Hormone Therapy For Breast Cancer Side Effects

Muscle And Bone Changes

You might develop pains in your joints. This often settles down after a few weeks. You can take a mild painkiller to help control aches and pains.

Some hormone therapies such as aromatase inhibitors can cause thinning of your bones. Tamoxifen can cause bone thinning in pre menopausal women. Tamoxifen doesnt cause bone thinning in post menopausal women, and it can help to maintain the strength of your bones.

Weight bearing exercise can help to build up the bones and protect them. This means any exercise where you are carrying your own weight, such as walking, running, cycling or exercise in the gym.

Swimming is not weight bearing exercise. So, although it is good for you in other ways, it won’t help with bone thinning. Check with your doctor before starting any new type of exercise, especially if you have not exercised for a while.

Bone thinning can lead to osteoporosis and bone fractures if it continues for a few years. So, your doctor may treat you with a drug to strengthen your bones.

• Get more information on osteoporosis risk and hormone therapy

Side Effects Of Aromatase Inhibitors Versus Side Effects Of Tamoxifen

Although both aromatase inhibitors and tamoxifen can cause menopausal symptoms such as hot flashes, many of their side effects differ .

Your health care provider can treat many of these side effects.

Learn more about the side effects of tamoxifen.

Having Hormonal Therapy For Breast Cancer

Hormonal therapy drugs reduce the risk of breast cancer coming back. It is important to take it for as long as you have been prescribed it for. Try to make taking it part of your daily routine so it becomes a habit.

Most women cope well with the side effects of hormonal therapy. They may be more of a problem in the first few months, but usually get better over time. If the side effects do not improve or are difficult to cope with, talk to your specialist nurse or cancer doctor. They can prescribe drugs to help and suggest ways of coping.

If you are still having problems after this, then your cancer doctor may suggest changing to a different type of hormonal therapy.

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What Hormones Are Used To Treat Breast Cancer

Hormone Therapy for Breast Cancer. Some types of breast cancer are affected by hormones, like estrogen and progesterone. The breast cancer cells have receptors that attach to estrogen and progesterone, which helps them grow. Treatments that stop these hormones from attaching to these receptors are called hormone or endocrine therapy.

For The Population Studied As A Whole There Was An Overall Deterioration In The Quality Of Life At Two Years From Diagnosis This Deterioration Was Greater In Patients Who Had Received Hormone Therapy Especially After The Menopause By Contrast Chemotherapy Had A Bigger Effect On Quality Of Life In Non

It is important in the future that we are able to predict which women are going to develop severe symptoms with anti-hormonal treatment so that we can support them, added Dr Vaz-Luis. While it has been shown that hormone therapy provides a real benefit in reducing the relapse rate of hormone-dependent cancers which represent 75% of all breast cancers, the deterioration in quality of life may also have a negative effect on patient adherence to treatment. It is, therefore, important to offer them symptomatic treatment, in particular for menopausal symptoms, musculoskeletal pain, depression, severe fatigue and cognitive dysfunction and to combine this with supportive measures such as physical exercise and cognitive behaviour therapy.

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Explain The Difference Between Forced And Induced Menopause Are They Temporary Or Permanent

Tamoxifen works on the uterus as well. In young women, when given alongside Chemotherapy, there is onset of induced menopause due to the shutdown in the functioning of the ovaries. Tamoxifen has two effects: an estrogenic and an anti-estrogenic. So certain organs have the estrogenic effects while certain other organs have the anti-estrogenic effects. The cancer gets the anti-estrogenic effect. Tamoxifen is thus called a Selective Estrogenic Receptor Modulator or SERM. Due to this whole milieu of estrogenic and anti-estrogenic conditions, the periods get affected. In some women it may become irregular, stop entirely and in rare cases become excessive. It is important to keep in mind that even though the periods have stopped, it does not interfere with the womans chances of getting pregnant. Women may get a false impression that no periods mean no conception will happen. Please note that pregnancy during Tamoxifen treatment is highly unadvised because Tamoxifen is harmful to the fetus. So, this temporary stop in periods is not really menopause but just the result of hormonal disturbance. After a period of 3-5 years, periods may restart even though Tamoxifen is ongoing. The younger the woman, the higher her chances of resuming her periods. The periods may be scanty, but it means that they are still pre-menopausal and not reached menopause yet.

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Common Hormonal Therapy Side-effects and tips on how to manage themBy Dr Vani Parmar and Breast Cancer survivors

Younger women who are on Tamoxifen or on ovarian suppression may experience hot flashes, which tend to worsen on consumption of caffeinated drinks especially coffee. Exposure to certain temperatures also makes the hot flashes worse. Maintaining good hydration is prudent to reduce these effects. Mixing peppermint oil and water and spraying that on the back of the neck can provide relief. Stay cool with loose, comfortable cotton clothing and avoid make-up. Majority of hot flashes are spontaneous but transient and usually settle down with time.

• Vaginal Dryness

Application of coconut oil is a very effective remedy. It also helps with rash, itching and flaking skin around the groin area.

• Joint/muscle pains

Unwanted hair growth on the face along with thinning of hair in other areas is often seen.

Speak to a counselor and have these uncomfortable talks with your spouse.

Past Convener, Breast Cancer Working GroupProfessor, Surgical Oncology, Breast ServicesAdvanced Centre for Treatment, Research and Education in Cancer ,

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Possible Side Effects Of Hormone Therapy

Some side effects are common to all methods of hormone therapy and are due to the reduced levels of oestrogen.

These include:

Tamoxifen and aromatase inhibitors also produce some different side effects. You may experience some of the side effects listed, but are unlikely to experience them all.

For most people who are recommended to take hormone therapy for breast cancer, the risks of treatment are outweighed by the benefits.

Here is a list of possible side effects that might be experienced on tamoxifen and aromatase inhibitors:

Is It Safe To Take Estrogen After Breast Cancer

Local estrogen therapy likely reduces the risk of breast cancer recurrence in breast cancer survivors considerably. But by how much is a difficult question to answer, for three reasons: More clinical studies are needed. Only a limited number of small studies have examined the effects of local estrogen therapy on breast cancer survivors.

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Types Of Hormone Therapy For Prostate Cancer

Hormone therapy may be part of prostate cancer treatment if the cancer has spread and cant be cured by surgery or radiation therapyor if the patient isnt a candidate for these other types of treatment. It may also be recommended if cancer remains or returns after surgery or radiation therapy, or to shrink the cancer before radiation therapy.

Additionally, hormone therapy may be combined with radiation therapy initially if theres a high risk of cancer recurrence. It can also be given before radiation therapy to shrink the cancer and make other treatments more effective. Other types of hormone therapy for prostate cancer include:

What Types Of Hormone Therapy Are Used For Breast Cancer

Several strategies are used to treat hormone-sensitive breast cancer:

Blocking ovarian function: Because the ovaries are the main source of estrogen in premenopausal women, estrogen levels in these women can be reduced by eliminating or suppressing ovarian function. Blocking ovarian function is called ovarian ablation.

Ovarian ablation can be done surgically in an operation to remove the ovaries or by treatment with radiation. This type of ovarian ablation is usually permanent.

Alternatively, ovarian function can be suppressed temporarily by treatment with drugs called gonadotropin-releasing hormone agonists, which are also known as luteinizing hormone-releasing hormone agonists. By mimicking GnRH, these medicines interfere with signals that stimulate the ovaries to produce estrogen.

Estrogen and progesterone production in premenopausal women. Drawing shows that in premenopausal women, estrogen and progesterone production by the ovaries is regulated by luteinizing hormone and luteinizing hormone-releasing hormone . The hypothalamus releases LHRH, which then causes the pituitary gland to make and secrete LH and follicle-stimulating hormone . LH and FSH cause the ovaries to make estrogen and progesterone, which act on the endometrium .

Examples of ovarian suppression drugs are goserelin and leuprolide .

Blocking estrogens effects: Several types of drugs interfere with estrogens ability to stimulate the growth of breast cancer cells:

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When Are Hormone Blockers Used

Hormone inhibitors and blocker options may depend on a persons stage of life.

• Hormone inhibitors are only used in postmenopausal women. They can be given to premenopausal women if steps are taken by the treatment team to put the ovaries to sleep by blocking the ovaries from producing estrogen or progesterone.
• Hormonal therapy may also be called anti-hormone treatment. Think of it as the opposite of hormone replacement therapy . If pathology tests show that the tumor in your breast has hormone receptors , then hormonal therapy may be recommended for you after the completion of your acute treatment .
• Hormonal therapy keeps breast cancer cells from receiving or using the natural female hormones in your body which they need to grow. Hormonal therapy also blocks the ability of health breast cells to receive hormones that could stimulate breast cancer cells to regrow again in the form of recurrence of the breast cancer within the breast or elsewhere in the body.

Questions To Ask The Health Care Team

• What side effects are common from the hormone therapy treatment you are recommending for me?

• When is it likely that side effects will occur? How often?

• How long will side effects last? Could any of them be permanent?

• Is there anything I can do to prepare for these side effects?

• What can the health care team do to prevent or relieve side effects?

• Who should I tell if I begin experiencing side effects from hormone therapy? How soon?

• What side effects are considered emergencies? What should I do if I experience an urgent side effect?

• Who do I contact if I have questions about specifci side effects?

• How can I reach them during regular business hours? After hours?

• Are there any support groups you can recommend to help cope with the fear of side effects?

• Are there other ways I can cope with my fears about the effects of treatment?

• Can you recommend a social worker, counselor, or supportive or palliative care specialist for me to talk with?

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Do You Advise Fertility Preservation For Young Patients

Women must realise that fertility preservation is not straight forward. Preservation of the eggs , sperm or fertilised egg are ways to increase ones chances of conception but are not guaranteed. There are lots of nuances that must be weighed in balance. Harvesting an egg is actually a process that requires stimulating the ovary first to produces lots of eggs. This can consequently end up stimulating the cancer too, since tumours can be hormone sensitive. So, we do not advise repeated ovarian stimulations. One attempt before Chemotherapy has started is usually the best choice. For a healthy woman, ovarian stimulations can be done up to 6 times, but this is absolutely not recommended for a breast cancer patient.

Joint Discomfort And Pain

Joint symptoms related to hormone therapy for breast cancer do not tend to improve with the use of medications that you might take for typical arthritis, like acetaminophen or ibuprofen, Mayer says.

What helps: Acupuncture and activity both show promise. âWe do have evidence that acupuncture can be helpful for joint pain,â Mayer says. âRegular exercise can also help reduce joint pain as well as helping you sleep better at night.â

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Estrogen Receptor Blockers Estrogen Receptor Blocker Drugs Attach Directly To And Block The Estrogen Receptors On Cancer Cells So That The Cancer Cells Cant Use Estrogen They Do Not Affect The Level Of Estrogen In The Body Estrogen Receptor Blockers Are Also Called Selective Estrogen Receptor Modulators

Tamoxifen

Tamoxifen is the most commonly used anti-estrogen drug. It is used in post-menopausal and premenopausal women. Tamoxifen is given by mouth as a pill.

Tamoxifen is the hormonal therapy drug used most often to lower the risk that DCIS or LCIS will lead to an invasive breast cancer.

Tamoxifen very slightly increases the risk for uterine cancer, deep vein thrombosis and stroke. Doctors will carefully weigh these risks against the benefits of giving this drug before they offer it to women who have a personal or a strong family history of these conditions. Usually the benefits of taking tamoxifen outweigh these risks.

Fulvestrant

Fulvestrant is an anti-estrogen drug that reduces the number of estrogen receptors on breast cancer cells. It is given as an injection into the muscles of the buttocks.

Fulvestrant is used in post-menopausal women if the breast cancer has grown after they were treated with tamoxifen. It is also used in postmenopausal women with locally advanced or metastatic breast cancer that have never been treated with hormonal therapy.

Side Effects Of Tamoxifen And Toremifene

The most common side effects of tamoxifen and toremifene are:

• Vaginal dryness or discharge
• Changes in the menstrual cycle

When tamoxifen treatment starts, a small number of women with cancer that has spread to the bones might have a tumor flare which can cause bone pain. This usually decreases quickly, but in some rare cases a woman may also develop a high calcium level in the blood that is hard to control. If this happens, the treatment may need to be stopped for a time.

Rare, but more serious side effects are also possible:

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What Side Effects Can I Expect After Hormone Therapy

Because hormone therapy blocks your bodys ability to produce hormones or interferes with how hormones behave, it can cause unwanted side effects. The side effects you have will depend on the type of hormone therapy you receive and how your body responds.

People respond differently to the same treatment, so not everyone gets the same side effects. Some side effects also differ if you are a man or a woman.

Who Should Use Tamoxifen

Tamoxifen can help women and men with hormone receptor-positive breast cancer. The drug can lower the risk of breast cancer in:

• Women who are high-risk of breast cancer due to a family history of disease or mutated breast cancer genes.
• Women and men who have already been diagnosed with breast cancer to prevent recurrence of cancer, including:
• Development of breast cancer in the opposite, untreated breast.

• American Cancer Society. Breast Cancer Hormone Receptor Status. Accessed 11/18/2021.
• American Cancer Society. Hormone Therapy for Breast Cancer. Accessed 11/18/2021.
• American Cancer Society. Tamoxifen and Raloxifene for Lowering Breast Cancer Risk. Accessed 11/18/2021.
• BreastCancer.org. Low-Dose Tamoxifen May Be an Option to Reduce Risk of Recurrence, Invasive Disease After Non-Invasive Breast Cancer. Accessed 11/18/2021.
• BreastCancer.org. Tamoxifen . Accessed 11/18/2021.
• National Breast Cancer Foundation. Hormone Therapy. Accessed 11/18/2021.
• National Cancer Institute. Hormonal Therapy. Accessed 11/18/2021.
• Susan G. Komen. Side Effects of Tamoxifen. Accessed 11/18/2021.
• Susan G. Komen. Tamoxifen. Accessed 11/18/2021.
• Susan G. Komen. Tamoxifen and Raloxifene to Reduce Breast Cancer Risk. Accessed 11/18/2021.
• Susan G. Komen. Tumor Characteristics: Hormone Receptor Status. Accessed 11/18/2021.

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Why Do Women With High Risk Of Breast Cancer Need Hormone Therapy

Women at moderate or high risk of breast cancer because of their family history may be offered hormone therapy to reduce their risk of developing breast cancer. Drugs used to reduce the risk of breast cancer in women who have not had breast cancer include: These drugs are usually taken for five years. 6.

Talk With Others Who Understand

On MyBCTeam, the social network for people with breast cancer and their loved ones, more than 58,000 members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.

Have you found effective ways to manage the side effects of hormonal therapy to treat breast cancer? Share your experiences in the comments below, or start a conversation by posting on MyBCTeam.

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