You may have battled breast cancer and are now taking medication that your doctor has prescribed to stop it from coming back. These medications are very important in reducing the risk of the cancer coming back. But sometimes they can cause minor side effects. Since these treatments usually last for a long time, like 5 years, sometimes 7-10, it is important to be aware of these side effects.
Why is this hormone therapy given?
Simply put, two out of three types of breast cancer grow because of the hormones estrogen and progesterone in our bodies. These are called "hormone-positive" cancers. Hormone therapy works by stopping these hormones from reaching the cancer cells.
Two main types of medication are used for this.
| Drug type | Functionality | Who is most often prescribed it? |
|---|---|---|
| Tamoxifen | This stops the estrogen hormone from entering the cancer cell. It's like sealing the gas tank of a car. Even if there is gas, the car won't start. | For women who have not gone through menopause. |
| Aromatase Inhibitors For example: Anastrozole, Exemestane, Letrozole | These medications reduce estrogen levels throughout the body, which means they reduce the amount of fuel that cancer needs. | For women who have gone through menopause. |
The important thing is that these treatments really do help save lives, so it's essential to manage side effects and continue treatment if they occur.
What are the most common side effects and what can be done about them?
Most people don't experience severe, life-threatening side effects. However, some minor discomfort may occur. If you experience any of these, be sure to tell your doctor .
Hot flashes and night sweats
This is common for women during menopause. Both of these hormone treatments can cause this condition.
What can be done?
- First, you can try making small lifestyle changes . Keep your bedroom a little cooler , and put on a fan.
- When dressing , wear several layers of clothing that you can take off if necessary, rather than wearing one thick layer at a time.
- Keep a bottle of cold water by your bed. Some people also like to keep an ice pack under their pillow.
- Some people also find relief through acupuncture .
If these things don't help and you're still experiencing discomfort, your doctor may prescribe medication. Some antidepressants (such as SSRIs, SNRIs) and gabapentin can help. However, some medications can interfere with the success of your cancer treatment, so it's important to discuss the best medication with your doctor.
Does your vagina feel dry? (Vaginal Dryness)
This is another common condition caused by a decrease in estrogen levels in the body.
What can be done?
- There are vaginal lubricants and moisturizers available at pharmacies.
- If these do not provide relief, your doctor may prescribe a topical estrogen cream that only works on the vaginal tissues and is not absorbed by the body. However , you should discuss with your doctor whether this is right for you and what the risks and benefits are.
Mood swings, depression, and sleep problems
Some people may experience mood swings, anxiety, depression, and sleep problems while taking this treatment.
What can be done?
- If you're feeling this way, don't hide it. Depression is a medical condition. There are effective treatments for it, such as medication and psychotherapy .
- Things like meditation, exercise like tai chi, and cognitive behavioral therapy (CBT) can be very helpful in calming the mind.
Joint Pain and Discomfort
The joint pain caused by this hormone treatment may not be relieved by painkillers like paracetamol and ibuprofen that we usually take for arthritis.
What can be done?
- There is evidence that acupuncture can relieve this pain.
- Regular exercise not only reduces joint pain, but also helps you get a good night's sleep.
Other things to consider
Bone loss
This is a side effect that can occur especially in people taking aromatase inhibitors, because these medications reduce estrogen levels throughout the body. Over time, bone density can gradually decrease, possibly leading to a condition called osteoporosis.
What can be done?
- It is important to take a vitamin D supplement and engage in weight-bearing exercise to strengthen bones.
- Your doctor will refer you for bone density tests (bone scans) at regular intervals.
- If the initial signs of bone thinning (osteopenia) begin to appear, your doctor may prescribe medications such as bisphosphonates, which control bone loss.
Serious but rare risks
There is a very small risk of blood clots in people taking tamoxifen. If you have a history of blood clots or if someone in your family has had one, you should tell your doctor before taking this medicine.
Also, there is a very small risk of uterine cancer in postmenopausal women taking tamoxifen. This is why aromatase inhibitors are often prescribed to women of that age.
Will changing the medication provide relief?
Yes. Sometimes, if the side effects of one drug are severe, switching to another may provide relief. For example, there are three types of aromatase inhibitors. Because they have slight differences in how they work, someone who doesn't respond well to one type may be able to tolerate another.
But this decision is not one you make alone. Talk to your doctor about any discomfort you are experiencing, and he or she will decide to change your medication if necessary.
Whatever the case, never stop taking your medication without talking to your doctor. Cancer clinics have many ways to help you manage these side effects. If you stop taking your medication on your own, you may increase the risk of your cancer coming back. So always talk openly with your doctor.
Take-Home Message
- Hormonal therapy for breast cancer is a highly effective treatment that prevents the cancer from coming back and saves lives.
- Side effects are common, often not serious, and can be managed.
- If you feel any discomfort, talk to your doctor about it openly. There are solutions for that.
- Simple lifestyle changes (exercise, diet, staying in a cool environment) can alleviate many side effects.
- Do not stop taking hormone therapy for any reason without medical advice. It is very risky.
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