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Hormonal Therapy as a Treatment for Breast Cancer
The link between hormones and breast cancer has been known for many years. Certain hormones help some breast tumors grow, and certain hormones block the growth of some tumors.
Doctors once treated some breast cancers by removing the glands which make certain hormones. This was done to block the effects of hormones or lower their levels in the blood. Now, drugs instead of surgery are used to get the same results.
Hormones helps control certain organs and tissues in the body. The endocrine system contains glands that release or control hormones.
The endocrine system includes:
· The ovaries, which release hormones called estrogen and progesterone.
· The adrenal glands, which release hormones called androgens. Some androgens are converted to estrogen after menopause.
· The pituitary gland, which controls the endocrine glands and the release of hormones.
Hormonal Therapy as a Treatment for Breast Cancer
Doctors consider many factors when deciding whether or not to treat breast cancer with hormonal therapy. Not all breast tumors respond well to hormonal therapy, so it is important to determine how well they will respond before treatment is given.
Tests called hormone receptor assays may be done on a sample of your tumor. These tests help determine how much a tumor depends on hormones for growth, and help predict how well it will respond to hormone therapy. Usually, tumors that test positive for hormonal receptors grow more slowly and may be controlled by hormonal therapy. About two-thirds of all breast tumors are estrogen receptor, or ER, positive. Tumors may also be progesterone receptor, or PR, positive.
Women who are older or who have gone through menopause usually have a greater chance of responding to hormonal therapy.
Many women whose tumor has metastasized, or spread, can be treated with hormonal therapy. Usually the longer a women has been free of disease before the metastasis, the better the chance that hormonal therapy will be effective. Women whose tumor has metastasized to soft tissue or bone have a somewhat higher chance of responding to hormonal therapy.
It is very important that you take your pills exactly as the doctor prescribed. Be sure that you don’t run out of pills.
Drugs used most often in hormonal therapy include:
· Megace (Megestrol)
Other drugs used less often include:
· Danocrine (danozol)
Side Effects and How to Cope With Them
Hormonal therapy has fewer side effects compared with chemotherapy. It can often be given over a long period of time with few problems. When one drugs stops working, it can often be changes to another drug. Hormone-sensitive tumors may respond to three or more different drugs over a period of time.
The side effects are usually much milder compared to those from chemotherapy. Women on hormonal therapy can often carry on their usual activities and have less interruption to their daily routines.
Keep in mind that the type and severity of side effects depends largely on what drug you are taking. Also, each woman may have a slightly different experience with side effect, even from the same drug.
Listed below are common side effects related to the drugs given in hormonal therapy:
· Mild nausea and vomiting
· Change in appetite
· Weight gain
· Fluid retention
· Skin rash
· Pain at the tumor site
· Irregular menstrual periods
· Vaginal bleeding
· Hot flashes
· Vaginal dryness
· Mood changes
· Changes in hair growth
More serious, but rare, side effects may also include the following :
· Greater chance of having blood clots
· Raised levels of calcium in the blood (more common in patients with bone metastasis)
· Lowered platelet count
Report any side effects promptly to your doctor or nurse. Also report any other changes you notice besides the side effects listed here.
Some of these side effects are quite subtle and may not appear to be caused by hormonal therapy. Such side effects include sleeplessness, changes in sexuality, mood changes, and weight changes. While they may not seem serious, these side effects can be uncomfortable and can becomes a source of stress.
Here are a few tips for dealing with some side effects:
· Nausea– Take pills with milk or after eating; don’t take them on an empty stomach.
· Weight changes or change in appetite- Eat a variety of foods from the four major food groups, and maintain a level of activity that is comfortable for you. Ask your doctor for advice before beginning any new diet or exercise.
· Pain– Be sure to take any pain medicine as prescribed.
· Vaginal dryness- To relieve vaginal dryness, try a vaginal lubricating product such as Replens. Two other products, Lubrin and astroglide, can also be used for lubrication before intercourse. All products can be bought at drugstores without a prescription. If these products are not on the shelf, ask the pharmacist to order them for you.
· Hot flashes– let your doctor or nurse know if any side effect causes problems or discomfort. Medicine that does not contain hormones may be available to relieve hot flashes.
· Emotional stress or mood changes- Take advantage of support and self-help groups for women with breast cancer. Such groups may be helping in finding ways to deal with some problems related to treatment, or just in finding someone to talk to.
Ask your nurse or social worker for information on support groups available in your area. They can also give you a copy of A community Resource Guide for Persons with Breast Cancer, that lists information about support groups and other helpful services.
· Changes in sexuality – some ideas for coping with changes in your sexual activity can be found in books.
Ask for the booklet, Questions and Answers about Sexuality for Women with Breast Cancer. All these publications suggest that it is healthy to try new solutions when the things change.
Try to keep a positive attitude and enjoy each day one at a time. A positive outlook can help you cope with the challenges you may face.
Name of Medication
Number of Pills to take (dosage)
Many patients recommend using a seven day pill box, marked with the days of the week, for keeping track of their medication. This type of pill box is inexpensive and can be bought at your local pharmacy.