17108 Hormone Therapy To Treat Cancer

Overview

Hormone therapy is a cancer treatment that slows or stops cancers that need hormones to grow. Hormones are natural chemical messengers your body makes. Some cancers, especially some breast, prostate and womb cancers, have tiny receivers (called receptors) on their cells that pick up hormones and use them as fuel to grow. Hormone therapy works by blocking those hormones or lowering the amount your body makes, so the cancer cells get less of what they need. It is sometimes called hormone treatment or endocrine therapy. It is not the same as hormone replacement therapy (HRT), which is used for menopause symptoms.

Yes. Hormone therapy is one of the most common treatments for hormone-sensitive breast and prostate cancer worldwide, and it is also used for some womb cancers.

Symptoms

Common symptoms

• Tiredness or low energy
• Hot flushes and night sweats
• Joint and muscle aches or stiffness
• Mood changes, low mood or feeling tearful
• Trouble sleeping
• Lower sex drive and, in women, vaginal dryness or discomfort during sex
• Changes in weight or appetite
• Thinning hair or hair changes
• Feeling sick or mild indigestion
• Bone thinning over time, which can raise the risk of fractures

Symptoms in children

• Hormone therapy for cancer is rare in children and is only used by specialist children's cancer teams.
• If it is used, the team watches growth, puberty and bone health closely.
• Parents and carers are given clear information about what to look out for and who to call.

Symptoms in older adults

• Side effects can overlap with other health conditions, such as heart problems, arthritis or diabetes.
• Bone thinning and falls become more of a concern, so bone health is often checked.
• Tiredness and dizziness can affect daily life, so the team will review all your medicines together.
• Treatment choices are usually adjusted to fit your overall health and what matters most to you.

Causes

Main causes

• Hormone therapy is used when a cancer grows faster because of hormones. This is most common in some breast cancers (which can be driven by oestrogen or progesterone), prostate cancers (driven by testosterone), and some womb cancers.
• Doctors test a sample of the cancer for hormone receptors. A 'positive' result means the cancer is likely to respond to hormone therapy.
• Sometimes hormone therapy is used before surgery to shrink a tumour, and sometimes after surgery to lower the chance of the cancer coming back.

Risk factors

• Having a cancer that tests positive for hormone receptors is the main reason hormone therapy is offered.
• Your menopause status affects which type of hormone therapy is suitable.
• Past blood clots, bone health, heart health and liver health are checked, because some treatments can affect these.
• Other medicines you take and any allergies are reviewed before treatment starts.
• Personal preference matters too. Your team will talk through the benefits and the side effects so you can decide together.

When to see a doctor

See a doctor urgently if:

• You develop a high temperature, shivering or feel very unwell
• You have sudden breathlessness, chest pain, or a swollen painful leg
• You cannot keep fluids down, or you have severe pain
• You notice any sign of a serious reaction after treatment, such as swelling of the face or lips, or a widespread rash
• You feel very low, hopeless, or have thoughts of harming yourself

Book a routine appointment if:

• Side effects are bothering you day to day, such as hot flushes, joint pain, low mood or trouble sleeping
• You are finding it hard to remember to take your treatment
• You want to talk about bone health, sexual wellbeing, or fertility
• You are thinking about stopping treatment early. Please talk to your team first rather than stopping on your own
• You have questions about your follow-up plan or test results

Diagnosis

Hormone therapy is not a diagnosis itself. It is offered after tests show that a cancer depends on hormones. Doctors take a small sample of the cancer (a biopsy, or a sample taken during surgery) and test it for hormone receptors. They also check your general health and hormone levels so they can choose the safest option for you.

Tests that may be done

• Biopsy of the cancer, with laboratory testing for hormone receptors
• Blood tests to check hormone levels, blood counts, liver, kidney and bone health
• Scans such as X-ray, ultrasound, CT, MRI or bone scan to see the size of the cancer and whether it has spread
• Sometimes extra laboratory tests on the cancer sample to guide treatment choices
• Bone density scan, if bone thinning is a concern
• Heart checks if your team thinks they are needed

What to expect at your appointment

You will usually have a conversation with a specialist team about what the tests show, what the treatment is for, and how long it is likely to last. You should have the chance to ask questions and to bring someone with you. Starting treatment is your decision, and you can take time to think.

Treatment

Hormone therapy aims to slow or stop hormone-sensitive cancers by lowering hormone levels or blocking hormones from reaching cancer cells. It can be the main treatment, or used alongside surgery, radiotherapy, chemotherapy or other treatments. Your plan depends on the type of cancer, its stage, whether you have been through menopause, and your overall health.

Self-care at home

• Take your treatment as agreed with your team, and use reminders if you find it hard to remember
• Keep a simple diary of side effects so you can describe them clearly at appointments
• Stay gently active, which helps with tiredness, joint stiffness and mood
• Look after your bones with weight-bearing activity, enough calcium and vitamin D from your diet, and sensible sun exposure
• Ask your team or pharmacist before starting any new medicine, vitamin or herbal supplement, as some can interact with treatment
• Use sunscreen and avoid sunburn, as some treatments make your skin more sensitive
• Get plenty of rest and tell people close to you how you are feeling
• Keep up with any vaccinations or checks your team advises

Medical treatments

There are two broad approaches. One lowers the amount of hormone your body makes, usually by giving a regular injection or by removing the organs that produce the hormone. The other blocks the hormone from attaching to cancer cells, usually with tablets taken daily. Some treatments are used only before menopause and others only after, and some are used for men with prostate cancer. Your specialist team will explain which approach suits your cancer and why, what benefits to expect, and what side effects are likely. They will also tell you what to do if side effects become difficult. Always talk to your team before changing or stopping any treatment.

When is surgery considered?

Surgery is sometimes part of hormone therapy. For some cancers, an operation to remove the ovaries or the testicles permanently lowers the hormones that feed the cancer. This is a big decision and is only offered after a full discussion of the benefits and downsides, including that it cannot be reversed. Surgery may also be used to remove the original tumour before or after hormone therapy. Your team will explain whether this applies to your situation.

Living with this condition

Many people work, care for family and carry on with normal life during hormone therapy, though some days will feel harder than others. Side effects often settle or become easier to manage over time. Plan demanding tasks for when you have the most energy, ask for practical help, and keep appointments written down so nothing gets missed.

Lifestyle tips

• Stay active in a way you enjoy, starting gently and building up
• Protect your sleep with a regular bedtime and less screen time late at night
• Cut down on alcohol and avoid smoking, which supports bone and heart health
• Keep cool with layers, fans and cool drinks if hot flushes bother you
• Use a water-based lubricant or moisturiser if you have vaginal dryness, and talk to your team about sexual wellbeing
• Stay connected with friends, family and support groups rather than coping alone

Diet and exercise

A balanced diet with plenty of vegetables, fruit, whole grains, and protein supports energy and bone health. Aim for some weight-bearing and muscle-strengthening activity most days, plus gentle movement like walking or swimming. Ask your team before starting a new exercise plan, especially if you have bone thinning, pain or other health conditions, and ask whether you should see a physiotherapist or dietitian.

Mental health and emotional wellbeing

It is very common to feel anxious, low, angry or worried about the future when you are having cancer treatment. Side effects can also affect mood and body confidence. These feelings are understandable and treatable. Talking therapies, peer support and, where appropriate, medicines can help. If you ever feel hopeless or have thoughts of harming yourself, please reach out to your doctor, your cancer team, or your local emergency services straight away. You do not have to cope alone.

Prevention

You cannot prevent the need for hormone therapy, because it depends on the type of cancer you have. What you can do is take the treatment as agreed, attend your follow-up appointments, and look after your general health so you are in the best position to cope with treatment.

Vaccines

Vaccines do not prevent hormone-dependent cancers. However, keeping up with the vaccinations your team recommends is important, because some cancer treatments lower your immunity.

Screening programmes

Screening programmes for breast and cervical cancer are available in many countries, including through the NHS in the UK, and can find changes early. Screening does not prevent cancer, but it can help catch it sooner. Ask your local health service what you are eligible for, and see your doctor promptly about any new lump, unusual bleeding or change in your body.

Complications

If left untreated

• Hormone-sensitive cancers may continue to grow and spread, which can make treatment harder later
• Symptoms such as pain, tiredness or bleeding may get worse
• The risk of the cancer coming back after surgery or radiotherapy is higher if hormone therapy is not taken as advised
• Some side effects, such as bone thinning, are more likely to cause problems if they are not checked and managed

Long-term outlook

For many people, hormone therapy is a highly effective part of treatment that lowers the chance of the cancer returning and helps keep it under control. Side effects can be hard at times, but most are manageable with support, and your team can adjust the plan to suit you. Many people live well for many years after treatment. Your own outlook depends on your type of cancer, how far it had spread, and how it responds, and your specialist team can talk this through with you honestly.

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