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Hormone Therapy in India

What is Hormone Therapy?

Hormone Therapy, also known as endocrine therapy or hormonal therapy or hormone treatment, is a type of systemic therapy that stops or slows down the growth of cancer cells by blocking, adding or removing the hormones from the body. Some types of medications can also be taken in the hormone therapy that stops the production of the hormones or can interfere with the activity of the hormone. The surgical removal of the gland can also be done as this gland is responsible for producing the hormones. Hormone therapies can also be given after chemotherapy, surgery and radiotherapy for breast cancer for reducing the chances of the cancer coming back. Some of the cancers that are hormone sensitive include –

  • Womb Cancer (uterine)
  • Prostate Cancer
  • Breast Cancer

Types of Hormone Therapy

Hormone therapy is categorized into different types that include –

  • Womb Cancer Hormone Therapy
  • Prostate Cancer Hormone Therapy
  • Breast Cancer Hormone Therapy

Womb Cancer Hormone Therapy : The activity and growth of the cells lining the womb can get affected by the female hormones progesterone and estrogen. Hormone progesterone is given for shrinking the larger womb cancers or for treating the recurring womb cancer. Megestrol (Megace) and Medroxyprogesterone acetate are considered as the different types of progesterone treatment.

Prostate Cancer Hormone Therapy: The goal of the hormone therapy is to stop or slow down the growth of the cancer and also to stop or reduce the body making testosterone. Anti-androgens and pituitary down regulators are the different types of hormone therapy.

  • Anti-androgens:  The receptors are contained in the prostate cancer cells that take up testosterone. The anti-androgen drugs attach themselves to these receptors and this helps in stopping the testosterone to reach the prostate cancer cell. Flutamide (Drogenil), Cyproterone acetate (Cyprostat) and Bicalutamide (Casodex) are the different types of anti-androgens.
  • Pituitary down Regulators: Testicles are responsible for making testosterone and the amount of testosterone is controlled by the pituitary gland. The testicles are prevented from making testosterone by the pituitary down regulators drugs. This is done by blocking the signal from the pituitary gland to the testicles. Triptorelin (Decapetyl), Leuprorelin (Prostap) and Goserelin for prostate cancer (Zoladex) are some of the types of pituitary down regulators.

Breast Cancer Hormone Therapy: Breast cancers are affected by the female hormones such as progesterone and estrogen. Breast cancers are either named as progesterone receptor positive or estrogen receptor positive and sometimes both. The hormone therapy prevents the entering of these female hormones into the breast cancer cells. Pituitary down regulators, Aromatase inhibitors and Tamoxifen are the different types of hormone therapies for treating breast cancer.

  • Pituitary down Regulators:  Pituitary gland is a gland present inside the brain and is responsible for controlling the quantity of sex hormones made by the ovaries. The ovaries are prevented from making progesterone or estrogen by the pituitary down regulators drugs. The signal is blocked from the pituitary gland to the ovaries. One can have this treatment only if the condition of menopause has not yet occurred. The reason behind this is that the ovaries do not produces hormones after the menopause. Leuprorelin and Goserelin for breast cancer.
  • Aromatase Inhibitors: This is considered as a new type of hormone therapy and can only be taken if a woman has gone through the phase of menopause. Estrogen is no more made by the ovaries after the menopause. The body after menopause still makes a little quantity by changing the other hormones known as androgens into estrogen. Aromatase (an enzyme) is responsible for making this change. The Aromatase enzyme is blocked by the Aromatase inhibitors so that it will not be able to convert androgen into estrogen. Letrozole (Femara), Exemestane (Aromasin) and Anastrozole (Arimidex) are the three types of Aromatase inhibitors.
  • Tamoxifen: This is considered as the most common hormone therapy for treating breast cancer. This therapy can be done on both pre-menopausal and post-menopausal women. Estrogen hormone is prevented from reaching into the cancer cells.

Hormone Replacement Therapy (HRT)

When the levels of progesterone and estrogen drop considerably in some women then hormone replacement therapy is given. The aim of this therapy is to replace the female hormones that are not produced after menopause.

Symptoms of a drop in the Estrogen Levels

The estrogen is responsible for regulating moisture of the vagina and it also maintains skin temperature and bone density. Some of the symptoms can be seen when there is a drop in the estrogen level that include –

  • Build-up of fat in the abdomen
  • Vaginal dryness
  • Breasts gets smaller
  • Sleep problems
  • Hot flashes
  • Urinary problems
  • Moodiness
  • Memory and concentration difficulties
  • Thinning hair
  • Irregular periods
  • Night sweats
  • Lower fertility

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)

  • It protects against brain aneurysms
  • It results in improved muscle function
  • It lowers mortality in younger postmenopausal women
  • It reduces the risk of heart attack and heart failure

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