Hormones are substances produced by glands in our body. Once released, through the bloodstream the hormones reach the target tissue where they regulate their activity by binding to specific receptors present on cell surface of the tissue.
Numerous scientific discoveries have shown that in some cases the hormones produced by our body can increase the incidence of some neoplasms by behaving as endogenous natural carcinogens.
The tumors whose growth could be stimulated in some cases by hormones are those of the breast, endometrium, ovary, prostate and kidney.
The hormones most involved in the onset of the tumor are estrogens, androgens and prolactin.
To counteract their production or their proliferative action, a new therapy has been developed for several years which is called hormone therapy. The most used drugs are the following:
- Antiestrogenic
In women they prevent the combination of estrogen product by the body with the receptor present on cancer cells stimulating their growth.
It is mainly used in pre-menopausal women but also in post-menopausal women.
These drugs are commercially available under the following names: Nolvadex®, Kessar®, Nomafen®, Tamoxene® or with the generic name Tamoxifene.
- Anti-androgens
In men they prevent the combination of androgen (testosterone) producted by the body with the receptor present on cancer cells stimulating their growth.
- Aromatase inhibitors
In women they prevent the conversion of androgens into estrogen that normally takes place in the liver, muscle and fatty tissue, consequently the total estrogen levels decrease. They are reserved for postmenopausal women.
These drugs are commercially available under the following names: Arimidex®, Femara®, Aromasin® or with the generic names Anastrozole, Letrozole and Exemestane respectively.
- Progestin
Equipped with anti-estrogenic action.
They are reserved for postmenopausal women and in those there therapy with antiestrogens or aromatase inhibitors has failed.
- Analogues of the LHRH
In women and men they inhibit the production of estrogens and androgens by the ovaries and the testicle.
In women they are reserved only for those in the pre-menopausal state and induce a temporary blockage of the menstrual cycle.
These drugs are commercially available under the following names: Decapeptyl®, Enantone® and Zoladex®
Hormone therapy is always indicated when cells express hormone receptors on their surface. Not all cancer cells express them therefore not all of them are sensitive to the action of hormones therefore hormone therapy is not effective in these patients.
Hormone therapy can be administered:
- Orally via capsules or tablets
- Subcutaneously
The possible side effects of hormone therapy are as follows:
- Hot flashes
- Insomnia
- Weight increase
- Skeletal pain
- Vaginal dryness
- Mood swings and depression
- Erection difficulties