Hormone Therapy

What is hormone therapy?

Some cancers need hormones to grow. Hormones are the body’s messengers. For example, estrogen and progesterone in women and testosterone in men play a part in the growth of some cancer cells.

Hormone therapy, also called endocrine therapy, slows or stops the growth of these cancers. It does this in one of two ways:

• Stopping the body from making the hormone
• Keeping the hormone from acting on the cancer cell

Hormone therapy is different from hormone replacement therapy, which is used for menopause symptoms.

Who is it for?

Hormone therapy is mostly used for certain breast and prostate cancers, meaning cancers that are sensitive to hormones. Your doctor tests a sample of the tumor, for example with a hormone receptor test, to find out whether your cancer depends on hormones.

Hormone therapy is often used along with other treatments, such as surgery, radiation therapy, or chemotherapy. The goal may be one of these:

• Shrinking the tumor before surgery or radiation therapy
• Lowering the chance that the disease comes back after other treatments
• Treating disease that has come back or spread
• Easing symptoms in some prostate cancer patients who are not good candidates for surgery or radiation therapy

Every patient’s treatment plan is different; ask your doctor about your own situation.

How is hormone therapy given?

The main ways are:

• Pills: usually taken at home.
• Shots: under the skin or into a muscle, at a doctor’s office, clinic, or hospital.
• Surgery: removing the organs that make the hormone, which means the ovaries in women or the testicles in men. This is only suggested in special cases.

Only your doctor decides the type of medicine, the dose, and how long you take it. This depends on the type of cancer and the goal of treatment. With pills, taking them regularly is important. If you forget a dose, do not decide on your own what to do; ask your doctor or pharmacist.

Hormone therapy usually goes on for a long time, so taking your medicine regularly and keeping your appointments matters. If side effects bother you, report them; your doctor may change the medicine or the plan. Stopping the medicine on your own can make the treatment work less well.

Your doctor will see you regularly during treatment. In prostate cancer, you may have a blood test called PSA. In breast cancer, you may have mammograms and sometimes imaging and blood tests.

What is each session or visit like?

If your treatment is pills, you usually have no sessions, and your visits are only for checkups and tests.

If your treatment is a shot, a nurse or doctor gives it at an office or clinic. The shot is usually quick, and your doctor decides how far apart they are, for example every few weeks or months. The spot may be a little sore or red afterward. If you have severe redness, swelling, or pain, tell your care team.

Common side effects and how to care for yourself

Side effects depend on the type of medicine, the type of cancer, and your sex. These are side effects that some people have:

• Hot flashes and sweating. Wear layers of cotton clothing and keep your room cool.
• Changes in sex drive. This is common and nothing to be embarrassed about. Talk openly with your doctor about it.
• Fatigue. Get enough rest. Light walking can help.
• Weaker bones. Talk to your doctor about checking your bone density and about nutrition.
• Weight gain. A balanced diet and as much physical activity as you can manage help, and you can talk to a dietitian.
• Mood changes. If sadness or anxiety lasts, tell your doctor.
• In women: vaginal dryness and changes in periods (before menopause). In men: breast tenderness or enlargement.

Before you start, ask your doctor which side effects are more likely with your medicine and what tests you will need. Do not start any medicine, supplement, or herbal product without telling your doctor.

When to call right away

Call your care team if you:

• Have pain or swelling in one leg, especially the calf
• Suddenly have trouble breathing or chest pain
• Suddenly have weakness on one side of the body, trouble speaking, or a severe, sudden headache
• Have unusual bleeding or discharge that worries you
• Have new, severe bone pain, or weakness or numbness in your legs
• Have a fever of 38 degrees Celsius (100.4 degrees Fahrenheit) or higher
• Have thoughts of harming yourself

If you have severe trouble breathing, chest pain, or signs of a stroke, call 115 (Iran’s emergency number) or go to the nearest emergency room.

Every patient’s treatment plan is different; ask your doctor about your own situation.