Overview
Hormone therapy, also known as hormone replacement therapy (HRT), involves the administration of hormones to alleviate symptoms caused by hormonal imbalances or deficiencies. It is commonly used in various medical conditions, including menopause, certain cancers, and gender transition.
Hormones are chemicals synthesized by organs of our endocrine system. These chemicals regulate the functioning of cells in multiple organs. Hormones can act on cancer cells to increase their growth. Hence hormone therapy includes:
- Blocking of action of hormones
- Inhibiting the synthesis of hormones
- Alteration of the hormonal receptors
Alternate Names
Hormonal therapy or endocrine therapy and Hormone Replacement Therapy (HRT).
Body Location
Prostate cancer, breast cancers, and other types of hormone-dependent cancers.
Procedure Type
Surgical, percutaneous, and noninvasive.
How is Hormone Therapy Performed?
The healthcare professional can prescribe pills, capsules, or liquid medication for hormone therapy in hormonal therapy. Patients can take these at home. The frequency and dosage of the drugs depend on the type and stage of cancer.
Another option for the administration of hormonal therapy is injections. These injections can be given intramuscularly or subcutaneously, and their frequency depends on the type of cancer. These can be given at treatment centres or in hospitals.
Some cancers require intensive hormone therapy that involves surgical removal of hormone synthesizing organs, for example, the removal of testicles in prostate cancer and ovaries in breast cancer. This therapy ensures long-term results, and there is no need for medications in the future.
Hormone therapy is given as continuous therapy or intermittent therapy with breaks in between treatment intervals. For metastatic cancers that have spread to other body parts, hormonal treatment is shared with other targeted therapies. This combination can provide effective treatment for patients.
Preparation for Hormone Therapy
- Hormonal therapies are effective for tumor cells that respond to hormones. Hence, tests like measuring prostate-specific antigen (PSA) levels are performed before starting the treatment.
- Blood analysis identifies if the tumor is positive for estrogen receptors or progesterone receptors for breast cancers.
- For oral therapy, the individual must follow the prescription and instructions. Some drugs require special precautions that are by the caregiver team as well as healthcare professionals.
- The injection site commonly used for injectable medicines in hormone therapy is the arms, hips, or legs. The injection site is prepared to prevent injection site infections.
- The patients who inject themselves have to follow the procedure taught to them.
- Surgical ablations will be performed in special medical centres or hospitals. These surgeries are performed under general anaesthesia or spinal anaesthesia.
Follow Up
While taking the hormonal therapy, the follow-up visits are scheduled for close monitoring. The follow-up also helps identify the side effects of the treatment. You might be advised for regular tests during follow-up visits to analyze the effectiveness of treatment. These tests include mammograms, PSA tests, bone scans, X-rays, MRI, and CT scans.
These tests help to identify the recurrence of cancer if any. Even after the completion of cancer treatment, the follow-up visits will continue. It will help to determine the recurrence of cancer. If the individual is free from cancer for five consecutive years, follow-up visits will be once a year. These follow-ups also help manage long-term side effects of cancer, including anaemia, problems in bones, depression, urine inconsistency, and anxiety.
Risks of Hormone Therapy
Hormonal therapies can be associated with various risk factors that vary based on the type of therapy. For example:
- Hot flashes
- Decreased bone density with high chances of fracture
- Decreased sexual drive
- Tiredness
- Decrease in muscle mass
- Weight gain
Some severe but rare risks associated with hormone therapy include:
- Increase in risk of cardiovascular diseases
- Increases risk of other cancers
- Blood clots in legs and lungs
Recovery From Hormone Therapy
After completion of therapy, the levels of hormones begin to become normal. Reaching the normal levels will take several weeks. As the level of hormones rises, the side effects of hormonal therapy start to disappear. The complete disappearance of side effects might take months to years. Some side effects such as decreased bone density, reduced muscle mass, and weight gain will require exercise and other physical activities to return to normal after stopping hormone therapy.
In elderly patients, the recovery from hormonal treatment might get delayed. In the case of surgical ablations, the changes are permanent. Side effects are irreversible and permanent in these cases. An expert team of caregivers and dieticians can recommend lifestyle and dietary changes for quicker recovery from residual side effects.
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