What Breast Cancer Patients Should Know About Hormone Therapy

Breast cancer is not just one disease, but rather a group of many subtypes, each with distinct characteristics that direct the recommended treatment plan. The most common subtype is hormone receptor-positive (HR+) breast cancer, which grows in response to hormones like estrogen and progesterone.

For many patients with hormone receptor-positive breast cancer, hormone therapy is an important part of their treatment plan. This highly effective treatment aims to block or lower the levels of these natural hormones that fuel certain breast cancers. However, it's important to understand how hormone therapy works, its potential drawbacks, and which patients are the best candidates for this approach.

Understanding How Hormone Therapy Targets Breast Cancer

Breast cancer cells may have receptors that attach to estrogen (ER-positive or ER+) or progesterone PR-positive or PR+). When these hormones bind to receptors, they can stimulate cancer growth.

Hormone therapy works by either blocking hormones from attaching to their receptors on cancer cells or reducing the production of specific hormones in the body. By interfering with these processes, hormone therapies can slow or stop tumor growth and lower the risk of cancer returning.

When Is Hormone Therapy Used?

Hormone therapy may be recommended at various stages of care, depending on your diagnosis and treatment goals. It’s commonly used by patients with hormone-positive breast cancer for five to ten years after surgery. Doing this significantly lowers the likelihood of recurrence.

Hormone therapy can also be used before surgery (neoadjuvant therapy) to shrink a tumor for easier removal or to treat recurrent or metastatic breast cancer. Healthy women with a strong family history or inherited gene mutations, such as BRCA1 and BRCA2, may also be candidates for hormone therapy before cancer develops.

Common Types of Hormone Therapies for Breast Cancer

There are several types of hormone therapy, especially for hormone receptor-positive breast Several types of hormone therapy are used to treat hormone receptor-positive breast cancers. Three common approaches include:

1. Medications that block estrogen's effect on breast cancer cells

These drugs create a barrier that prevents hormones from attaching to cancer cells, slowing tumor growth and promoting cancer cell death. Medications that block hormones fall into two categories:

• Selective estrogen receptor modulators (SERMs), such as Tamoxifen and Toremifene (Fareston)

• Selective estrogen receptor degraders (SERDs), like Fulvestrant (Faslodex) and Elacestrant (Orserdu)

2. Ovarian suppression in premenopausal women

Since the ovaries are the primary source of estrogen before menopause, ovarian function may be suppressed through:

• Surgery to remove the ovaries (oophorectomy)

• Medications known as luteinizing hormone-releasing hormone (LHRH) agonists, such as goserelin (Zoladex) and leuprolide (Lupron). These may be used alone or in combination with other hormone therapies.

3. Lowering hormone production in postmenopausal women

After menopause, estrogen is primarily produced in fat tissue through an enzyme called aromatase. Aromatase inhibitors (AIs) reduce estrogen levels in postmenopausal women, starving cancer cells of their necessary fuel. Common options include:

• Letrozole (Femara)

• Anastrozole (Arimidex)

• Exemestane (Aromasin)

Learn more about how breast cancer treatment is affected by hormone status.

Who Is a Candidate for Breast Cancer Hormone Therapy?

Hormone therapy is primarily used for hormone-receptor-positive breast cancers. Your cancer care team will determine the most suitable option for you based on whether you are premenopausal or postmenopausal.

For premenopausal women, hormone therapy can suppress the ovaries' ability to produce estrogen and block hormones from attaching to cancer cells. Your breast cancer specialist will choose hormone therapy treatments carefully to minimize bone loss and other unwanted side effects. Ovarian suppression, achieved either through surgery or medication, often leads to early menopause. Many patients take hormone therapy for 5 to 10 years to reduce the risk of cancer recurrence.

In postmenopausal women, ovarian suppression is less critical, but it is still important to block estrogen production from fat cells. While side effects may be more severe in postmenopausal women, not all patients will experience them.

Advantages and Disadvantages of Breast Cancer Hormone Therapy

Despite potential side effects, most women find that the advantages of hormone therapy often outweigh the disadvantages, making it a valuable treatment option for breast cancer. It is important to be well-informed about what to expect, so you can make the best decision regarding your treatment plan and prepare for potential side effects.

Benefits of Hormone Therapy for Breast Cancer

Many patients experience significant advantages from hormone therapy, including:

• Lower risk of recurrence: Hormone therapy is one of the most effective ways to prevent hormone-receptor-positive breast cancer from returning, decreasing the likelihood of recurrence by at least 40% when used as prescribed.

• Improved survival rates: Hormone therapy provides long-term benefits that can significantly enhance survival rates over time.

• Convenient treatment: Medications are typically taken orally, allowing patients to administer them at home rather than visiting the clinic for infusion treatments.

• Non-cytotoxic: Unlike chemotherapy, which damages all cells – both healthy and cancerous – hormone therapy specifically targets hormone-sensitive breast cancer cells, without the same harmful effects.

• Effective for advanced breast cancers: This treatment can help control the growth and symptoms of advanced hormone receptor-positive breast cancers.

Potential Drawbacks of Breast Cancer Hormone Therapy

While hormone therapy has many benefits, there are some disadvantages to consider:

• Requires long-term use: The length of hormone therapy varies among patients, lasting on average from 5 to 10 years or longer, depending on individual circumstances.

• Side effects: Due to the long-term use of hormone therapies, side effects can also last for an extended period. Common side effects include hot flashes, mood swings, joint pain, vaginal dryness, and fatigue. Your oncologist may suggest different medications or adjust doses if side effects become difficult to manage.

• Risk of serious complications: Blood clots and stroke may be experienced, particularly by postmenopausal women taking Tamoxifen. Talk with your oncologist about this risk for you.

• Bone density loss: Premenopausal women may experience reduced bone density when taking Tamoxifen.

• Not effective for all breast cancers: Only specific types of breast cancer respond to hormone therapy. Hormone receptor-negative cancers do not benefit from this type of treatment.

You should discuss your use of hormone therapy with your primary care physician and gynecologist so they are aware of all medications you’re using.

Breast Cancer Hormone Therapy Treatment in the South Chicago Suburbs

At Affiliated Oncologists, our breast cancer specialists are here to create a personalized plan tailored to your diagnosis. If hormone therapy is part of your treatment plan, we are here to help you weigh the benefits and risks so you feel confident in your decision.

If you or a loved one was diagnosed with hormone receptor-positive breast cancer and is seeking treatment in the South Chicago suburbs, the oncologists at Affiliated Oncologists are here to support you every step of the way. We have several convenient locations close to home, including Chicago Ridge, Hazel Crest, Mokena, Orland Park, and Palos Heights.

Categories: Breast Cancer