What Patients Should Know About Hormone Therapy For Breast Cancer

Breast cancer is not just a single disease. Instead, it includes several types and subtypes, each with unique characteristics that influence how the cancer grows and responds to treatment. One of the most common types is hormone receptor-positive (HR+) breast cancer, which grows in response to hormones such as estrogen and progesterone.

For many patients diagnosed with HR+ breast cancer, hormone therapy plays an important role in treatment. This therapy works by blocking or lowering the hormones that can fuel cancer growth. While hormone therapy is highly effective for many people, it is helpful to understand how it works, who it may benefit, and what potential side effects to expect when considering this approach.

How Hormone Therapy Treats Breast Cancer

Some breast cancer cells have receptors that allow hormones like estrogen and progesterone to attach to them. These are known as estrogen receptor-positive (ER+) or progesterone receptor-positive (PR+) cancers. When hormones bind to these receptors, they can stimulate cancer cells to grow and multiply uncontrollably.

Hormone therapy works in two main ways:

• Blocking hormones from attaching to their receptors on cancer cells

• Reducing hormone production in the body

By interfering with these processes, hormone therapy can slow tumor growth and reduce the risk that the cancer will return.

Common Types of Hormone Therapies for Breast Cancer

Several types of hormone therapy are used to treat hormone receptor-positive breast cancers. The right option depends on factors such as menopausal status and whether the cancer cells are estrogen-positive (ER+), progesterone-positive (PR+), or both. More than half of estrogen receptor-positive breast cancers are also positive for progesterone receptors.

1. Medications that block estrogen's effect on breast cancer cells

Some medications prevent estrogen from attaching to cancer cells, slowing their growth and helping destroy them. These include:

• Selective estrogen receptor modulators (SERMs), such as Tamoxifen and Toremifene (Fareston)

• Selective estrogen receptor degraders (SERDs), like Fulvestrant (Faslodex) and Elacestrant (Orserdu)

2. Lowering hormone production in postmenopausal women

After menopause, estrogen is mainly produced in fat tissue through an enzyme called aromatase. Aromatase inhibitors (AIs) reduce estrogen production in the body, which helps “starve” cancer cells that are sensitive to hormones. Common AI medications include:

• Letrozole (Femara)

• Anastrozole (Arimidex)

• Exemestane (Aromasin)

3. Ovarian suppression for premenopausal women

Before menopause, the ovaries produce most of the body’s estrogen. In certain cases, treatment may focus on stopping hormone production. Ovarian suppression can be achieved through:

• Surgical removal of the ovaries (oophorectomy).

• Medications known as luteinizing hormone-releasing hormone (LHRH) agonists stop the ovaries from producing estrogen. Examples of these drugs include goserelin (Zoladex) and leuprolide (Lupron). These may be used alone or in combination with other hormone therapies.

Learn more about hormone receptor status in breast cancer.

When Hormone Therapy May Be Recommended

Hormone therapy is most commonly used after surgery to help prevent the cancer from coming back. It’s typically recommended for at least five years. It can be started before surgery and is also used for recurrent breast cancer to slow the spread.

In some cases, healthy women who have a strong family history of breast cancer or inherited gene mutations, such as BRCA1 and BRCA2, may also consider hormone therapy to help prevent cancer from developing.

Advantages and Disadvantages of Breast Cancer Hormone Therapy

For many women, the benefits of hormone therapy often outweigh the potential side effects, making it an important part of breast cancer treatment. Understanding what hormone therapy involves and what you could expect along the way can help you feel more confident in your care.

Benefits of Hormone Therapy for Breast Cancer

Hormone therapy offers several significant benefits for many breast cancer patients, including:

• Lower risk of recurrence: Hormone therapy is one of the most effective ways to reduce the chance that hormone-receptor-positive breast cancer will return. It has been noted that taking hormone therapy as prescribed can decrease the likelihood of recurrence by at least 40%.

• Improved long-term survival: By slowing or stopping cancer growth, hormone therapy can contribute to better long-term outcomes for many patients.

• Convenient treatment: Many hormone therapy medications are taken orally, allowing patients to continue treatment from home rather than requiring frequent clinic visits.

• Non-cytotoxic: Unlike chemotherapy, which can affect both cancerous and healthy cells, hormone therapy specifically targets hormone-sensitive breast cancer cells.

• Effective for advanced disease: Hormone therapy can also help manage symptoms and control tumor growth in advanced hormone receptor-positive breast cancers.

Potential Drawbacks of Breast Cancer Hormone Therapy

While many patients have been effectively treated with hormone therapy, it’s important to understand that there are some disadvantages to consider:

• Requires long-term commitment to treatment: Hormone therapy often continues for several years—approximately 5 to 10 years or longer—depending on individual circumstances.

• Side effects: Some people experience hot flashes, mood swings, joint pain, vaginal dryness, and fatigue. How long these side effects may last often depends on the duration of hormone therapy use. Your oncologist can recommend different medications or adjust doses to help manage these effects if they occur.

• Risk of serious complications: Some medications, particularly tamoxifen, may increase the risk of blood clots in certain individuals.

• Bone density changes: Hormone therapy can lead to reduced bone density over time, especially in younger women receiving ovarian suppression.

• Not effective for all breast cancers: Only hormone receptor-positive breast cancers respond to hormone therapy. Tumors that do not rely on hormones for growth will require a different type of treatment approach.

Personalized Breast Cancer Care With Hormone Therapy in Brevard County

At Cancer Care Centers of Brevard, our breast cancer doctors are here to create a personalized plan that reflects each patient’s unique diagnosis. If this includes hormone therapy, we will help you weigh the benefits and potential side effects so you can feel confident moving forward.

If you have recently been diagnosed with breast cancer, schedule a consultation or a second opinion with one of our oncologists in Palm Bay, Rockledge, Melbourne, and Merritt Island, Florida.

Categories: Breast Cancer