Breast cancer treatment hormone therapy

BREAST CANCER TREATMENT: HORMONE THERAPY

 

It has long been recognized that the female hormone oestrogen can stimulate the growth of breast cancer. Most oestrogen is produced by the ovaries until they cease to function at the menopause. Even after the menopause, some oestrogen is still produced by the adrenal glands.
The most common hormone treatment is tamoxifen, which is usually given as tablets, and which blocks the action of oestrogen on breast cancer cells and thus prevents them growing. It will act against any malignant cells which may have spread to other parts of the body before the breast cancer was removed surgically.
The many trials which have been carried out to assess the use of tamoxifen have shown it to be of benefit to almost all women with breast cancer.
Hormone therapy with tamoxifen cannot guarantee a cure, but it does significantly reduce the risk of the cancer recurring. Tamoxifen has to be taken for at least 2 years, and some doctors recommend it is continued for 5 years or more.

Side-effects of tamoxifen
Tamoxifen causes few side-effects. Some women suffer from nausea or tiredness, and frequent hot flushes similar to those experienced at the time of the menopause are quite common. Pre-menopausal women may develop irregular periods, and older women may have vaginal spotting of blood. However, as other causes of vaginal discharge need to be ruled out, you should tell your doctor immediately if you experience this.
A recent study indicated that tamoxifen may be associated with a slight increase in the incidence of cancer of the lining of the womb (endometrial cancer). Vaginal discharge or bleeding may be an early sign of this type of cancer. As in 80 per cent of cases endometrial cancer is curable, and the increase in risk for women taking tamoxifen is small, its benefits for those with breast cancer still outweigh its risks.

The ovaries
If there is a high risk that the breast cancer has spread to other parts of the body in pre-menopausal women, it may be advisable to stop their ovaries producing oestrogen. The ovaries can be removed surgically, in an operation called bilateral oophorectomy, or they can be treated by radiotherapy, which is usually given over a period of a week and which will gradually stop the ovaries working over the next few months. Alternatively, a drug called goserelin (Zoladex) can be given by injection once a month, usually for 2 years.

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