I got in my car and flew down the highway. By the time I reached her, my mother had had a chance to talk with her doctors about treatment options, but she was still confused. The doctor had talked to her about the advantage of hormone therapy. What on earth did he mean? Wasn’t that what women were supposed to take right after menopause?
What is hormone therapy?
Some breast cancer tumors use female hormones like estrogen and progesterone for fuel. The hormones help them grow larger and faster and make them more likely to spread to other parts of the body. Hormone therapy—not to be confused with hormone replacement therapy which raises the levels of estrogen and progesterone in the body—lowers the amount of female hormones in the body, so the tumor cannot draw upon the energy it needs. The advantage of hormone therapy, then, is that it essentially cuts off the tumor’s food supply.
What are the different types of hormone therapy?
Probably the most common type of hormone therapy are the selective estrogen receptor modulators (SERMs). The common breast cancer drug tamoxifen falls into this category of medications. These drugs are usually taken as pills. They work by attaching themselves to the estrogen receptor cells on the tumor, blocking them so that the estrogen cannot get in to fuel the tumor.
Another type of hormone therapies are the aromatase inhibitors such as Arimidex and Femara. These drugs work by blocking the production of estrogen. Aromatase inhibitors used to be given primarily to women with breast cancers that did not respond to tamoxifen and were often used after the cancer has metastasized (spread) to other parts of the body. Now, however, some doctors are recommending aromatase inhibitors as the first treatment used rather than as the last resort.
Another type of hormone therapies are the pituitaries downregulators such as Zoladex. These drugs work on the part of the brain that sends the signal to the ovaries to produce estrogen. These medications are usually given by injection. The advantage of hormone therapy of this type is that it may preserve a young woman’s fertility, although there are no guarantees. Some of the time, pituitaries downregulators cause premature menopause.
A cruder form of hormone therapy is surgery to remove the ovaries, the chief sources of estrogen production in the body.
Should all women with breast cancer receive hormone therapy?
No, some types of breast cancer do not have cells that are receptive to hormones. There is no advantage of hormone therapy if a woman does not have a hormone-responsive tumor.
What is the survival rate among women with breast cancer who receive hormone therapy?
Survival rate is influenced by many factors other than mode of treatment. Some of these other factors include how aggressive the tumor is, how far advanced the cancer is when diagnosis is made, and whether the breast tumor is primary (originating in the breast) or secondary (originating from cancer in another part of the body).
That said, thanks to better screening and treatment, women are living longer with primary breast cancer. According to statistics, around 80% of the women who are diagnosed with breast cancer today will still be alive five years from now. After ten years, 71% will still be alive. Even though breast cancer remains the second leading cause of cancer deaths in the United States (lung cancer is first), the treatment and cure statistics are encouraging.
So if you or a loved one is fighting breast cancer, ask the doctor to describe the advantage of hormone therapy and decide together whether hormone therapy is the right choice in your unique situation.