Hormone Therapy
Some cancers grow and spread in response to hormones. When this happens, your SCRI Oncology Partners medical oncologist may recommend hormone therapy as part of a personalized treatment plan to slow the cancer’s growth. Despite being called hormone therapy, it commonly works by blocking hormone production. It is often used to treat breast cancer, ovarian cancer, and prostate cancer.
Your SCRI Oncology Partners cancer doctor will review the results of your biopsy to see if hormone receptors are present and if hormone therapy would be effective. In addition to standard hormone therapy, we offer clinical trials that provide our patients in Middle Tennessee with access to new hormone therapies and options for new ways of using existing treatments.
What is Hormone Therapy and How Does it Work?
Hormones are naturally occurring substances that stimulate the growth of certain hormone-sensitive tissues. This happens when a hormone, such as estrogen, progesterone, or testosterone, binds to receptors on cancer cells, causing them to grow.
Hormone therapy works by slowing the production of hormones that fuel cancer cells or by blocking their interactions with cancer cells. Cutting off that fuel source can slow or even stop cancer growth.
Patients may receive hormone therapy at different times depending on their type and stage of cancer. It may be used:
- Before surgery to help shrink a tumor or to understand a tumor’s response to hormone therapy to guide future treatment decisions
- After surgery to lower the likelihood of recurrence
- To ease symptoms caused by advanced (metastatic) cancer
- For cancer that has returned after completing initial treatment
The right timing and the specific therapies will be determined by your oncologist as these decisions are highly individualized.
Managing Side Effects
Hormone therapy can be taken as a pill, injection, or infusion, depending on the medication and the frequency you need to take it. For some patients, surgery to remove hormone-producing organs, such as the ovaries in women and the testicles in men, may be recommended in addition to hormone therapy medications. Side effects can vary but may include, but are not limited to:
- Hot flashes
- Night sweats
- Mild nausea
- Fatigue
- Joint or muscle discomfort
- Hair loss or thinning
- Mood changes
- Vaginal dryness in women
- Weight gain
- Changes in bone density
Removal of the ovaries or testicles can result in additional side effects, including infertility, sexual changes, mood swings, and an increased risk of osteoporosis. Most side effects can be managed, and our team works closely with you to keep you feeling your best during treatment.
Breast Cancer Hormone Therapies
Many breast cancers are driven by estrogen and/or progesterone. These are called hormone receptor-positive (HR-positive) breast cancers. If testing confirms the tumor cells express hormone receptors, hormone therapy will be a key part of treatment.
Several types of hormone therapy medications may be used in breast cancer treatment.
- Selective estrogen receptor modulators (SERMs), such as tamoxifen and toremifene (Fareston), block estrogen from attaching to cancer cells in certain tissues, like breast tissue.
- Selective estrogen receptor degraders (SERDs), such as fulvestrant (Faslodex), elacestrant (Orserdu), and imlunestrant (Inluriyo), block estrogen and also break down estrogen receptors to further limit their activity.
- Aromatase inhibitors (AIs), such as anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara), block the enzyme aromatase, which reduces estrogen production in the body.
- Luteinizing hormone-releasing hormone (LHRH) agonists, such as goserelin (Zoladex) and leuprolide (Lupron), suppress ovarian function, which lowers estrogen levels.
- Surgery to remove the ovaries (oophorectomy) stops the production of estrogen in the body.
SCRI Oncology Partners is part of clinical trials designed to study a number of hormonal therapies in various forms that can more effectively block the estrogen receptor, attempt to reduce side effects, or work in combination with other therapies, such as targeted therapies, to achieve a more effective outcome.
Prostate Cancer Hormone Therapies
Prostate cancer typically grows due to male hormones called androgens, particularly testosterone. Hormone therapy for prostate cancer, or androgen deprivation therapy (ADT), focuses on lowering testosterone levels or blocking their effects.
There are several types of ADT used for treating prostate cancer.
- Luteinizing hormone-releasing hormone (LHRH) agonists such as goserelin (Zoladex), leuprolide (Lupron), leuprolide acetate (Eligard), and triptorelin (Trelstar) prevent the pituitary gland from secreting a hormone called luteinizing hormone that leads to decreased testosterone production
- Luteinizing hormone-releasing hormone (LHRH) antagonists, such as degarelix (Firmagon) and relugolix (Orgovyx), block LHRH from binding to its receptors in the pituitary gland, which stops the testicles from producing androgens (such as testosterone)
- Androgen receptor pathway inhibitors, such as apalutamide (Erleada), enzalutamide (Xtandi), and darolutamide (Nubega), specifically target androgen receptors to prevent their activation from androgens
- CYP17 inhibitors, such as abiraterone (Zytiga) and ketoconazole (Nizoral), reduce the production of androgens by blocking the CYP17 enzyme, which is necessary for the body to produce androgens in certain parts of the body
- Surgery to remove the testicles (orchiectomy or surgical castration)
Hormone therapy can help shrink tumors, slow cancer growth, relieve pain, and lower prostate-specific antigen (PSA) levels. It’s often used with other treatments, especially for advanced prostate cancer.
Gynecologic Cancer Hormone Therapies
Hormone therapy can also play a role in certain gynecologic cancers, including some types of endometrial (uterine) and ovarian cancers that are sensitive to estrogen and progesterone. In these cases, hormone therapy may be used to slow cancer growth or manage recurrence.
These decisions are highly individualized as there are many nuances to the selection of treatments utilized in ovarian and endometrial cancer, including the subtype of the cancer, if it is behaving aggressively, where the cancer is located, and its stage. The specifics should be discussed directly with your oncologist, as the treatment of gynecologic cancers is very different from breast cancer.
Most hormone therapy medications used to treat endometrial and ovarian cancer are those that are also used in treating breast cancer. Progestins, such as medroxyprogesterone acetate (Provera) or megestrol acetate (Megace), may also be used. Discuss with your oncologist whether hormone therapy should be included in your gynecologic cancer treatment plan.
Personalized Cancer Care in Nashville
At SCRI Oncology Partners, we are committed to leading the way in clinical research to discover how hormone therapies can be effectively combined with other targeted treatments, ultimately improving outcomes for our patients and reducing treatment-related symptoms. We understand that every patient and their needs are unique. That’s why we take a personalized approach to care.
If you’re in the Nashville area and considering your cancer treatment options, our team is here to support you at every stage of your journey.
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We’re here when you need us
If you were recently diagnosed or would like a second opinion, request an appointment with one of our experienced cancer doctors right here in Nashville.
We’re here when you need us
If you were recently diagnosed or would like a second opinion, request an appointment with one of our experienced cancer doctors right here in Nashville.
We’re here when you need us
If you were recently diagnosed or would like a second opinion, request an appointment with one of our experienced cancer doctors right here in Nashville.