Has your doctor told you about a type of medication called SERMs or SERDs for treating breast cancer? Don't worry, these names may sound a bit complicated. Today, we'll talk in simple terms about what they are, how they work, and what you need to know about them. These are two very important types of drugs that can help us fight breast cancer .
What are SERMs? How do they work?
Simply put, SERMs (Selective Estrogen Receptor Modulators) are a type of medication that stops the growth of breast cancer cells. However, they only work on a specific type of cancer. That is the type of cancer known as Estrogen Receptor-Positive . Only 75% of the breast cancers seen in our country belong to this type.
Imagine, these cancer cells have little "antennas" on their surface. In medicine, we call these receptors . When the hormone estrogen in our body attaches to these antennas, the cancer cell receives a signal to "divide and grow more."
This is what SERMs do:
They go and block those antennas, that is, the receptors. Then the estrogen hormone has nowhere to come and attach itself. Because it doesn't receive the signal, the growth of cancer cells stops or is largely controlled.
The important thing is, it's called 'selective' for a reason. While these drugs block the action of estrogen in the breasts, they allow the hormone to function well in other parts of the body, such as the bones and uterus. That's what makes them special.
Types of SERMs and their uses
There are several main types of SERMs approved for breast cancer.
| Name of the drug | Main use cases |
|---|---|
| Tamoxifen |
|
| Toremifene | |
| Raloxifene |
So what are SERDs?
SERDs (Selective Estrogen Receptor Downregulators) are a type of medication that works a little more powerfully than SERMs. Like SERMs, they also block estrogen receptors. But in addition, SERDs reduce the number of receptors (downregulate) and also change the function of the remaining receptors, making them less effective.
There are currently two types of approved SERDs:
- Fulvestrant
- Elacestrant
These are mainly given for advanced, hormone receptor-positive and HER2-negative breast cancers. HER2-negative means that the cancer cells do not have a protein called HER2 on their surface that helps them grow.
How to use this medicine?
- SERMs: Most of these come in pill form. Your doctor will tell you to take 20mg to 40mg per day. If you are taking these drugs to prevent cancer from coming back, you will usually need to continue taking them for 5 to 10 years.
- SERDs: For example, fulvestrant comes as two injections . These two injections are given into a muscle in the buttock. They are given three times during the first month of treatment and then once a month thereafter.
In what situations are SERMs and SERDs given?
There are several situations in which your doctor may prescribe these treatments.
| Opportunity | Explanation |
|---|---|
| Before surgery (Neoadjuvant Therapy) | If your tumor is large, this medicine can be given before surgery to shrink it and make it easier to remove. |
| After surgery (Adjuvant Therapy) | This treatment is given to destroy any small cancer cells that may remain after surgery and to prevent the cancer from coming back. |
| For Late-Stage Cancer | If the cancer has spread to other parts of the body outside the breast, these medications can help control or slow its growth. |
| For Prevention | Even if you haven't had breast cancer, if your risk of developing it is higher than average due to factors such as genetics, SERMs may be prescribed to reduce that risk. |
What are the side effects and risks of these treatments?
Like any medication, these can have side effects. But not everyone gets them. It's important to be aware of the possible side effects.
Side effects of SERMs
The side effects often seen are similar to those experienced during menopause.
- Hot flashes
- Vaginal dryness, discharge, or light bleeding
- Night sweats
- Nausea
- Mood changes
Rare but serious side effects:
- Very small increase in the risk of uterine cancer
- Blood clots in the legs (Deep Vein Thrombosis, or DVT) or blood clots in the lungs (Pulmonary Embolism)
- Cataracts
- Thinning of bones in women before menopause
Side effects of SERDs
- Temporary pain at the injection site
- Nausea
- Bone, muscle, or joint pain
- Headache
- Laboriousness
- Hot flashes
Very important: SERDs can reduce the number of platelets, which help blood clot. This can slightly increase the risk of bleeding. Also, both of these medications are never recommended during pregnancy or if you are trying to get pregnant . It is essential to use a non-hormonal form of birth control while taking these medications and for at least a year after stopping treatment.
If your doctor suggests this treatment, talk to him/her about it. Don't be afraid to ask questions like, "What benefits will this medication give me?", "What side effects can I expect?", and "How long will I need to take this medication?"
Take-Home Message
- SERMs and SERDs are highly effective treatments for estrogen receptor-positive breast cancer. They block the action of the hormone estrogen, which is essential for the growth of cancer cells.
- Not all of these medications are suitable for everyone. Only your doctor can determine the best treatment for you based on the type of cancer, your age, and your health.
- Side effects may occur, but most of them are manageable. Talk to your doctor about any discomfort you experience, no matter how minor.
- It is very important to avoid pregnancy while taking this medication. Be sure to consult your doctor about appropriate birth control methods.
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