk of cancer coming back and the risk of developing new cancers.
However, you should also be aware of the side effects that we discussed in that table. Especially the risk of uterine cancer. That is why it is mandatory to have regular pelvic exams while taking this medication. Also, if you experience any unusual vaginal bleeding, you should tell your doctor immediately.
A little more about Aromatase Inhibitors (AIs)
This type of medication works by stopping the production of the hormone estrogen in women after menopause. This deprives cancer cells of the hormone they need to grow.
The main risk of this medication is osteoporosis , which is the risk of bones becoming weak and easily broken. For this reason, your doctor will likely do a bone density test before you start taking this medication and while you are taking it. He or she may also recommend that you take calcium and vitamin D supplements.
Other and advanced treatments
In addition to the main types of medications mentioned above, there are other types of medications that are used, especially when the cancer has spread to other parts of the body (advanced or metastatic).
For example, there are drugs like `Fulvestrant (Faslodex)` and `Toremifene (Fareston)`. In addition, there are many advanced drugs called `Targeted Therapy` today. `Palbociclib (Ibrance)`, `Abemaciclib (Verzenio)`, `Alpelisib (Piqray)` are examples of such drugs. These work by targeting specific proteins that help cancer cells grow. These are often given to patients in combination with the aforementioned hormone therapy.
All of these treatment decisions are made based on your condition, the type of cancer, your age, and your overall health. So don't be afraid to discuss any questions you have with your doctor .
Special treatment for those who have not gone through menopause (Ovarian Ablation)
If you are not yet menopausal, meaning you are having regular periods, your body's main estrogen hormone is produced by your ovaries. So, for someone with ER-positive cancer, your doctor may decide to stop these ovaries from producing estrogen. This is called ovarian ablation/suppression .
There are several ways to do this:
- Surgical removal of the ovaries : This is a permanent method.
- Radiation therapy to the ovaries: This can also permanently stop the function of the ovaries.
- Medication to temporarily stop the ovaries from working: Medications called `(LHRH) agonists` (often injections) are used for this. As long as you take these medications, your ovaries will not produce hormones.
Research has shown that along with suppressing these ovaries, hormone therapy like tamoxifen can achieve very good results.
Take-Home Message
- Hormone therapy is not a treatment for all breast cancers. It is only given to hormone receptor-positive (ER/PR-positive) cancers.
- The treatment that is most suitable for you (e.g. Tamoxifen or Aromatase Inhibitor) will be determined by your doctor, based on your age and health condition.
- All of these medications can have side effects. Don't be afraid of them, just be aware of what they are. If you experience any unusual symptoms, tell your doctor immediately.
- It is very important to have the tests prescribed by the doctor on time during treatment.
- Be sure to openly discuss your fears, doubts, and questions with your medical team. This will be a great strength in your healing journey.
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