Hormone therapy is key in fighting some cancers, with nearly1 98% of patients with prostate and breast cancers using it. This treatment uses drugs or surgery to stop cancer growth. It also helps ease symptoms for those who can’t have other treatments1.
It’s important to understand hormone therapy if you have cancer or hormonal imbalances. This guide will explain how it works, its methods, and possible side effects. We aim to help you make smart choices about your health.
Key Takeaways
- Hormone therapy is a cancer treatment that uses drugs or surgery to slow cancer growth. It targets cancers that need hormones to grow, like some breast and prostate cancers.
- This therapy can also manage symptoms from hormonal imbalances, such as those during menopause.
- It works by stopping the body from making hormones or changing how they work in the body.
- Hormone therapy might be used alone or with other treatments like surgery, radiation, or chemotherapy.
- Knowing about the side effects and how to get hormone therapy is key to making good choices about your cancer care.
What is Hormone Therapy?
Hormone therapy, also known as hormone replacement therapy (HRT), changes the body’s hormones to slow or stop cancer growth2. It can stop the body from making hormones or change how they work. This makes it a key part of cancer treatment for many people2.
How Hormone Therapy Works
Hormone therapy changes the body’s hormonal system to stop cancer growth and spread2. It does this by blocking hormone production, changing how hormones work, or using synthetic hormones2.
Types of Hormone Therapy
- Oral medications: Hormone therapy can be given as pills, like Premarin, Estrace, and Estratab3.
- Injectable drugs: Doctors may use injectable hormones to manage symptoms2.
- Surgical hormone therapy: Removing hormone organs, like ovaries or testicles, can be a therapy option2.
The type of hormone therapy depends on the cancer type, the patient’s age, health, and other factors2. Doctors pick the best therapy based on the patient’s needs and situation2.
“Hormone therapy is a crucial component of cancer treatment for many patients, as it can effectively slow or stop the growth of hormone-sensitive cancers.”
There are two main types of hormone replacement therapy (HRT): estrogen therapy and combination therapy (estrogen and progesterone)2. Doctors choose the best option based on symptoms, medical history, and what the patient prefers2. Estrogen therapy comes in many forms, like pills, patches, gels, rings, creams, tablets, and sprays, often starting with low doses2. Combination therapy uses estrogen and progesterone to lower the risk of uterine cancer, given as pills, patches, or IUDs2.
| Hormone Therapy Mechanism | Examples |
|---|---|
| Blocking hormone production | Aromatase inhibitors, Luteinizing hormone-releasing hormone agonists |
| Interfering with hormone receptors | Selective estrogen receptor modulators (SERMs), Selective androgen receptor modulators (SARMs) |
| Replacing natural hormones | Estrogen therapy, Progesterone therapy |
Systemic hormone therapy uses products that go into the bloodstream to help organs and tissues2. Local hormone therapy applies products directly to certain areas, like the vagina, to ease symptoms with lower doses234.
Cancers Treated with Hormone Therapy
Hormone therapy is key in treating cancers like breast, prostate, endometrial (uterine), and adrenal cancers5. Its success depends on the cancer type, stage, and if it’s hormone-sensitive.
For breast cancer, hormone therapy is often used for tumors that respond to hormones6. Tamoxifen, a SERM, is a top choice for breast cancer5. It helps both premenopausal and postmenopausal women, and men with hormone-sensitive breast cancer5. Aromatase inhibitors like anastrozole and letrozole are used after menopause5. LH blockers such as goserelin are for those not yet in menopause5.
Prostate cancer also benefits from hormone therapy7. Treatment may include surgery to remove testicles (orchiectomy)7.
Endometrial (uterine) cancer and some adrenal cancers use hormone therapy too7. Progestin is the main hormone therapy for uterine cancer, slowing cell growth7.
Hormone therapy can also prevent cancer in those at high risk, like for breast cancer5. Medicines like tamoxifen and raloxifene are used for prevention5.
“Hormone therapy is an essential component in the management of hormone-sensitive cancers, offering promising treatment options and potential preventive measures.”
Using Hormone Therapy with Other Cancer Treatments
Hormone therapy is often paired with treatments like surgery, radiation, and chemotherapy. It can be given before or after main treatments. Before, it’s called neoadjuvant hormone therapy and helps shrink tumors8. After, it’s called adjuvant hormone therapy and lowers the chance of cancer coming back8. This combination can greatly improve patient outcomes.
Neoadjuvant Hormone Therapy
Given before main treatments, neoadjuvant hormone therapy aims to shrink tumors. This makes them easier to remove or treat8. It’s especially useful for breast and prostate cancers, where hormone-sensitive tumors respond well.
Adjuvant Hormone Therapy
Adjuvant hormone therapy follows main treatments to target any remaining cancer cells. It aims to prevent cancer from coming back8. This type of therapy is common for breast and prostate cancers, boosting long-term survival rates.
| Cancer Type | Neoadjuvant Hormone Therapy | Adjuvant Hormone Therapy |
|---|---|---|
| Breast Cancer |
– Aromatase inhibitors (e.g., anastrozole, letrozole, exemestane) for postmenopausal women8 – Selective estrogen receptor modulators (SERMs) like tamoxifen for premenopausal women8 |
– Aromatase inhibitors for postmenopausal women8 – SERMs like tamoxifen for premenopausal women8 – Ovarian suppression in premenopausal women8 |
| Prostate Cancer | – Androgen deprivation therapy (ADT) using drugs like Leuprolide and Goserelin8 |
– Continuation of ADT8 – Androgen blockers like enzalutamide if other treatments are no longer effective8 |
| Endometrial Cancer | – Progestins, Tamoxifen, LHRH agonists, and aromatase inhibitors8 | – Continuation of hormone therapy from neoadjuvant stage8 |
Combining hormone therapy with other cancer treatments significantly improves patient outcomes9. Healthcare providers can tailor treatment plans by understanding neoadjuvant and adjuvant hormone therapy.
“Hormone therapy is a critical component of cancer treatment for many patients, and using it in combination with other therapies can be highly effective.”
Potential Side Effects of hormone therapy
Hormone therapy is a key part of treating many cancers. It can have side effects that patients need to know about. These effects differ for men and women, based on the cancer and the therapy type.
Side Effects in Men
Men with prostate cancer on hormone therapy might feel hot flashes, have less desire, trouble getting an erection, lose bone density, and feel tired11. These issues with desire and erections can get better in 3 to 12 months after stopping treatment. But, some men might not get better, depending on the drug and how long they used it12. They also risk losing bone density, or osteoporosis, from the treatment12.
Side Effects in Women
Women on hormone therapy for breast or endometrial cancer might feel hot flashes, have dryness in the vagina, want less sex, feel sick to their stomach, have joint pain, and face other health issues11. This therapy can make them go through menopause, causing vaginal dryness, mood swings, sweating, and less desire for sex11. This menopause can be temporary or last forever, making symptoms worse than in natural menopause because it happens fast13.
Women might also have digestive problems like throwing up, constipation, diarrhea, or eat less13. There’s a slight chance of getting blood clots with some hormone therapies, especially if they’ve had blood clots before11.
It’s key to remember that these side effects can vary from person to person. Talking to a healthcare provider is crucial to handle them well12. Managing these effects is a big part of hormone therapy, as they can really affect how well someone lives.
The side effects of hormone therapy show how important it is for patients and their doctors to talk openly. Working together to deal with these effects helps patients feel more secure and happy during their treatment.
Cost Considerations for Hormone Therapy
The cost of hormone therapy can change a lot. It depends on the treatments needed, how long you need them, and where you live14. Many men and women choose bioidentical hormone replacement therapy (BHRT) for its natural approach. But, the cost can be a big concern14.
How you get your hormones, like through creams, gels, lozenges, or capsules, affects the cost. Costs can be between $60 and $250 a month14. Synthetic hormone replacement therapy (HRT) might cost between $30 to $500 a month14. The complexity of BHRT, which can include many hormones, also affects the price14.
Insurance coverage for hormone therapy varies a lot. Some insurance covers it fully or partly, but not all hormones are covered14. Transgender people often face more financial challenges. They are more likely to be uninsured, unemployed, and poor15. They also often face insurance denials for care and need mental health referrals15.
To lower the cost of hormone therapy, you can try using generic meds, looking for prescription help, comparing prices, and choosing cheaper pharmacies14. Picking a trusted provider like MediVera Compounding Pharmacy can help with costs and quality14.
The cost of hormone therapy is very important. Patients should talk with their doctors about costs and options to make sure the treatment is affordable and works well14. By being informed and using resources, people can make good choices and get the hormone therapy they need for their health141516.
How Hormone Therapy is Administered
Hormone therapy is key in treating breast and prostate cancers17. It comes in forms like pills, shots, and surgery. The choice depends on the therapy type and the patient’s needs.
Oral Hormone Therapy
Oral hormone therapy uses pills or capsules with hormones or drugs that change hormones. It’s easy for patients to use at home. Common types include anti-estrogens like Tamoxifen and aromatase inhibitors such as Anastrozole1718.
Injectable Hormone Therapy
Injectable therapy gives shots under the skin or into muscles. Shots are given at different times, like monthly or yearly, based on the drug. Luteinizing Hormone-Releasing Hormone (LHRH) agonists, like Goserelin, are often given this way1719.
Surgical Hormone Therapy
Surgery removes hormone-producing organs like the testicles or ovaries. It’s a one-time, low-cost option that lowers hormone levels19. It’s used when other therapies don’t work well.
The way hormone therapy is given depends on the therapy type, the patient’s needs, and treatment goals. Checking how well the therapy works is key. This may involve tests or measuring tumor markers171819.
Where You Receive Hormone Therapy
The place where you get hormone therapy depends on the type of treatment. Oral hormone pills are taken at home. But, injectable hormones are given in a doctor’s office, hospital, or clinic. Surgery for hormone therapy happens in a hospital20.
Planned Parenthood gives hormone therapy to those 16 and older. Kids 16-17 need a parent or guardian there20. But, kids under Missouri SB 49 can’t get hormone therapy in Missouri after August 28, 2023. They can get care in Fairview Heights, IL, though20.
Visiting Planned Parenthood costs $250 plus more for labs. Follow-up visits are $200 plus labs if needed20. If you can’t pay, they might help you out20. If you get an injectable, you’ll learn how to give it to yourself20.
Insurance for hormone care is different for everyone. Some people don’t use insurance for this20. If insurance won’t cover your meds, you might use GoodRx.com20. You might need blood tests, done with a blood draw20. You pay with credit card or cash at the start of your visit20.
The cancer care team will tell you where to get each type of hormone therapy. They make sure you get the right care in the right place20.
“Feminizing hormone therapy is used by transgender women and nonbinary people to change their bodies with female hormones during puberty.”21
Feminizing hormone therapy has risks like blood clots and heart issues21. Doctors watch over you to keep these risks low and make sure the therapy works and is safe21.
For complicated hormone needs, you might see a team of expert endocrinologists at places like the UCLA Gender Health Program22. They work with your primary doctor for care that meets your specific needs22.
| Hormone Therapy Location | Type of Hormone Therapy |
|---|---|
| Home | Oral Hormone Medications |
| Doctor’s Office, Hospital, Clinic | Injectable Hormone Therapy |
| Hospital | Surgical Hormone Therapy Procedures |
Monitoring Hormone Therapy Effectiveness
When undergoing hormone therapy for cancer, it’s key to keep a close eye on its effects. Doctors use tests to see how well the therapy is working and adjust it as needed23.
For those with prostate cancer, PSA tests are crucial to check the therapy’s success23. Breast cancer patients might get imaging tests like mammograms or blood tests to check hormone levels23. These tests help spot any signs that the cancer is growing, guiding treatment choices.
Regular check-ins with the cancer care team are also vital. They look at the patient’s health, talk about side effects, and go over test results. This way, they make sure the hormone therapy stays on track for each person’s needs.
| Monitoring Hormone Therapy | Frequency | Target Levels |
|---|---|---|
| Serum testosterone and estradiol | Every 3 months for the first year, then every 6-12 months | Testosterone: 30-100 ng/dl, Estradiol: |
| Prolactin and triglycerides | Before initiating therapy and during follow-up visits | Maintain within normal ranges |
| Potassium | If taking spironolactone | Maintain within normal ranges |
| Bone mineral density (BMD) | Before starting hormones for individuals at risk of osteoporosis, or at age 60, earlier if hormone levels are consistently low | Maintain healthy BMD |
| Cancer screenings | As recommended for the specific cancer type | Early detection of any new or progressing cancer |
Keeping a close watch on hormone therapy helps doctors make sure it’s working right for each person23. Regular tests and check-ups are key to managing the therapy and keeping up overall health during cancer treatment.
Special Dietary Needs During Hormone Therapy
Hormone therapy can change how our bodies work and what we weigh24. If you’re getting hormone therapy, you might see changes in muscle, fat, and how hungry you feel24. To keep a healthy weight, it’s smart to work with a nutrition expert to plan your meals.
The latest diet advice from 2020-2025 suggests eating a mix of veggies, fruits, whole grains, lean meats, and low-fat dairy24. For those on hormone therapy, this advice can be adjusted to fit your needs25. Foods like fatty fish, whole grains, flaxseeds, and fresh spices can help balance your hormones and reduce side effects25.
It’s important to get enough calcium and protein if you’re on hormone therapy26. Women on HRT should aim for at least 1,000 mg of calcium a day from foods like dairy, fortified juices, and fish with bones26. Foods high in protein, like lean meats and plant-based options, support muscle health and well-being26.
| Food Source | Calcium Content |
|---|---|
| 1 cup of milk or calcium-fortified orange juice | ~300 mg |
| 1 cup of yogurt | ~400 mg |
| 30g of cheddar cheese | ~200 mg |
| 4 sardines (including bones) | ~184 mg |
By teaming up with health experts and eating a balanced diet, you can handle the weight changes from hormone therapy better242526.
hormone therapy and Safety Precautions
Hormone therapy is usually safe, but safety steps are important for the patient and their family27. The safety steps depend on the medicine used27. It’s key to tell your cancer care team about all your medicines to avoid bad reactions27.
Hormone replacement therapy (HRT) has helped many women feel better for years27. Studies show it’s mostly safe for women27. But, a 2002 study made many women stop or not start HRT because of health risks27.
Most women can safely use hormone replacement therapy27. But, some women with certain health issues should choose other treatments27. Some women might feel breast tenderness, headaches, or stomach pain from HRT27.
Before starting hormone therapy, talk to your doctor about the good and bad parts28. Think about your age, health risks, what you prefer, and what other options you have28. Talking with a doctor is key to using hormone therapy safely and well28.
Some hormone therapy is made by pharmacists for specific needs29. These hormones aim to balance hormone levels but haven’t been fully approved29. Be careful with these hormones and talk to your doctor before using them29.
“Hormone therapy is a powerful tool, but it must be used with caution and under the guidance of a healthcare provider. Patients should be aware of the potential safety precautions and work closely with their care team to ensure the safe and effective use of hormone therapy.”
Deciding on Hormone Therapy Treatment
Choosing the right hormone therapy is a team effort between the patient and their cancer care team. Shared decision making lets the patient be a key part in looking at the good and bad of different treatments30. Patients can also get a second opinion from another oncologist before making a final choice on hormone therapy.
Shared Decision Making
Shared decision making is key in picking the best hormone therapy. It means the patient and their healthcare team talk openly about the options, their good and bad points, and what the patient wants and worries about30. This way, patients can feel well-informed and sure about their choice, which leads to better results.
Getting a Second Opinion
Patients can get a second opinion from another oncologist before starting hormone therapy. This can give new insights, check if the first idea is right, or suggest other ways to think about30. Getting a second opinion helps patients feel sure they’re making the best choice for them.
The choice of hormone therapy should be a careful, informed decision made with the cancer care team. By knowing about shared decision making and the perks of a second opinion, patients can be more involved in their treatment. This ensures they get care that fits them best.
When Should Hormone Therapy Begin?
The timing of starting hormone therapy depends on the cancer type and stage, as well as the treatment plan31. Sometimes, hormone therapy starts right after a cancer diagnosis. Other times, it comes later in the treatment plan. The cancer care team works with the patient to find the best time to start therapy, considering their unique situation and needs.
For breast cancer patients, hormone therapy is often advised for at least 5 years after surgery32. Common treatments include Tamoxifen for 5 years and aromatase inhibitors like anastrozole or letrozole for a similar time. Sometimes, patients take a mix of Tamoxifen and an aromatase inhibitor, with treatment length based on their needs.
Hormone therapy is also used for other cancers like prostate and endometrial cancer31. The timing and length of therapy depend on the cancer type, stage, and how the patient responds to treatment.
The decision to start hormone therapy and when is a team effort between the patient and their cancer care team32. They look at the patient’s specific situation and weigh the benefits and risks. This way, they create a treatment plan that aims to improve outcomes and reduce side effects313233.
Finding Credible Hormone Therapy Information
Looking into hormone therapy for cancer treatment means finding trustworthy sources. The American Cancer Society, National Cancer Institute, and top cancer centers are great places to start34. They offer detailed, current info on hormone therapies, their good points, and possible side effects.
It’s important for patients to ask their cancer care team for help finding reliable info on hormone therapy. Your doctors can guide you to safe sources and help you understand the information34. Working together, you can make choices that feel right for you.
Online tools like MedlinePlus and the U.S. Preventive Services Task Force are also great for learning about hormone replacement therapy during menopause34. These sites give you the lowdown on the risks, benefits, and ways to get hormone therapy.
Research is still going on about how menopause, hormone therapy, and health issues like osteoporosis and dementia are linked34. Groups like the NIH Osteoporosis and Related Bone Diseases National Resource Center and the National Institute on Aging offer lots of info and resources. They help patients understand these complex topics better.
Learning from trusted sources is key to making smart choices about hormone therapy for cancer treatment. By working with your healthcare team and using reliable resources, you can look at all your options. This way, you can pick the best path for you34.
“Patients should feel empowered to ask their cancer care team for guidance on finding credible information about hormone therapy.”
Hormone Therapy Research and Clinical Trials
Advances in hormone therapy are being made all the time through hormone therapy research and clinical trials. These studies test new or better hormone-based treatments, often with other therapies35. Patients can join clinical trials to get access to new experimental treatments not yet available elsewhere. Talking about clinical trial options with the cancer care team is key to making treatment decisions.
The Women’s Health Initiative (WHI) had 161,808 postmenopausal US women, with 68,132 in clinical trials35. The WHI followed women aged 50 to 79 from 1993 to 1998 for up to 20 years35. But the WHI trial found hormone therapy didn’t help prevent heart disease, dementia, or other chronic diseases in postmenopausal women35.
However, hormone therapy does help with symptoms like hot flashes and night sweats in menopause35. It also has fewer side effects in early menopause35. This shows the importance of thinking about when and how long to use hormone therapy.
There’s still a lot of hormone therapy research going on. For example, a recent trial looked at how aromatase inhibitor therapy affects breast cancer36. The study found that changes in Ki67 protein levels after treatment could help decide on further treatment36. As research and trials like these keep going, patients and doctors can make better choices about hormone therapy.
“Hormone therapy is a rapidly evolving field, and clinical trials are vital for improving treatment and care for patients. By participating in research studies, patients can access innovative therapies and contribute to advancing our understanding of hormone-based cancer management.”
– Dr. Emily Wellings, Oncologist and Principal Investigator, Hormone Therapy Research Institute
Conclusion
Hormone therapy is key in treating cancers like breast and prostate cancer. Studies show37 that estrogen therapy might slightly raise the risk of mild brain issues and Alzheimer’s. Estrogen plus progestin therapy could also increase Alzheimer’s risk. Research38 finds estrogen-only therapy lowers the risk of heart disease and breast cancer in women under 60. It’s important to start it within 10 years of menopause.
Studies show39 hormone therapy is safe and effective for women under 60 with menopause symptoms. The risk of breast cancer and other issues is low in this group. The Women’s Health Initiative study39 looked at over 160,000 postmenopausal women. It found Prempro increased risks but estrogen-only therapy was safe for younger women.
Knowing about hormone therapy helps patients make smart choices for their cancer care. Working with the cancer team to watch the therapy’s effects and safety is key for the best results.
FAQ
What is hormone therapy?
How does hormone therapy work?
What types of hormone therapy are available?
What cancers are treated with hormone therapy?
How is hormone therapy used with other cancer treatments?
What are the potential side effects of hormone therapy?
How much does hormone therapy cost?
How is hormone therapy administered?
Where do patients receive hormone therapy?
How is the effectiveness of hormone therapy monitored?
Are there any special dietary needs during hormone therapy?
What precautions are needed for hormone therapy?
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Source Links
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- Utilization and Costs of Gender-Affirming Care in a Commercially Insured Transgender Population – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9679590/
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- Hormone Therapy Specialist: 6 Foods You Need To Eat For A Balanced Hormone Health | Nulife Institute – https://www.nulifeinstitute.com/blog/hormone-therapy-specialist-6-foods-you-need-to-eat-for-a-balanced-hormone-health
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