Global Vision NGO : About Hormone Therapy

2.  Hormones are chemicals secreted by the body.
These chemicals are responsible for controlling
physical development from puberty to old age.
Some types of tumors require the presence of
hormones to grow. Doctors try to kill such tumors by
manipulating the body's hormone supply. This
involves administering a hormone or hormone-like
chemical, which counters the required hormone's
effects. This technique, called hormone therapy,
deprives the body of the hormone needed for
tumor growth. Malignancies of the breast and
prostate are especially vulnerable to this kind of
treatment.

3.  In earlier forms of the therapy, organs responsible
for hormone production, ovaries in the case of
women and testes in the case of men, as well as
the adrenal glands were removed. This resulted in
severe physical and psychological side effects
including hot flashes, increased risk of heart
disease, men growing breasts and facial hair in
women.

4.  Thanks to some new drugs, treatment can stem
hormone supply without these unacceptable side
effects. Tumor cells have proteins that sit on the cell
surface and combine chemically with hormones in
the bloodstream, taking them inside and using
them to grow. These proteins are called receptor
sites. The new drugs compete with hormones for
these sites. They are taken into the cell in
preference to the hormone and kill the cancer cell
from within. The most successful example of this is
Tamoxifen, a drug used for breast cancer therapy,
which competes with estrogen, a hormone
needed by breast cancer cells for growth.

5.  The tumour must first be tested for the presence
of estrogen receptors to ascertain whether
they will respond. A positive test means that the
cell has estrogen receptors and that the
cancer depends on hormones to grow and so
is likely to shrink with hormone manipulation.
The more the receptors, the better the chance
of success. Tamoxifen may be used along with
another hormone deprivation drug, called
aminogluthethimide, which targets the adrenal
glands, another hormone producing site.
Steroids may be needed while therapy is going
on, but once therapy is stopped; the adrenal
glands will again start normal functioning.

6.  In an analogous case, the drug Leuprolide has
been used to treat prostate cancer by starving
tumours of testosterone. However the effect
may not last for very long. After a year or two,
the body becomes immune to hormone
suppression and the cancer could become
resistant to the therapy. So doctors are
beginning to use a drug like flutamide along
with leuprolide to ensure a more complete
deprivation of the male hormone. This therapy
is especially useful for men who cannot have
surgery.

7.  The real value of hormone therapy is in
combination with other therapies. They may be
used before surgery to shrink a tumour to an
operable size or after surgery to mop up or control
cells that escaped the scalpel. In some cases this
may be enough, but in others, chemotherapy may
still be indicated to finish the job. However, less
toxic doses of these drugs may then be required.

8.  Although side effects to hormone therapy are far
milder than those to chemotherapy, they should
not be dismissed. Men may notice softened skin or
larger breasts, while women may develop a
lowered voice. Hot flashes can be relieved by daily
doses of Vitamin E. Weight gain from steroids can
be reversed by taking a low sodium diet and
regular exercise. These side effects are all
reversible.
 Side effects must be closely monitored to
determine how the treatment is working. If you
experience bone pain, for example, it could be an
indication that hormones are affecting distant sites.
Reporting such side effects to the doctor is very
important.