Hormone Therapy

Overview of Hormone Therapy in India

Hormonal therapies represent a type of advanced cancer treatment that may be useful for many different primary cancers that develop in the body. Many of these tumors are stimulated by hormone levels; for example, prostate cancer develops as a response to the amount of testosterone circulating in the body, which will promote the development of cancerous cells in the prostate gland. Hormonal therapy works not only to kill cancerous cells, but it works to halt the progression of the growth of cancerous cells as well. Patients who are not surgical candidates or are not able to be treated with radiation will often benefit from hormonal therapy.

At this time, some of the most common types of cancers that may be treated with hormonal therapies include, but are not limited to: breast, uterine, prostate, thyroid, and many others. Hormonal therapy is often referred to as endocrine therapy. Hormonal therapy does have some side effects, but often they can be successfully managed with supportive therapies or medications. Hormonal therapy may be recommended for the treatment of cancer only when the benefits of treatment will outweigh any potential for complications related to the treatment.

What Is Hormone Therapy For Cancer?

Hormones are chemical messengers that help regulate an array of activities throughout the body. The glands in your body release hormones into the bloodstream, and these hormones travel via the bloodstream to various organs, carrying instructions from the endocrine system. Your body cannot work properly without hormones. However, hormones can also help fuel the growth of particular types of cancers. Many of these types of cancers use hormones to help them grow, multiply and spread.

Hormonal therapy is the use of medications to eliminate a cancer's access to the hormones that are supporting its growth. Hormonal therapies may be used alone or in conjunction with other treatment modalities such as surgery, chemotherapy, or radiation therapy to help eliminate the cancer completely. Hormonal therapies may also be used in post-treatment situations to help reduce the risk of cancer recurrence.

Types of Hormone Therapy:

Hormone treatments are utilised to address the following types of cancer: breast, prostate and uterine by blocking or limiting the amount of hormones produced in the body. The main classes of medications you will encounter when using hormone therapy include the following: aromatase inhibitors, selective estrogen receptor modulators (SERMs), LHRH agonists, and anti-androgens. The medications can be given either orally or by injection for the purpose of decreasing the size of a tumour, and/or to help decrease the chance of developing another cancer.

Key Types of Hormone Therapy

Aromatase Inhibitors (AIs): Used to treat women after menopause who have breast cancer, AIs (for example, letrozole, anastrozole and exemestane) work by blocking the enzyme that produces estrogen.

Selective Estrogen Receptor Modulators (SERMs): Tamoxifen and toremifene are SERMs that block estrogen from binding to cancer cells. Tamoxifen is used for both pre- and postmenopausal women and men.

Luteinizing Hormone-Releasing Hormone (LHRH) Agonists: Also referred to as LH Blockers, these medications inhibit the production of estrogen by the ovaries (for breast cancer) or testosterone by the testicles (for prostate cancer). Goserelin and leuprolide are LHRH agonists.

Anti-Androgens: Abiraterone, enzalutamide and apalutamide are Anti-androgens that prevent the use of androgens (such as testosterone) in treating prostate cancer.

Estrogen Receptor Down Regulators (ERDs): Fulvestrant is an ERD that blocks and destroys estrogen receptors and is most frequently used in treating advanced breast cancer.

Progestins: Progestins are used in the treatment of endometrial cancer and act like progesterone.

Surgical Ablation: In specific cases, the surgical removal of hormone-producing organs such as the ovaries in females and testicles in males may be performed.

Procedure:

Evaluation

In​‍​‌‍​‍‌​‍​‌‍​‍‌ the evaluation stage, the doctor will review the patient’s medical history and symptoms and might also do a physical examination and laboratory tests to figure out whether hormone therapy is the right treatment for the patient.

Diagnostic tests

Diagnostic tests like blood tests, imaging studies, etc., might be done in order to verify the existence of hormone-related problems. They also provide oncologists with information to understand the patient's condition at different stages, treatment response and to further plan the treatment methods.

Biopsy

Sometimes doctors will order a biopsy to take a small piece of the diseased tissue so that a thorough examination can be done to establish the nature and exact details of the illness for which hormone therapy is being considered.

Individualised treatment with hormone therapy

After the evaluation and diagnostic tests, the doctor will design a hormone therapy plan that is most suitable for the patient’s specific requirements and health state.

Dosage

Determining the right amount of hormone therapy is done by the doctor, considering each patient’s medical history, lab results, and what they want to achieve through the treatment.

Management of side effects

Patients are informed about the potential side effects of hormone therapy before beginning treatment, and they are equipped with ways, including medication, to handle the side effects.

Follow-up sessions

Follow-up visits are very important to check up on the patient’s progress with hormone therapy, to see if the patient has experienced any side effects, and to change the treatment plan if ​‍​‌‍​‍‌​‍​‌‍​‍‌necessary.