What Is Hormonal Therapy?

May 4, 2018

We all have receptors on breast cells, but not everyone has estrogeninfo-icon receptors on their breast cancer cells. Estrogen sends signals that control cellinfo-icon pathways. Receptors on the surface of breast cancer cells work like satellite dishes. They detect and bring in hormoneinfo-icon signals. These signals can direct cells to grow, multiply and repair damage.

If estrogen receptors are found on breast cancer cells, the breast cancer is called estrogen receptor-positiveinfo-icon, or ERinfo-icon+. When progesteroneinfo-icon receptors are found, the cancer is progesterone receptor-positiveinfo-icon or PRinfo-icon+. About two-thirds of breast cancers are hormone receptorinfo-icon-positive, also known as hormone-sensitive. They may be:

  • Both ER-info-iconpositive and PR-info-iconpositive
  • ER-positive only
  • PR-positive only

Even if the cancer has only one type of receptorinfo-icon, or tests just slightly positive, studies show hormonal therapyinfo-icon can benefit you.

Hormonal therapy for breast cancer is not the same as estrogen or hormone replacement therapyinfo-icon, also called ERT or HRT, used in menopauseinfo-icon. ERT or HRT replaces or puts back hormones. It is not advised for women affected by breast cancer.

How Hormonal Therapy Works

Hormonal therapyinfo-icon for breast cancer blocks estrogeninfo-icon. It interferes with the signals that hormoneinfo-icon receptors send to cells. Depending on the type, hormonal therapy may block estrogen receptors, reduce the amount of estrogen made, or lessen the number of hormone receptors.

You may receive hormonal therapy after surgeryinfo-icon, chemotherapyinfo-icon or radiationinfo-icon. Or, your doctor may recommend you take hormonal therapy at the same time as other treatment, such as targeted therapies for HER2-positive disease. In some cases, you may take hormonal therapy to shrink tumors before surgery.

Depending on the type of hormonal therapy, you may take it as a pill, as liquid or by injectioninfo-icon. Another option is oophorectomyinfo-icon, surgery to remove the ovaries. If you have oophorectomy, you may receive additional hormonal therapy afterward. It is also possible to take medicineinfo-icon that stops the action of the ovaries.

The standard course of hormonal therapy treatment is daily for 5 to 10 years. Be sure to ask your providers how you will receive treatment, how often you will take it and why they recommend each combination. Even though they work in different ways, hormonal therapies have been shown in long-term research to be effective against hormone receptorinfo-icon-positive disease. No matter what other treatments you receive, hormonal therapy can lower the chances  breast cancer will come back.

Because hormonal therapy can change the amount of estrogen in your body or the way your ovaries work to produce estrogen, they impact your fertilityinfo-icon. If you are premenopausalinfo-icon, talk with your healthcare team about ways to protect fertility while on hormonal therapy.

How Do You Know if You Need Hormonal Therapy?

Your doctor will recommend hormonal therapyinfo-icon if the cancer tests estrogen receptor-positiveinfo-icon, progesterone receptor-positiveinfo-icon, or both. If it does, this means the hormones your body naturally makes helps the cancer to grow. Right after diagnosisinfo-icon, you had tests that checked the hormonal status of the cancer cells. You can find the results of those tests in your pathology reportinfo-icon.

Which hormonal therapy you get will depend on your menopausal status, or whether you still get your monthly period regularly, get it only sometimes, or have stopped having your period permanently because of age or medicineinfo-icon.

Adjuvant and Neoadjuvant Hormonal Therapy

In early-stage breast cancerinfo-icon, you can receive hormonal therapyinfo-icon either before or after primary therapyinfo-icon with surgeryinfo-icon and with chemotherapyinfo-icon or radiationinfo-icon, if these treatments are needed.

When hormonal therapy is given after surgery, it is called adjuvant therapyinfo-icon. It also might be given at the same time you receive another treatment, such as radiation therapyinfo-icon, chemotherapy or trastuzumabinfo-icon (Herceptininfo-icon).

Some people receive hormonal therapy before surgery, called neoadjuvant therapyinfo-icon. Your doctor may suggest neoadjuvant hormonal therapy if you have a tumorinfo-icon that is too large to be removed with lumpectomyinfo-icon. This may increase the chances you can preserve your breast.

Hormonal Therapy Side Effects

Many people experience side effects from hormonal therapyinfo-icon, though how bad they are and how often they happen differs for each person. Side effects can include hot flashes, vaginal dryness, fatigue, bone thinning or pain, hair thinning, nausea and loss of interest in sex.

If you become uncomfortable during treatment, there are many medicines and methods to help you. Let your doctors and nurses know about your concerns before you start treatment. Your team has many options to lessen, manage or stop side effects.

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