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Hormone Therapy

Hormone Therapy. Argosy University - Twin Cities RTH240- Principals & Practice II Covin Norlin Anam Vohra. What is h ormone therapy (HT)?. (Stanford Cancer Center, 2014). Hormones are chemicals produced by glands (ovaries and testicles)

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Hormone Therapy

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  1. Hormone Therapy Argosy University - Twin Cities RTH240- Principals & Practice II CovinNorlin Anam Vohra

  2. What is hormone therapy (HT)? (Stanford Cancer Center, 2014) Hormones are chemicals produced by glands (ovaries and testicles) Help some cancer cells grow (breast and prostate cancer) Kill cancer cells, make cancer cells grow more slowly, or stop them from growing A form of cancer treatment- may involve taking medications that interfere with the activity of the hormone or stop the production of the hormones and/or involve surgically removing a gland that is producing the hormones

  3. How does it work? (Stanford Cancer Center, 2014) Physicians recommend a hormone receptor test-to determine treatment options- particularly whether cancer cells are sensitive to hormones The test also measures the amount of certain proteins (called hormone receptors) within cancer tissue- hormones can attach to these proteins A positive test indicates the hormone is most likely helping the cancer cells to grow- HT blocks the way the hormone works and helps keep the hormone away from the cancer cells

  4. Continued (Stanford Cancer Center, 2014) • A negative test indicates the hormone does not affect the growth of the cancer cells • The type of HT a person receives depends upon: • type and size of the tumor • age of the person • presence of hormone receptors on the tumor

  5. When is it given? (WebMD, 2014) • HT prescribed either before or after other treatments • Neoadjuvant Treatment= HT given before the primary treatment • Helps kill cancer cells and contribute to the effectiveness of the primary therapy • Adjuvant Treatment= HT given after the primary cancer treatment • Helps improve the chance of a cure

  6. Continued (WebMD, 2014) • For some cancers- patients given HT right after diagnosis and before other treatment • To shrink the tumor or halt the disease advance • Other cancers (i.e. prostate cancer)- HT is helpful in alleviating the painful and distressing symptoms of advanced disease • HT cannot cure prostate cancer but it will usually shrink or halt the advancement of the disease- often for years

  7. Breast Cancer Hormone Therapy

  8. Breast Cancer (BreastCancer.org, 2014) • HT treats hormone-receptor-positive breast cancers in two ways: • by lowering the amount of estrogen in the body • by blocking the action of estrogen on breast cancer cells  • Estrogen makes hormone-receptor-positive breast cancers grow- reducing the amount of estrogen or blocking its action can reduce the risk of early-stage hormone-receptor-positive breast cancers recurring after surgery • HT helps shrink or slow the growth of advanced-stage or metastatic hormone-receptor-positive breast cancers

  9. Hormone Therapy Agents (National Cancer Institute, 2012) • HT may be considered for women whose breast cancers test positive for estrogen and progesterone receptors: • Tamoxifen (Nolvadex) is a medication used in HT to treat breast cancer by blocking the effects of estrogen on the growth of malignant cells in breast tissue (does not stop the production of estrogen)

  10. Continued (National Cancer Institute, 2012) • Aromatase Inhibitors: drugs recently approved by the US Food and Drug Administration (FDA)- to prevent the recurrence of breast cancer in postmenopausal women • Anastrozole (Arimidex) and Letrozole (Femara)- prevent estrogen production • Anastrozole effective only in women who have not had previous HT for breast cancer • Letrozole is effective in women who have previously been treated with tamoxifen- possible side effects of these drugs include osteoporosis or bone fractures

  11. Continued (National Cancer Institute, 2012) • Fulvestrant (Faslodex)- used for recurrent breast cancer- eliminates the estrogen receptor rather than blocking it, as is the case with Tamoxifen, Letrozole, or Anastrozole • Used following previous antiestrogen therapy- side effects include hot flashes, mild nausea, and fatigue • Men with breast cancer may also be treated with Tamoxifen

  12. Common Side Effects (BreastCancer.org, 2014) Hot flashes and sweats Change to your periods Less interest in sex Vaginal dryness or discharge Feeling sick Painful joints Mood changes Tiredness

  13. Possible Long Term Side Effects (BreastCancer.org, 2014) Bone thinning: particularly associated with taking aromatase inhibitors for a long period Womb cancer: particularly associated with taking Tamoxifen but the benefits of reducing recurrent cancer outweighs the risks Eyesight changes: Tamoxifen Risk of blood clots: Tamoxifen- specifically affects the legs or lungs

  14. Prostate Cancer Hormone Therapy

  15. Why Hormone Therapy is used? (Stanford Cancer Center, 2014) • Advanced or metastatic: HT can shrink the cancer and slow the growth of tumors, relieving signs and symptoms • Locally advanced: HT may make external beam radiation therapy more effective • HT reduces the high risk of recurrence after initial treatment

  16. Hormone Therapy Agents (Mayo Clinic Staff, 2014) Luteinising hormone (LH) blockers:include Goserelin (Zoladex), Buserelin, Leuprorelin(Prostap), Histrelin(Vantas), and Triptorelin(Decapeptyl) Gonadotrophin releasing hormone (GnRH) blockers: Degarelix (Firmagon) Anti androgens: Flutamide (Drogenil) and Bicalutamide(Casodex) Abiraterone

  17. Common Side Effects (Mayo Clinic Staff, 2014) Erection problems (impotence) Hot flashes and sweating Breast tenderness Tumor flare pain

  18. Possible Long Term Side Effects (Mayo Clinic Staff, 2014) Weight gain Memory problems Mood swings and depression Bone thinning (osteoporosis) Risk of earlier heart attack

  19. Advantage of Using Hormone Therapy Used as an adjuvant to traditional treatment Minimal (less severe) side effects from HT A range of different HTs provides more options if side effects occur and become problematic Effectiveness of each HT agent varies and is under current clinical trials

  20. References American Cancer Society. (2014). Hormone therapy for breast cancer. Retrieved from http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-treating-hormone-therapy BreastCancer.org. (2014, January 12). Hormonal therapy.Retrieved from http://www.breastcancer.org/treatment/hormonal Mayo Clinic Staff. (2014). Hormone therapy for prostate cancer. Retrieved from http://www.mayoclinic.org/tests-procedures/hormone-therapy-for-prostate-cancer/basics/definition/prc-20015058 National Breast Cancer Foundation Inc. (2012). Hormone therapy.Retrieved from http://www.nationalbreastcancer.org/breast-cancer-hormone-therapy

  21. Continued National Cancer Institute. (2012, August 2). Hormone therapy for breast cancer. Retrieved from http://www.cancer.gov/cancertopics/factsheet/Therapy/hormone-therapy-breast Stanford Cancer Center. (2014). Hormone therapy for cancer treatment. Retrieved from http://cancer.stanford.edu/information/cancerTreatment/methods/hormone.html WebMD. (2014). Hormone therapy and breast cancer. Retrieved from http://www.webmd.com/breast-cancer/hormone-therapy-overview

  22. Thank you!

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