Hormone Therapy San Diego involves taking medicine that blocks or interferes with hormones in the body. It can help control cancer and prevent health problems that occur with age.
It can also reduce symptoms of menopause and improve long-term health. But the benefits and risks depend on what type of hormone therapy you take and how you use it.
Hormone therapy uses medications to block or change the way hormones work in the body. It is one part of cancer treatment and often is given with other drugs or treatments, such as surgery or radiation. It can be used to treat hormone-sensitive cancers that depend on estrogen and progesterone to grow, such as uterine cancer or breast cancer. It can also be used to help reduce the risk that cancer will come back after treatment, called recurrent or metastatic cancer.
Many people who have hormone-sensitive cancer will take some type of hormone therapy for the rest of their lives. It may be daily, monthly, or yearly. The length of time will depend on your health and what kind of treatment plan is being followed for your cancer.
You will need to have regular blood tests and doctor visits while on hormone therapy. Some types of hormone therapy are delivered through a skin patch, gel, ring, or pill that is taken by mouth. Others are injected into the body with a needle. You will also need to follow your health care team’s instructions for what to do if you get sick or have other medical problems while on hormone therapy.
There are different ways to use hormone therapy for menopause, including a combination of medications, such as the estrogen estriol and progestin medroxyprogesterone acetate or the drug letrozole (Femara). This medication is usually given by mouth in a capsule or a gel that is put on the skin. It can also be put into the uterus through an intrauterine device that contains the hormone levonorgestrel. This device is approved for pregnancy prevention and bleeding control in the United States under the brand names Liletta, Kyleena, and Mirena. It is also sometimes used “off-label” along with estrogen to help relieve symptoms of perimenopause, such as irregular periods and hot flashes.
Some women will also need to have a surgical ablation, which involves removal of an organ that makes certain hormones. For example, the testicles may need to be removed to decrease testosterone levels as a part of prostate cancer treatment. Or the ovaries may need to be surgically removed to stop making estrogen as part of breast cancer treatment, which is called an ovarian ablation or bilateral orchiectomy. This is done in a hospital or specialized medical center.
Injected hormone therapy
The type of hormone therapy you get will depend on the type of cancer and where it has spread. Hormone therapy can’t cure advanced prostate cancer, but it can stop it from growing and help control symptoms like bone pain. It may also help you live longer.
Some types of hormone therapy are given as injections. Others are taken as tablets. Your doctor will give you a prescription and you’ll go to a pharmacy to pick it up on a regular schedule. You can find out more about what to expect when having hormone treatment and how to manage your side effects in our booklet, Living with hormone therapy: a guide for men.
You might be offered an injection called lHRH agonists (luteinizing hormone receptor agonists). These work to make your body produce less testosterone. You’ll usually be given a course of anti-androgen tablets as well. You’ll start these before your first lHRH agonist injection and keep taking them for a few weeks.
Other kinds of hormone therapy are used to treat prostate cancer that has spread to other parts of the body (advanced or metastatic prostate cancer). These can be given alone or in combination with other treatments, including radiotherapy. You might be offered abiraterone (Zytiga(r)), enzalutamide (Xtandi(r)) or apalutamide (Erleada(r)). These are newer types of hormone therapy and they’re also sometimes called second-line hormone therapy. They’re often given when your cancer stops responding to other hormone therapies.
These drugs are able to reduce levels of testosterone in the blood, so they can stop your tumours from growing. But they can cause other side effects, such as muscle and joint pain. You might also have problems with your sexual function. These side effects can affect both men and women.
Your doctor will check your PSA level before starting hormone therapy and regularly throughout your treatment. This is to see whether the treatment is working and to catch any changes in your PSA that might mean the cancer is coming back or has stopped responding.
Most of the time, hormone therapy doesn’t cause long-term side effects. But some do last beyond the end of your treatment and need to be managed. Your health care team can help you manage these, so it’s important to tell your doctor about any problems that might be related to your hormone therapy.
Oral hormone therapy
Hormones are chemicals that travel in the bloodstream and help control how some cells and organs act or grow. They are produced by glands (such as the thyroid, parathyroid, adrenal glands, pancreas, ovaries and testicles). Hormone therapy changes the levels of these hormones in your body by blocking them or lowering them. It can help control cancer that uses hormones to grow and improve your quality of life during and after treatment.
You might need oral hormone therapy if you have a certain type of breast or prostate cancer that uses hormones to grow or spread. It can also be used to relieve side effects of other treatments. Hormone therapy can be taken by mouth or as an injection into a vein. It can also be used to treat menopause symptoms such as hot flashes and vaginal dryness. The type and duration of hormone therapy you need depends on your age, the severity of your menopause symptoms and the types of cancer treatments you receive.
Medications called aromatase inhibitors reduce estrogen levels by blocking the enzyme that turns other hormones into estrogen. They are often used in combination with tamoxifen to treat estrogen receptor-positive (ER-positive) cancer. ER-negative cancers are less likely to use estrogen to grow. Tamoxifen is often given with an ovarian suppression drug called progestin to prevent ovulation.
For some premenopausal women, a surgery to remove the ovaries can be used to lower estrogen and may help to control breast cancer that uses hormones to grow. This is known as ovarian ablation or suppression. In addition, a surgical removal of the testicles to reduce testosterone can be done to control some forms of prostate cancer. This is called bilateral orchiectomy.
Your UPMC Hillman Cancer Center team will carefully review your options for hormone therapy during your appointment at a dedicated office visit for this discussion. They will consider your age, family history and personal medical history as well as the severity of your menopause symptoms. They will also talk about your risk of developing osteoporosis and other health problems. UPMC Hillman Cancer Center care teams will work with you to find the best ways to manage side effects during and after hormone therapy.
Side effects of hormone therapy
Hormones are chemicals that help control the activity of certain cells and organs by moving through the bloodstream. They play a role in many body functions, including growth and development, reproduction, mood and how the body turns food into energy. Hormone therapy changes the amount of hormones produced in the body. This can cause side effects. Before you start hormone therapy, talk with your doctor about what to expect and ask questions.
The side effects of hormone therapy can vary depending on the type and dose of drugs used. They can include hot flashes, night sweats, vaginal dryness and thinning or loss of hair. Some types of hormone therapy can increase your risk for heart disease or gallbladder disease. It is important to discuss the risks and benefits of hormone therapy with your doctor at an office visit that is dedicated to this discussion.
Some hormone-related side effects, like thinning or loss of hair, may get better after the first few weeks of treatment. Others, such as hot flashes or vaginal dryness, may take longer to go away. Your doctor can prescribe medications to help ease these symptoms if they are bothersome.
Depending on the type of cancer you have, it is possible that hormone therapy will affect fertility. Women who are trying to conceive should not begin hormone therapy until they are sure they will be able to get pregnant. Men should avoid hormone therapy if they are trying to father children, as it can lower sperm counts. This can be reversed after stopping hormone therapy for 3-6 months, but the sperm count will not return to normal immediately.
Anti-hormone therapy can also treat some cancers by blocking or lowering the hormones that promote tumor growth. It is usually used in combination with other cancer treatments, but it can be used on its own. These drugs can be taken by mouth or injected. Surgery to remove an organ that makes hormones is also sometimes used.
After you complete hormone therapy, your doctor will watch you closely to make sure the treatments are helping and do not cause any unwanted side effects. You will have routine blood, urine or saliva tests to check your hormone levels and adjust the dose if needed.