Hormone therapy in oncology Hormones - are natural substances that are produced by the endocrine glands in the body. Their network is called the endocrine system. Hormones are moved in the bloodstream and act as messengers between different parts of the body. They perform a variety of functions, one of the most important is to control the growth and activity of certain cells and organs. Artificial or synthetic hormones created in the laboratory.

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Glands and the hormones they produce

  1. Ovaries - small sexual organs on both sides of the uterus, produce female hormones - estrogen and progesterone are involved in reproduction.
  2. Testicles - organs of the male reproductive system that produce testosterone, taking part in reproduction.
  3. Pituitary - small gland at the base of the brain synthesizes luteinizing hormone (LH) stimulates the ovaries and testes.
  4. Adrenal glands - glands above kidneys producing corticosteroids, mineralocorticoids (eg aldosterone), estrogens (postmenopausal), testosterone (in small amounts).
  5. The pancreas is located behind and below the stomach produces glucagon (raises blood sugar levels) and insulin (reduces the amount of blood sugar).

What is hormone therapy?

Some types of cancer are using hormones for growth. Hormone therapy in oncology uses drugs to block the effects of hormones. For some types of malignant tumors it is useless. By this method of turning, when the disease is sensitive to this treatment or gormonalnozavisimyh. These cancers include:

  • breast oncology;
  • prostate cancer;
  • ovary tumor;
  • uterine cancer;
  • malignant tumor of the kidney.

Hormone therapy alters the levels of hormones in the body. There are three ways to do this:

  • Remove gland which synthesizes hormones.
  • Affect the prostate with radiation therapy to destroy the hormone producing cells.
  • Taking hormones or other drugs that prevent or stop production of hormones or their effects.

Drugs, surgery , Or radiation therapy of certain organs affect the levels of hormones.

Hormone therapy is often combined with other types of cancer treatment. Sometimes it is used before or after them.

The principles of hormone therapy

Hormone-dependent tumors for growth and development are needed hormones. Such treatment can slow or leave by the disease:

  • blocking the synthesis of hormones;
  • prevent the action of hormones on the cancer cells.

Doctors tested tumor samples with assays to determine:

  • type of hormone receptors on the surface of malignant cells;
  • the number of receptors;
  • whether hormone therapy is effective.

The higher the level of the hormone receptor (positive test), the more sensitive will be the tumor to this method. If the receptors are absent or very few of them (a negative test), then the treatment will probably not affect the growth of cancer cells and other therapies will bring more results.

Hormone therapy is used as in the early stages of the disease, and late, if the tumor is sensitive to changes in hormone levels. Sometimes the disease is first reacted to this method of treatment, but later become resistant. In some cases, the tumor begins to grow again, and does not respond to further hormonal therapies. In other situations, the disease is responsible to replace drugs. For example, tamoxifen applied first, then it changed to anastrozole (Arimidex), or letrozole (Femara).

Types of hormone therapy in Israel

There are several types of hormone therapy. Choice is due to certain factors - the type of tumor, the stage, personal factors (age, the entry of women in menopause), the presence of hormone receptors on the surface of cancer cells.

Surgery

Surgical removal of hormone producing glands to stop the synthesis of hormones or create an anti-hormonal effect in the body. This may be the operation of resection in the treatment of ovarian cancer or breast removal of the testes (orchiectomy) in prostate cancer.

Radiation therapy

The irradiation destroys hormone producing tissue, stopping the production of these substances. For example, radiotherapy may be directed to the ovaries, stopping estrogen synthesis. Radiation oncologist calculates the dose, frequency and duration of radiation therapy to tailor treatment for each cancer patient. Usually held remote radiotherapy.

Hormonal drug therapy

Some drugs interfere with hormone producing cells synthesize hormones, while others affect the effect of the substance in the body. Hormone therapy used for the following types of cancer:

Consider the details.

Hormone therapy in breast cancer

Female hormones - estrogen and progesterone - affect the malignant breast tumor. Physicians describe these types of cancer as estrogen receptor positive or progesterone receptor positive breast cancer. Treatment prevents hormones to malignant breast cells.

Of course the the with In treatment in Israel are Different drugs are Used:

  • Tamoxifen.
  • Aromatase inhibitors.
  • Inhibitors of secretion of luteinizing hormone.

The patient may be given one or more drugs. With early diagnosis to prevent recurrence, tamoxifen is recommended for 2 or 3 years. Depending on menopause prescribe aromatase inhibitors.

Based on the study results it is known that sometimes other drugs hormone therapy works effectively than tamoxifen as monotherapy.

Hormone therapy with tamoxifen

One of the most common drugs used in breast cancer. Women before menopause and after may take tamoxifen. He warns of estrogen from entering cancer cells. Some of them have an area called receptors. When estrogen binds to the receptors, it stimulates the tumor cells to divide. Tamoxifen blocks the receptors.

Aromatase inhibitors in hormone therapy

These drugs are prescribed, if a woman has reached menopause. During this period, the ovaries stop producing estrogen. But the body still produces a small amount of hormones by converting androgens to estrogens. For this to happen requires the enzyme aromatase. Inhibitors block it, preventing the transformation.

There are some drugs in hormone aromatase inhibitors:

  • anastrozole (Arimidex);
  • exemestane (Aromasin);
  • letrozole (Femara).

Inhibitors of secretion of luteinizing hormone

Pituitary gland - a gland in the brain that regulates the amount of hormones that are produced by the ovaries. In women, the data blockers prevent the production of estrogen or progesterone by the ovaries. This is due to the suppression of the signal transmitted from the pituitary to the ovaries.

This treatment is prescribed, unless the woman has not reached menopause. After that, the ovaries do not produce hormones, so the drug does not help. The only inhibitor that is used for breast cancer - goserelin (Zoladex).

Hormone therapy for prostate cancer

Prostate cancer depends on the male hormone testosterone. Hormone therapy in this disease clinics Israeli directed at reducing or arresting the production of the substance. I used a variety of drugs.

Inhibitors of secretion of luteinizing hormone

The pituitary gland coordinates the synthesis of testosterone produced in the testicles. Inhibitors suppress the production of luteinizing hormone. Accordingly, the testicles stop to create testosterone.

Drugs prescribed for prostate cancer - goserelin (Zoladex), leuprorelin (Prostap) and triptorelin (Decapetyl).

antiandrogens

Prostate cancer cells have certain areas - receptors. Testosterone is attached to them, which stimulates cells to begin the process of dividing. Antiandrogens bind to receptors, preventing testosterone get to malignant segments. In the treatment of several drugs used: bicalutamide (Casodex), cyproterone acetate (Cyprostat) and flutamide (Drogenil).

Blocker (antagonist) gonadotropin-releasing hormone (GnRH)

These drugs prevent the flow of messages from the hypothalamus to the pituitary gland to produce luteinizing hormone. Last stimulates the testes to produce testosterone. Currently there is only one GnRH blocker - Degarelix (Firmagon).

Hormone therapy is a cancer of the uterus in Israel

Female hormones - estrogen and progesterone - affect the growth and activity of the cells that line the body. Doctors administered progesterone to reduce the large tumor volume at any relapses. There are different medications in Israeli hospitals, including medroxyprogesterone acetate (Provera) and Megestrol (Megace).

Hormone therapy in ovarian cancer

Some types of ovarian tumors have receptors for estrogen. It is believed that tamoxifen may benefit as a means to treat them. But it is not known how hormonal therapy is suitable for the fight against this disease. Doctors are doing research with tamoxifen and letrozole.

Kidney cancer hormonotherapy

Sometimes it may control the disease for some time at medroxyprogesterone (Provera) kidney cancer drug relapse. This is a man-made version of the hormone progesterone. Currently, it is not often used in the treatment of kidney cancer, as new methods, such as biological therapy, have a better effect. But this drug may be appropriate if, for some reason, do not apply other treatments.

Possible complications and consequences of hormone therapy for women

Potential side effects are due to hormonal therapy views.

Fatigue

The patient may experience fatigue during treatment. Doctors advise on how to improve the condition.

Digestive problems

Hormone therapy is the cause of certain problems with the gastrointestinal tract. This can be nausea, but usually in a mild form, it passes after a few days or weeks. The doctor will prescribe anti-emetics.

Sometimes there is constipation or diarrhea. Condition is easily controlled through diet or medication. If the diarrhea becomes serious, lasts more than 2-3 days, you should inform your doctor.

The patient may lose appetite, or it may increase that will cause weight gain.

menopause symptoms

If a woman has not reached menopause, the hormone under the influence of this period can begin. Condition is temporary or permanent. If a woman takes blocker luteinizing hormone, menstruation stops. In the case where the patient tamoxifen, monthly is still there, but they can stay or become more scarce.

If a woman has reached menopause may develop other symptoms that were not previously - vaginal dryness, hot flashes, sweating, decreased sex drive.

On emerging problems should be reported to your doctor. There is treatment available that will facilitate the state.

thinning hair

Some types of hormone therapy can cause hair thinning. Doctors will give detailed recommendations on how to deal with this problem.

Changes in bone and muscle tissue

The patient may experience pain in the joints. it often takes place only a few weeks later. Doctors prescribe mild painkillers to control the condition.

Some drugs such as aromatase inhibitors, can lead to bone thinning. Tamoxifen can cause this condition in premenopausal women. In women after menopause, the drug does not have such an effect.

Exercise where a person carries their own weight, enhance and protect the bone. It is walking, jogging, biking, exercise in the gym. Swimming in this matter will not benefit. It is important to consult with your doctor before embarking on any new type of exercise, especially if earlier a person was not engaged in it.

Thinning of the bones causes osteoporosis and fractures, if the process lasts for several years. Such a condition doctors treated with bisphosphonates to strengthen bone tissue.

Weight gain

Sometimes there is weight gain. State control through diet and exercise. A nutritionist will give expert advice, how to manage their own weight.

Headache

In some cases, this symptom occurs in connection with the reception of certain hormone drugs. The physician should be aware of this. Can help light analgesics, such as paracetamol.

Memory Problems

Some women say that memory condition worsens during hormone treatment for a while. But there are ways to improve the quality of life, for example, to make lists, not to forget. It is normal that this side effect is upset. You should talk with your doctor.

Mood swings and depression

Hormone therapy is able to influence mood. Some patients say swings and even depression during treatment with goserelin. Can help communicate with family, or with a qualified physician.

blood clots

Tamoxifen can increase the risk of blood clots in the veins of the lower extremities. This condition is called deep vein thrombosis.

Possible complications and consequences of hormone therapy for men

Potential side effects are caused by the drug of choice.

Fatigue

Perhaps the weakness of the state in the course of treatment.

Erection problems

It is a common complication of hormone therapy for prostate cancer. It is due to the cessation of the production of testosterone. Once the treatment is stop, violations go. Recovery time - from 3 months to a year or longer. In some men, these problems become permanent, depending on the drug and the duration of his admission.

The doctor will give detailed advice on the matter.

Hot flashes and sweating

These symptoms occur in women during the passage through menopause. Their causes a decrease in testosterone levels. Gradually, as the adaptation to treatment condition improves. In most cases, hot flushes occur when using luteinizing hormone blockers, since they are completely stopped testosterone. Drinking hot tea, coffee, smoking - symptoms worsen.

But in some cases, hot flushes persist throughout the treatment. When serious problems with sweating, you can discuss them with your doctor. There are treatments that can help.

Breast tenderness

This state cause high doses of bicalutamide (Casodex). There is pain, swelling of the breast tissue. Tamoxifen reduces soreness in 6 out of 10 men taking bakalutamid. Sometimes it helps a small dose of radiation therapy in the breast area before the start of hormone treatment.

Pain associated with tumor

The pain, the cause of which is a secondary prostate cancer, may temporarily worsen when the patient begins to hormonal treatment. Before the start of leuprorelin injections (Prostap) or Zoladex (Goserilin) ​​doctor prescribes a different hormonal drug to prevent outbreaks of bone pain. If the pain does not subside, prescribed bisphosphonates.

weight Gain

Body weight may increase. Control the process through diet and exercise. But often in the course of hormone therapy, this struggle is ineffective.

Memory Problems

In some cases, the memory condition worsens during treatment. Will benefit the establishment of lists, not to forget. You should talk with your doctor if this symptom has a significant impact on life.

Depression and mood swings

Treatment effect on the mood, particularly in the application of Zoladex. It will be useful to communicate with loved ones or a psychologist.

Abnormalities in the bones

Complication of hormone therapy for prostate cancer becomes a thinning of the bones (osteoporosis). Studies have shown that the risk of problems such as bone fractures, higher in men who have long-term treatment, which is aimed at blocking testosterone (for example, Zoladex). Your doctor may suggest taking vitamin D and calcium to reduce the risk of osteoporosis. Other recommendations:

  • No smoking.
  • Reduce the amount of alcohol.
  • Enter in lifestyle such loads as walking and so on.

The risk of early heart attack

According to the study, men older than 65 years the probability of dying from a heart attack over the passage of hormone therapy for 6 months. This is due to the fact that some of the side effects of treatment, such as weight gain, can worsen the disease.

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