How Hormone Therapy Works
Hormones are chemicals in the body that regulate various functions, including cell growth. In certain cancers, hormones promote the growth of malignant cells. Hormone therapy works in two main ways:
- Lowering hormone levels in the body to reduce the fuel source for cancer cells
- Blocking hormone receptors on cancer cells, preventing the hormone from attaching and stimulating growth.
Types of Hormone Therapy
For Breast Cancer:
Estrogen receptor-positive (ER+) and progesterone receptor-positive (PR+) breast cancers rely on estrogen and progesterone to grow. Hormone therapy for breast cancer works by blocking these hormones.
- Tamoxifen: A selective estrogen receptor modulator (SERM) that blocks estrogen receptors on breast cancer cells, making it harder for the hormone to stimulate growth. Tamoxifen is commonly used in both premenopausal and postmenopausal women.
- Aromatase Inhibitors (AIs): Drugs like anastrozole and letrozole work by reducing estrogen production in postmenopausal women. AIs are often used after menopause because the ovaries stop producing estrogen, and these drugs block the small amounts produced in other tissues.
- Ovarian Suppression: In premenopausal women, drugs like goserelin may be used to stop the ovaries from making estrogen temporarily.
For Prostate Cancer:
Prostate cancer often grows in response to androgens (male hormones like testosterone). Hormone therapy for prostate cancer, also called androgen deprivation therapy (ADT), works by reducing the levels of testosterone or blocking its effect on prostate cancer cells.
- LHRH Agonists: Drugs like leuprolide or goserelin lower testosterone levels by stopping the production of the hormone.
- Anti-androgens: Drugs like flutamide or bicalutamide block the action of testosterone on prostate cancer cells.
- Orchiectomy: Surgical removal of the testicles, which drastically reduces testosterone levels.
When Is Hormone Therapy Used?
Hormone therapy can be used in several scenarios, depending on the type and stage of cancer:
- Adjuvant Therapy: After surgery or radiation, hormone therapy helps reduce the risk of cancer returning by eliminating remaining hormone-dependent cancer cells.
- Neoadjuvant Therapy: Before surgery, hormone therapy can shrink tumors, making them easier to remove.
- Metastatic Cancer: In advanced cancer that has spread to other parts of the body, hormone therapy can help control the growth of cancer.
- Prevention: In some high-risk patients, hormone therapy may be used to lower the chance of developing hormone-sensitive cancers.
How is Anemia Diagnosed?
A simple blood test can measure your hemoglobin levels. If you have lupus and are experiencing symptoms of anemia, your doctor may order this test to determine if low hemoglobin is contributing to your symptoms. If you are diagnosed with anemia, treatment may include dietary changes, supplements, or adjustments to your lupus medication.
Benefits of Hormone Therapy
- Reduces Recurrence Risk: Hormone therapy is especially effective in lowering the risk of cancer coming back in hormone-sensitive cancers like breast and prostate cancer.
- Prolongs Survival: In patients with advanced cancer, hormone therapy can slow disease progression and improve quality of life.
- Shrinks Tumors: Before surgery, it can shrink tumors, making surgical removal easier.
Side Effects of Hormone Therapy
While hormone therapy can be effective, it also comes with potential side effects due to hormonal changes:
- Hot Flashes: Common in both men and women receiving hormone therapy.
- Bone Loss: Long-term hormone therapy can lead to osteoporosis, particularly in postmenopausal women or men on androgen deprivation therapy.
- Weight Gain and Fatigue: Hormone therapy can cause weight gain and fatigue as the body's metabolism adjusts to changes in hormone levels.
- Mood Swings and Depression: Emotional and psychological effects can occur as a result of hormone fluctuations.
- Sexual Dysfunction: Reduced libido and sexual function are common side effects, particularly in prostate cancer patients.
Ongoing Research and Clinical Trials
Researchers are continually studying hormone therapy to improve its effectiveness and reduce side effects. Ongoing clinical trials are exploring new drugs and combinations with other treatments like chemotherapy and immunotherapy to enhance outcomes.