What is hormone therapy?
Hormones are chemicals produced by various glands in the body. They help manage the functions of certain cells but can also influence the growth of certain cancers. Hormones that can stimulate cancer include:
- Estrogen
- Progesterone
- Testosterone
Hormone therapy, also called endocrine therapy, works by blocking hormones or by altering the effects of hormones that can stimulate cancer. It’s primarily used to treat cancer by slowing its growth or reducing the likelihood of recurrence. It’s also used to relieve symptoms in cases where other treatments like surgery or radiation are not options.
Hormone therapy may involve medications that modify hormone function or surgeries that remove hormone-producing organs like the ovaries or testicles. At Penn Medicine, our gynecologic oncologists, urologists, and medical and surgical oncologists are experienced in administering hormone therapy as part of an overall treatment plan for cancer or other conditions.
Types of hormone therapy for cancer treatment
Hormone therapy is not appropriate for all types of cancer. It’s often used to treat adrenal cancer, uterine cancer, ovarian cancer, prostate cancer, and breast cancer. The type of hormone therapy medications used will depend on the type of cancer you have. Penn Medicine uses hormone therapy medications to treat breast cancer and prostate cancer.
Tamoxifen is a medicine that works by blocking estrogen from binding to breast cancer cells that have estrogen receptors. Roughly two thirds of all breast cancers have estrogen receptors. When estrogen binds to these receptors, it stimulates those cells to grow. Other hormonal therapy medications for breast cancer include aromatase inhibitors, which block estrogen production using an enzyme called aromatase, and fulvestrant, a drug that interferes with the effects of estrogen on the estrogen receptor itself.
Hormone therapy treatments for prostate cancer help lower the testosterone level or block how testosterone interacts with cancer cells. Hormonal therapy medications like leuprolide, bicalutamide, and abiraterone help prevent prostate cancer cells from growing. These medications are important in treating advanced (metastatic) prostate cancer and are also used in combination with radiation for certain patients.
Hormone therapy for noncancerous conditions
By replacing hormones in your body, hormone therapy can be an effective treatment for conditions other than cancer, including hypothyroidism, osteoporosis, and menopause.
Thyroid hormone therapy uses synthetic hormones to boost low levels of natural thyroid hormones in the body. It’s commonly used to treat hypothyroidism, a condition where the thyroid gland has stopped producing enough hormones naturally. Hormone therapy may also be used to control the growth of an enlarged thyroid gland or to supplement natural hormones if the thyroid has been removed.
When estrogen levels decrease during menopause, some women may experience bone loss. Hormone therapy can help manage osteoporosis, a disease that causes bones to become weak and brittle. In women with menopause, hormone therapy typically involves taking a combination of estrogen and progestogen (a synthetic form of progesterone), the primary hormones in the female reproductive system. Estrogen can help women who experience significant symptoms of menopause, like severe hot flashes, and protect against bone loss, reducing the risk of fractures.
As menopause approaches, the body produces less estrogen. Lower estrogen levels can lead to uncomfortable symptoms such as hot flashes, night sweats, vaginal dryness, mood swings, and insomnia. Hormone therapy for menopause, also referred to as hormone replacement therapy (HRT), is a treatment designed to manage menopause symptoms by replenishing the body’s declining estrogen levels.
Who is a candidate for hormone therapy?
Hormone therapy is typically recommended for patients who have hormone-sensitive cancers or types of cancer whose growth is driven by hormones. If you have any of the following cancer types, your doctor may include hormone therapy as part of your treatment plan.
- Hormone receptor-positive breast cancers
- Prostate cancers that rely on testosterone to grow
- Ovarian cancers with hormone-sensitive tumors
- Certain advanced or metastatic cancers
It may also be used to treat noncancerous conditions, including:
- Hypothyroidism
- Osteoporosis
- Menopause
What to expect when starting hormone therapy
Hormone therapy can be administered orally, by injection, or through surgery. Your doctor will talk to you about which method will be most effective for your individual situation.
Your doctor may prescribe pills, capsules, or liquid hormone medications to take by mouth. These are typically taken at home, and the dosage and frequency will vary depending on the specific drug prescribed and the type of cancer you have.
Certain hormone therapies are administered through injections, which can be given into a muscle (like the arm, leg, or hip) or just under the skin in the abdominal area. The frequency of injections will depend on the drug used and the cancer type. Hormone therapy injections are typically given at a treatment center or doctor’s office, though some patients or caregivers may be trained to administer them at home.
Surgery can also serve as a form of hormone therapy. Hormone therapy for men with prostate cancer may involve removing the testicles (orchiectomy) while hormone therapy for women with breast cancer may require removal of the ovaries (oophorectomy). Both surgeries can help reduce the body’s hormone production and slow cancer growth. If your doctor recommends surgery, they will share instructions to help you prepare for the procedure.
Recovering after hormone therapy
When you receive hormone therapy, you may experience side effects that continue throughout and after your treatment. You can take steps to help manage these side effects and support your body during hormone therapy:
- Maintain a healthy, balanced diet
- Ensure you get a good amount of sleep
- Limit your alcohol consumption
- Avoid tobacco and smoking
- Stay active with regular exercise
Hormone therapy can also impact your sex life. These changes may continue throughout your treatment. While sexual function may gradually return after your treatment ends, it can take up to a year, and some may not experience improvement. During your treatment, having strong social and emotional support can be very helpful. Your care team will closely monitor your health and work with you to manage any side effects. They can suggest ways to ease symptoms and maintain your overall well-being.
Side effects of hormone therapy
Hormone therapy may have different effects depending on the type of treatment you receive and your individual medical history. Your doctor will discuss any potential side effects with you and explain the benefits and risks to help you make informed decisions about your care.
If you are receiving hormone therapy for prostate cancer, you may experience:
- Hot flashes
- Reduced sexual desire
- Erectile dysfunction
- Fatigue
- Weight gain
- Memory issues
- An increased risk of other health problems, including fractures due to bone loss
If you are receiving hormone therapy for breast or ovarian cancer, you may experience:
- Hot flashes
- Vaginal discharge, dryness, or irritation
- Reduced sexual desire
- Fatigue
- Nausea
- Muscle and joint pain
- An increased risk of fracture due to bone loss
- An increased risk of stroke, blood clots, cataracts, heart disease, and developing other cancers
Why choose Penn Medicine for hormone therapy
Your Penn Medicine care team provides the most appropriate hormone therapy treatment for your individual situation. When used to treat cancer, hormone therapy may be administered as a standalone treatment or in combination with other treatments. We tailor treatment plans to your specific needs based on your cancer type, stage, and overall health.
Penn Medicine has a team of hormone therapy experts who collaborate to ensure the best possible health outcome for you. This includes nurse navigators and oncology specialists who can answer your questions and provide streamlined access to support programs and services that can help you and your family throughout your treatment journey.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.
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