Hormone Therapy in India
What hormones are
Hormones are natural substances made by glands in our bodies. The network of glands that make hormones is called theendocrine system. Hormones are carried in our bloodstream and act as messengers between one part of our body and another. They have lots of effects and one of these is controlling the growth and activity of certain cells and organs
What hormone therapy is
Cancers that are hormone sensitive or hormone dependent need hormones to grow or develop. Hormone therapies can slow down or stop the growth of cancer by either
- Stopping hormones being made or
- Preventing hormones from making cancer cells grow and divide
Some cancers use these hormones to grow. Hormone therapy for cancer is the use of medicines to block the effects of hormones. It does not work for all types of cancer. Doctors use hormone therapy for people with cancers that are hormone sensitive or hormone dependent.
Cancers that can be hormone sensitive include
- Breast cancer
- Prostate cancer
- Ovarian cancer
- Womb cancer (also called uterine or endometrial cancer)
- and kidney cancer
Types of Hormone Therapy
There are a number of different types of hormone therapy. The type you have depends on a number of factors, including your type of cancer. There is information below about
Breast cancer hormone therapy
The female hormones oestrogen and progesterone affect some breast cancers. Doctors describe these cancers as oestrogen receptor positive (ER+) or progesterone receptor positive (PR+) or both. Hormone treatment for breast cancer works by stopping these hormones getting to the breast cancer cells. There are different types of hormone therapies for breast cancer, such as
- Tamoxifen : is one of the most common hormone therapies used for breast cancer. Both premenopausal women and postmenopausal women can take tamoxifen. It works by stopping the hormone oestrogen from reaching cancer cells. Some breast cancer cells have areas called receptors. When oestrogen locks onto the receptors, it can encourage the breast cancer cells to divide so that the cancer grows. Tamoxifen blocks these receptors
- Aromatase inhibitors: You may have an aromatase inhibitor if you have been through the menopause. After menopause, your ovaries stop producing oestrogen. But your body still makes a small amount by changing other hormones (called androgens) into oestrogen. We need an enzyme called aromatase to make this change happen. Aromatase inhibitors block this enzyme so that it can’t change androgens into oestrogen.
- Luteinising hormone (LH) blockers: A gland in the brain, called the pituitary gland, controls the amount of sex hormones made by the ovaries. In women, LH blockers are drugs that stop the ovaries making oestrogen or progesterone. They do this by blocking the signal from the pituitary gland to the ovaries
Prostate cancer hormone therapy
Prostate cancer depends on the male hormone testosterone for its growth. Hormone therapy aims to reduce or stop the body making testosterone to slow down or stop the growth of the cancer. There are different types of hormone therapy, including
luteinising hormone (LH) blockers : A gland in the brain called the pituitary gland produces luteinising hormone (LH) that controls the amount of testosterone made by the testicles. LH blockers are drugs that stop the production of luteinising hormone. So the testicles stop making testosterone.
anti androgens : Prostate cancer cells have areas called receptors. Testosterone attaches to these receptors and that can encourage the cells to divide so that the cancer grows. Anti androgen drugs work by attaching themselves to these receptors. So these drugs stop testosterone reaching prostate cancer cells. There are a few different types of anti androgen, including bicalutamide (Casodex), cyproterone acetate (Cyprostat) and flutamide (Drogenil)
gonadotrophin releasing hormone (GnRH) blockers.: Gonadotrophin releasing hormone (GnRH) blockers stop messages from a part of the brain called the hypothalamus that tell the pituitary gland to produce luteinising hormone. Luteinising hormone tells the testicles to produce testosterone. So blocking GnRH stops the testicles producing testosterone. There is currently only one GnRH blocker and it is called degarelix (Firmagon).
Womb cancer hormone therapy
The female hormones oestrogen and progesterone affect the growth and activity of the cells that line the womb. Doctors give the hormone progesterone to help shrink larger womb cancers. Or it can treat womb cancers that have come back.
Hormone Replacement Therapy (HRT)
Hormone replacement therapy (HRT) is a treatment used to relieve symptoms of the menopause. It replaces femalehormones that are at a lower level as you approach the menopause. The menopause, sometimes referred to as the “change of life”, is when a woman’s ovaries stop producing an egg every four weeks.
Symptoms of a drop in the Estrogen Levels
One of the main symptoms of low estrogen in menopausal women is sleep disturbances. Not being able to sleep well can lead to extreme fatigue during the day, which is another typical sign of low estrogen.
Because of sleep disturbances, women may also experience night sweats, heart palpitations and weight gain. In some cases, they may even have cold sweats. Other signs may include:
- Drier skin, eyes and vagina
- Joint pain
- Bladder and vaginal infections.
- Decreased sex drive is another sign.
- Depression which can result from symptoms
Who Shouldn’t Take Hormone Replacement Therapy?
If you have these conditions, you may want to avoid HRT:
- Blood clots
- Cancer (such as breast, uterine, or endometrial)
- Heart or liver disease
- Heart attack
- Known or suspected pregnancy
Indications for hormone replacement therapy
Current indications for the use of HRT are:
- For the treatment of menopausal symptoms where the risk:benefit ratio is favourable, in fully informed women.
- For women with early menopause until the age of natural menopause (around 51 years), even is they are asymptomatic.
- For those women under 60 years who are at risk of an osteoporotic fracture in whom non-oestrogen treatments are unsuitable.
How Hormone Replacement Therapy is taken
- This therapy can be taken in the form of an implant. The insertion of the small pellets of estrogen is done under the skin of thigh, tummy or buttock. This is done under local anesthesia.
- This therapy can be taken in the form of tablets either through the mouth or can also be directly placed into the vagina for treating dryness.
- HRT is given as a patch that will stick to the skin.
- A gel or cream can also be applied either to the vagina for treating vaginal dryness or can also be applied to the skin.
Benefits of Hormone Replacement Therapy (HRT)
Perhaps the largest benefit women receive from hormone therapy is relief from:
- Hot flashes
- Night sweats
- Sleep difficulties
- Vaginal dryness