Hormone therapy is a powerful tool in the treatment of certain types of breast cancer. For women with hormone receptor-positive breast cancer, this therapy can help reduce the risk of recurrence, improve survival rates, and provide peace of mind during recovery. At Genesis Lifestyle Medicine, we understand the complexities of cancer treatment and are dedicated to offering hormone therapy plans to help patients achieve the best possible outcomes. This article will explore how hormone therapy works, its benefits, and what you can expect.
What is hormone receptor-positive breast cancer?
Hormone receptor-positive breast cancer is a type of cancer that grows in response to hormones like estrogen and progesterone. These cancers have receptors (proteins) that attach to these hormones, stimulating cancer cells to grow and divide. Roughly two-thirds of breast cancers are classified as hormone receptor-positive. This means that treatments targeting these hormonal interactions can be highly effective in preventing the cancer from returning.
How hormone therapy works
Hormone therapy, also known as endocrine therapy, blocks or reduces the production of estrogen and progesterone, effectively cutting off the hormones that can stimulate cancer growth. Hormone therapy aims to prevent cancer cells from getting the signals they need to grow. Unlike chemotherapy, which targets all rapidly dividing cells, hormone therapy specifically targets hormone-sensitive breast cancer cells, resulting in a more focused treatment.
Types of hormone therapy
There are three main types of hormone therapies available for cancer patients:
- Selective estrogen receptor modulators (SERMs): These drugs, such as tamoxifen, block estrogen receptors on breast cancer cells, preventing the hormone from promoting cancer cell growth. SERMs are typically prescribed to women who are pre-menopausal or who have recently gone through menopause.
- Aromatase inhibitors (AIs): Drugs like letrozole, anastrozole, and exemestane belong to this category. AIs work by reducing the production of estrogen in the body, particularly in post-menopausal women, by inhibiting the enzyme aromatase, which converts other hormones into estrogen. Since estrogen is no longer produced by the ovaries after menopause, AIs can be highly effective in reducing estrogen levels.
- Selective estrogen receptor degraders (SERDs): These drugs, such as fulvestrant, bind to estrogen receptors and promote their breakdown, effectively reducing the number of receptors available for estrogen to attach to. SERDs are often used in advanced breast cancer cases or when other hormone therapies have failed.
When is hormone therapy recommended?
Hormone therapy can be used at various stages of breast cancer treatment. It is often recommended in the following scenarios:
- Adjuvant therapy (after surgery): After the surgical removal of a breast tumor, hormone therapy can help reduce the risk of cancer recurrence. Taking hormone therapy for at least five years after surgery can significantly lower the chances of the cancer coming back, especially in hormone receptor-positive cases.
- Neoadjuvant therapy (before surgery): In some cases, hormone therapy may be used before surgery to shrink the tumor, making it easier to remove. This is helpful for patients with larger tumors or those who want to preserve as much breast tissue as possible.
- Treatment for recurrent or metastatic cancer: If breast cancer returns or spreads to other parts of the body, hormone therapy may slow its growth and help manage symptoms. This long-term treatment option may be combined with other therapies, such as targeted drugs.
Benefits of hormone therapy in preventing cancer recurrence
The main benefit of hormone therapy is its ability to significantly lower the risk of breast cancer recurrence. Research has shown that patients who take hormone therapy after surgery have a reduced likelihood of their cancer returning. For example, taking tamoxifen for five years after surgery has been found to lower the risk of cancer recurrence by nearly 50% in women with hormone receptor-positive breast cancer.
Hormone therapy can also improve survival rates, as it reduces the risk of cancer spreading to other parts of the body. For patients with advanced or metastatic breast cancer, hormone therapy can help slow the progression of the disease and improve quality of life.
Potential side effects of hormone therapy
Like all treatments, hormone therapy can come with side effects. While these vary depending on the specific medication and individual patient factors, some common side effects include:
- Hot flashes and night sweats: These are common, especially when using SERMs or AIs, and can sometimes be managed with lifestyle changes or additional medications.
- Bone and joint pain: AIs are known to cause joint stiffness and bone pain. Regular exercise, physical therapy, and certain medications can help manage these symptoms.
- Vaginal dryness and mood swings: Hormonal changes can lead to discomfort and mood variations, which should be discussed with your healthcare provider.
- Increased risk of blood clots: SERMs like tamoxifen may slightly increase the risk of blood clots, particularly in post-menopausal women.
How long is hormone therapy needed?
The duration of hormone therapy depends on the type of cancer, the risk of recurrence, and the patient's menopausal status. Most patients are advised to continue hormone therapy for at least five years. However, for those at a higher risk of cancer returning, extended therapy (up to 10 years) may be recommended. Longer durations of therapy can provide greater protection against recurrence, although it may also lead to more side effects.
In conclusion, hormone therapy plays a crucial role in the prevention of breast cancer recurrence for those with hormone receptor-positive tumors. By blocking or reducing the production of hormones that can stimulate cancer growth, hormone therapy offers an effective way to reduce the risk of cancer returning after surgery. While it is not without side effects, the benefits of this treatment often outweigh the risks for many patients. For more information don't hesitate to contact us with any questions you may have.