What to Expect from Hormonal Therapy for Breast Cancer

What to Expect from Hormonal Therapy for Breast Cancer

Hormonal therapy for breast cancer is designed to deal with cancers which have been shown to be affected by hormones in a woman’s body, namely estrogen and progesterone. When your doctor takes a sample of your tumor, they will be able to stage and grade the cancer, that is, see how far it might have spread, and whether or not the cells are similar to one another, or very irregular. That will give them an idea of the best treatment options for your cancer.

They will also investigate whether or not the cancer is sensitive to the two hormones mentioned. If it is, then it will be classified as estrogen-receptor positive (ER+) and or progesterone-receptor positive (PR+). If this is the case, then your doctor will recommend one or more hormonal treatments.

Your overall health

In addition to the type of cancer, the doctor will have to look at a range of other health factors to choose the right therapy. You need to consider:

  • your menopausal status (your age and whether or not you have stopped having periods)
  • your breast cancer stage
  • your history, if any, of blood clots
  • whether or not you have bone density issues, such as osteoporosis
  • any history of arthritis
  • a past history, or risk of, endometrial, uterine and/or ovarian cancer
  • any side effects you might have once you start taking a hormonal therapy

There are 7 drug available at the current time. The above factors will narrow down which is the best choice for you, and in particular, your age and menopausal status, since some of these drugs would not be suitable for younger women, and vice versa.

The 7 drugs, organized by class are:

Aromatase inhibitors:

  • Anastrozole
  • Letrozole
  • Exemestane

SERMs (selective estrogen receptor modulators):

  • Tamoxifen
  • Raloxifene
  • Toremifene

ERDs (estrogen receptor downregulators):

  • Fulvestrant

Aromatase inhibitors lower the amount of estrogen in the body. They are suitable only for women who have been through menopause. Exemestane is approved for adjuvant treatment of early-stage breast cancer in women who have received tamoxifen in the past.

Tamoxifen has been used for more than 30 years to treat breast and other cancers effectively. Fulvestrant not only stops estrogen from being absorbed into the system by the estrogen receptors, it destroys the receptors themselves. It can be used by women who have been through menopause and not had good results with tamoxifen.

Discuss the different options with your doctor, particularly the side effects of these medications, and you should increase your chances of being cancer-free.


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