If you or someone you know has been diagnosed with breast cancer, you've probably heard the term 'hormone therapy'. Hearing this name can sometimes make you a little scared and curious. What does it really mean? Is it dangerous? What does it do? Let's talk about all this in a very simple and friendly way today.
What is this hormone therapy?
Simply put, hormone therapy is a very effective treatment for some types of breast cancer. However, it is not given for all breast cancers. It is most important for cancers that are hormone receptor-positive (HR+) .
Think about it, there are two types of hormones that are naturally produced in our bodies called Estrogen and Progesterone. Some breast cancer cells are like a small plant. Just like a plant needs water, these cancer cells need these two hormones to grow and spread. We call this HR+ cancer. Roughly speaking, two out of three breast cancer patients have this type of cancer.
You may have seen things like this in your cancer report:
- Estrogen receptor positive (ER+)
- Progesterone receptor positive (PR+)
A cancer can be positive for one or both of these. ER+ is the most common type.
So what this hormone therapy does is very simple. It works in two main ways:
1. It blocks the hormones (estrogen and progesterone) that cancer cells need. It's like closing the water pipe to a plant.
2. Reduces estrogen levels in the body. This deprives cancer cells of the "nutrition" they need to grow and stops them from growing.
Importantly, hormone therapy for breast cancer is completely different from hormone therapy for menopausal symptoms, which works by increasing hormone levels. Cancer treatment does the exact opposite.
Why is this hormone treatment given?
Oncologists recommend this treatment in various situations.
- To reduce the risk of cancer: This treatment is given to people who are at high risk of developing breast cancer, for example, those with genetic mutations such as `BRCA1` and `BRCA2`, to prevent the development of cancer.
- In the case of DCIS: Control the growth of early stage breast cancer called `Ductal Carcinoma In Situ (DCIS).`
- Neoadjuvant Therapy: This treatment is given before surgery to shrink the tumor and make the surgery easier.
- Adjuvant Therapy: This is the most common type of therapy. It is given after surgery to remove the cancer, to prevent the cancer from coming back or to prevent cancer from developing in the other breast.
- When the cancer has spread (Metastatic Breast Cancer): If the cancer has spread to other parts of the body, this treatment is used to control the growth of those cells.
What are the main types of hormone therapy?
There are several types of hormone therapy. Your doctor will decide which treatment is best for you based on factors such as your age, whether you have gone through menopause, and the type of cancer. Let's look at the main types.
| Type of Therapy | How it works & Examples |
|---|---|
| Aromatase Inhibitors | These are mainly given to post-menopausal women. They stop the body from producing estrogen. Examples: Letrozole, Anastrozole, Exemestane. |
| SERMs (Selective Estrogen Receptor Modulators) | These drugs prevent the hormone estrogen from attaching to cancer cells. They can be used by both pre- and postmenopausal women . The most commonly used drug is Tamoxifen . |
| Ovarian Function Suppression | These are given to pre-menopausal women. They temporarily stop the production of estrogen from the ovaries. These are usually given as injections. Examples: Goserelin, Leuprolide. |
| SERDs (Selective Estrogen Receptor Downregulators) | These are similar to SERMs, but are more potent in blocking and destroying estrogen receptors. Example: Fulvestrant. |
How to get this treatment?
Most often, this treatment is given as a pill that you take daily. Some medications are also available as a liquid. Some, like medications that stop the ovaries from working, are given as an injection at your doctor's office once a month. Depending on your condition, this treatment may need to be taken for a long time, such as 5 or 10 years .
Are there any side effects to this treatment?
As with any treatment, some side effects may occur with this treatment. However , not everyone gets them, and not everyone feels them the same way . Some people may not experience any discomfort. The most common side effects are:
- Feeling tired and exhausted.
- Hot flashes.
- Joint and muscle pain or stiffness.
- Decreased sexual desire.
- Frequent mood swings.
- Nausea and vomiting.
- Vaginal dryness.
- Weight gain.
If you are experiencing any of these discomforts, don't be embarrassed or afraid to talk to your doctor . There are ways and medications that can help manage many of these side effects. So don't suffer alone.
Benefits and success of hormone therapy
One of the biggest advantages of this treatment is that it targets the most common type of breast cancer (ER+). Also, this treatment can be given in combination with other treatments such as chemotherapy and targeted therapy.
Research has clearly shown that hormone therapy significantly reduces the risk of cancer recurrence and prolongs the life of patients, making it a very successful and important treatment option.
Is chemotherapy or hormone therapy better?
This is like asking, "Which is better, a screwdriver or a hammer?" They are two different tools used for different purposes. Chemotherapy is a powerful treatment that kills rapidly dividing cells. Hormone therapy is a treatment that targets only hormone-dependent cancer cells. Sometimes you may need both, and sometimes you may only need one. Your doctor will decide which is best for you.
What if I don't like this treatment?
This is a very important question. Remember, your wishes and opinions are very important when it comes to treatment. Your doctor will recommend a treatment plan based on everything from the type of cancer you have, your overall health, your lifestyle, and your preferences.
If you have any fears, doubts, or dislikes about hormone therapy, don't hesitate to talk openly with your doctor about it . The most important thing is to talk about the benefits and drawbacks of the treatment, what to do if there are side effects, and whether there are other options, and make an informed decision that is in your best interest.
Take-Home Message
- Hormone therapy is a highly effective treatment for hormone (estrogen, progesterone)-dependent (HR+) breast cancer.
- This blocks the cancer cells from receiving hormones or reduces hormone levels in the body.
- This can be used before or after surgery to reduce the risk of cancer or to control cancer that has spread.
- Side effects are possible, but they can be managed. It is important to talk to your doctor about any discomfort.
- Discuss any questions or concerns you may have about treatment with your doctor and make the best decision together.
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