Hormone therapy can be used to shrink or eliminate cancer cells. Your physician will perform a hormone receptor test to examine what hormonal treatment options might work best to affect the tumor.
If the cancer cells are receptive to hormones, you may be placed on hormone therapy to shrink or eliminate the tumor. This can work for breast and prostate cancers that are sensitive to hormones.
Prostate cancer can be treated with androgen deprivation therapy, which cuts off the supply of testosterone.
Breast cancer may be treated by therapy that blocks hormones from attaching to cancer cells. It may also prevent your body from producing some types of hormones.
When is hormone therapy appropriate?
Hormone therapy may be attempted before other treatments, such as chemotherapy, radiation or surgery. This is called neoadjuvant treatment. Hormone therapy may shrink or prevent the advance of the disease while a more specific treatment plan is developed.
If hormone therapy is given after other forms of treatment are used, it is adjuvant treatment. The goal of hormonal therapies, in this case, is to improve the chance of a cure.
In advanced prostate cancers, it may be used to shrink the tumor and mitigate symptoms. It also may be used to reduce the risk or re-occurrence or to make external radiation beam therapy more effective.
In breast cancer, hormone therapy can prevent cancer from returning, slow or prevent it from spreading, or reduce the size of a tumor before surgery.
Treatment of advanced prostate cancer with hormone therapy
Advanced prostate cancer generally refers to cancer that has spread to areas remote to the prostate. Prostate cancer can spread to lymph nodes and often has a predilection to spread to the bone. Tests used to determine if spread has occurred generally include CT scans and bone scans.
For more than 60 years, the most effective treatment for advanced prostate cancer has been hormone therapy. This treatment was discovered by physicians who recognized that the prostate develops in men due to the presence of the male hormone: testosterone. They tested initially whether treatments that caused testosterone levels to fall to very low levels would control prostate cancer. Their hunch was correct: Men with widespread prostate cancer experienced remarkable regression of their tumors. These physicians and scientists won the Nobel Prize for this work.
In practice, hormone treatment today generally involves an injection, usually every three to four months.
It soon became evident, however, that after a variable period of time, the prostate cancer cells became resistant to hormone treatment. Cancer would begin to grow again and most men with this stage of disease ultimately died from cancer.
Over the past several years, major advances have occurred as new drugs have been developed to treat advanced prostate cancer. While in 2000, for example, hormone therapy was the only treatment available, at the present time there are many new therapies. Just a few of these include:
Chemotherapy: Two chemotherapy drugs are currently used for advanced prostate cancer – docetaxel and cabazitaxel. Both of these drugs have been demonstrated to significantly prolong the lives of men with prostate cancer.
Advanced Hormone Therapies: Two new hormonal therapies – abiraterone and enzalutamide – have been developed that build upon the effects of standard hormone therapies. Both of these drugs, given as a pill, have been demonstrated to significantly prolong the lives of men with prostate cancer.
Immunotherapy: New therapies are available and under development that harnesses the body’s own immune system to fight prostate cancer cells.
Clinical trials: At the UT Heatlh Cancer Center, in addition to the therapies listed above, a broad range of new agents have been made available to patients with advanced prostate cancer.
Types of hormone therapy
What are the side effects?
Each person reacts differently to hormone therapy. Possible side effects include:
- Hot flashes
- Nausea or vomiting
- Loss of sexual desire
- Loss of appetite
- Weight gain
- Skin rashes
- Joint and muscle pain
- Bone thinning
Women also may experience
- Vaginal spotting
- Increased fertility
- Irregular menstrual periods
- Vaginal dryness or itching
- Vaginal discharge
Men also may experience
- Breast enlargement
- Loss of muscle mass
- Memory problems
Less common side effects include
- Blood clots
- Endometrial or uterine cancer
Discuss with your health care professionals about how hormone therapy might affect you, what can be done to mitigate side effects and the possible long-term effects of hormone therapy on your body.