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8. Hormone (Endocrine) Therapy

Hormones are like messengers: along with the system of nerves, they regulate everything our bodies automatically do. Hormones are made in endocrine glands (such as the thyroid and adrenal glands) and they work by attaching to receptors on target cells. There are many hormones, including oestrogen and progesterone which control a woman’s menstrual cycle, for example.

Hormone therapy is a drug treatment which aims to prevent the hormone oestrogen from stimulating the breast cancer to grow. This kind of treatment is sometimes called endocrine therapy.

My doctor has recommended I have hormone therapy. How does this work?

Some breast cancers are stimulated to grow by the hormone oestrogen. Hormone therapies block oestrogen, preventing it from having any effect on breast cancer cells. They do this by stopping thehormone from attaching to the breast cancer cells or by lowering the overall amount of oestrogen in the body.

My friend didn’t have hormone therapy for her breast cancer, though I am. Why do some people have this treatment and not others?

Hormone therapy will only suit you if your breast cancer has receptors on its cell surface that latch on to hormones and use them to help it grow faster. This kind of cancer is called oestrogen or progesterone receptor positive breast cancer. Progesterone is another

hormone whose receptors indicate that oestrogen is being used to help the cancer grow. Like chemotherapy, hormone therapy is a systemic treatment because it can reach cancer cells anywhere in the body. The usual time to have hormone therapy is as an additional treatment after surgery and chemotherapy, or during or just after radiotherapy. It is quite common to have both chemotherapy and hormone therapy because the features of the cancer indicate that both will offer benefits.

Will having hormone therapy mean I need to have regular injections?

Most hormone therapies involve taking tablets once a day. There are one or two which are given by an injection into the tummy muscles, usually once a month. How long will I be taking hormone therapy?

If you have primary breast cancer, the hormone therapy usually lasts for five years. People taking hormone therapy for secondary breast cancer usually stay on it indefinitely, unless it is no longer effective at controlling the cancer.

My friend is on a different hormone therapy to me. Why would this be?

There are several hormone therapies used to treat breast cancer.

They include:

• tamoxifen;

• anastrozole (Arimidex®);

• letrozole (Femara®);

• exemestane (Aromasin®);

• goserelin (Zoladex®);

• fulvestrant (Faslodex®).

Some hormone therapies only work after or before the menopause, so the drug you have will depend on this, and also whether you have primary or secondary breast cancer. The doctor will also have to bear in mind any hormone therapies you may have had before.

Am I likely to get any side effects from hormone therapy?

Yes, and they will depend on which hormone you are taking. If your doctor recommends hormone therapy, ask what specific side effects you should expect. Generally side effects are similar to menopausal symptoms, such as hot flushes, night sweats, dry skin and mood swings. Some people also experience weight gain and some of the drugs cause joint pain. These often get better after taking the drug for some months. Do tell your doctor or breast care nurse about any side effects because they may be able to suggest ways of relieving them.

I was taking hormone replacement therapy. Is this the same as hormone therapy?

No, hormone replacement therapy (HRT) is used to treat symptoms women have at the time of the menopause. It is completely different as it supplies hormones to the body rather than preventing them from forming or working. It is not used in the treatment of breast cancer.

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