Hormonal therapy

 Over 11million people are diagnosed   with cancer every year worldwide.  Breast cancer is the most prevalent and lung cancer is the most common cause of cancer death

Hormonal Therapy

Who's Hormonal therapy for?
Before, after and during the menopause
Managing the Hormonal therapy
My Hormonal treatment
Question and Answer

When breast cancer is diagnosed at the early stages, you will usually have the  cancerous lump removed by surgery. The surgery is often accompanied by  radiotherapy of the area around the  cancer to remove any remaining cancer  cells.  However, because there is still the risk that some very small (micrometastatic),  undetectable cancer  cells may remain in the breast or in other  areas  of  the body, you may be given an additional drug treatment e.g. hormonal  treatment,  to  prevent  the  disease  returning.

Hormonal  treatment  is  primarily  a  way  of fighting the recurrence of breast cancer  (stopping  it  from  coming  back).  The  highest risk for recurrence is within  the   first  five  years  of  diagnosis,  and  peaks  at  around  2  years.

Your  doctor  will  takea sample from your breast lump and he or she will test the  sample  to  find  whether or not your tumour is being encouraged to grow by your own natural oestrogen.

If  this  is  the  case,  your  doctor will almost certainly recommend treatment after  surgery  in  the  form  of  hormonal  therapy. Such treatment, known as ‘adjuvant’ treatment', will generally be given for a period of 5 years.

If  your  cancer  is  at  a  more  advanced  stage,  then  surgery  may  not be appropriate  and  your  doctor  may  then  recommend  chemotherapy and/or hormonal therapy as the main form of treatment given.

Hormones in breast cancer

Hormones  are  produced  by  organs  or  cells in your body and affect bodily processes.  Oestrogen  is  one  of  a group of steroidal hormones that control female  sexual  development, promoting the growth and function of the female reproductive  organs  and  female  secondary  sexual characteristics such as breast development.

Many  breast  cancer  tumours,  particularly  those  in women who have gone through  the  menopause   (‘change  of  life’)  are  stimulated  to  grow  when oestrogen is present.

Receptors  are  very  small  parts  on  the  surface  of  a  cell.  If oestrogen is present,  it  will attach to oestrogen receptors on breast cancer cells and can cause the tumour grow larger.

Breast  cancers  that  are  stimulated  by  oestrogen are known as oestrogen receptor-positive  (ER+ve),  hormone  receptor-positive  or hormone sensitive. This  means the breast cancer cells may continue to grow when oestrogen is present.  Women  who  have  this  type of breast cancer are likely to respond well   to  hormonal   treatment.  Hormonal  treatment  works  by  removing  or blocking  the  source of oestrogen and so depriving the tumour of its stimulus to grow.

Hormonal therapy can be used as a form of 'Adjuvant therapy

'Adjuvant means “in addition to”.

In  breast cancer, this refers to additional treatment given following surgery to remove the tumour.After surgery, tiny, undetectable remnants of the disease, may  be   left  behind.  These  remnants  may,  after  several  years  or  even decades, develop into a tumour.

Adjuvant therapy helps to prevent or delay these cells from multiplying, and it may  decrease  the  chance  that  your breast cancer will come back (recur).

The   three   most   common  forms  of   adjuvant   treatment  are  radiation (radiotherapy),   chemotherapy   and  hormonal  therapy.  Most  women  with breast  cancer  will  receive  a  course  of  radiotherapy immediately following surgery  and  then  go  on  to  receive additional drug treatment in the form of chemotherapy  or  hormonal therapy – or sometimes both. Hormonal therapy is the most well tolerated of these.

“Endocrine” therapy

You   may  sometimes   hear  hormonal  therapy  referred  to  as  “endocrine therapy”.

“Endocrine”  is  a  word  used  to  describe  the  natural  hormones  (such as oestrogen)  that are secreted from glands in the body and affect the structure or function of other cells in the body.