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Hormonal therapy for breast cancer

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Overview of HT of breast cancer/ What is it.

At the outset, we tell you that hormone therapy should not be confused with hormone replacement therapy. Hormone therapy is a treatment that inhibits the hormones that help breast cancer cells to multiply.

How does it work?

The two female hormones, estrogen and progesterone can trigger growth of some breast cancer cells. So, hormonal therapy for breast cancer is directed against these two hormones. The modes of action are:

  • If the cancer cells have estrogen or progesterone receptors, then the drugs can block the hormones from attaching to the receptors. Thereby stopping growth of the cancer cells.
  • The drugs also aim lower the level of hormone in the so that the cancer cells do not receive the hormone they need to grow.
  • The drugs cause ovarian shutdown i.e.  turns off hormone synthesis from the ovary

Some common drugs used in the treatment are Tamoxifen, Aromasin, Fareston, etc.

Types of HT for Breast Cancer

  • Aromatase inhibitors- blocks the enzyme aromatase which covert androgen to estrogen. Thus very less or no estrogen is available to hormone-receptor-positive breast cancer cells. It’s given to postmenopausal women
  • SERMs- Selective estrogen receptor modulators sit on estrogen receptors of cancer cells, to block their access to estrogen
  • ERDs- Estrogen receptor downregulators modify the shape of breast cancer cell estrogen receptors, thereby affecting their function.

Who can undergo hormonal therapy for breast cancer?

  • Have hormone receptor-positive breast cancer cells
  • Are at high risk of having breast cancer
  • Had non-invasive breast cancer (DCIS) and need to prevent recurrence
  • Have invasive breast cancer and cannot undergo surgery
  • With a recurred breast cancer

How to prepare?

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Your doctor will determine if you are the right candidate to undergo a hormonal therapy. If yes, then he would decide the most suitable option for you.

Make sure you clarify all doubts in your mind. Some points

  • Let your doctor know if you are planning for pregnancy
  • Make sure you know the benefits and the side effects of the treatment
  • The cost involved in the therapy

What to expect?

The hormonal pill is taken orally, usually once in a day after the surgery. This is known as adjuvant therapy for early-stage breast cancer. This is also a preventive measure for breast cancer.

It can also be prescribed after completion of chemotherapy or along with radiation therapy to treat metastatic breast cancer.

Hormone therapy may also be given before operating on a breast tumour for the purpose of shrinking it. This technique is known as neoadjuvant treatment of breast cancer.

The duration, dose and the type of pill prescribed to you will depend on your medical condition and age.

Side effects of hormone therapy for breast cancer

Different drugs have their own individual side effects. However, some common ones are:

  • Headache, nausea, vomiting
  • Vaginal dryness
  • Low sexual drive
  • Can affect fertility
  • Risks of blood clots, especially in legs and lungs
  • Risk of stroke, cataract and uterus cancer
  • Mood swings, depression, hot flashes, headache

Hormone therapy is expensive, but it is highly effective. Your doctor (oncologist) will check your health thoroughly and then only go ahead with the treatment. Once you have started the therapy, you need to complete it.

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Written by: Saptakee sengupta
Date last updated: January 17, 2015