What is Hormone Therapy for Breast Cancer? Purpose, Types & Results

Hormone therapy for breast cancer is a treatment that blocks or lowers estrogen and progesterone hormones that fuel certain types of breast cancer. Think of it as cutting off the fuel supply that helps these cancers grow. This targeted approach can significantly reduce the risk of cancer returning and help shrink existing tumors in many patients.

What is hormone therapy for breast cancer?

Hormone therapy works by either blocking hormone receptors on cancer cells or reducing the amount of hormones your body makes. About 70% of breast cancers are hormone receptor-positive, meaning they use estrogen or progesterone to grow and multiply.

This treatment is completely different from hormone replacement therapy that some women use for menopause symptoms. Instead of adding hormones, cancer hormone therapy removes or blocks them to starve the cancer cells of what they need to survive.

The therapy comes in pill form you take daily or as monthly injections, depending on which type your doctor recommends. Most people continue this treatment for 5 to 10 years to get the best protection against cancer recurrence.

Why is hormone therapy for breast cancer done?

Your doctor recommends hormone therapy to prevent cancer cells from getting the hormones they need to grow. It's like removing the key that allows cancer to unlock and multiply in your body.

The main goals include reducing your risk of cancer coming back after surgery, shrinking tumors before surgery to make removal easier, and slowing cancer growth if it has spread to other parts of your body.

This treatment is only effective for hormone receptor-positive breast cancers. Your pathology report after a biopsy or surgery will show whether your cancer has estrogen receptors (ER-positive) or progesterone receptors (PR-positive).

What is the procedure for hormone therapy?

Most hormone therapy involves taking a daily pill at home, making it much more convenient than chemotherapy that requires hospital visits. Your doctor will determine which specific medication works best for your situation.

For premenopausal women, treatment often starts with monthly injections to stop your ovaries from making estrogen, combined with daily pills. Postmenopausal women typically take daily pills that block estrogen production in other body tissues.

Your medical team will monitor you regularly through blood tests and check-ups to ensure the treatment is working effectively and manage any side effects. These appointments usually happen every 3 to 6 months during your treatment.

How to prepare for your hormone therapy?

Preparing for hormone therapy starts with understanding what to expect and gathering support from your healthcare team. Your doctor will review your medical history and current medications to prevent any dangerous interactions.

You'll need baseline tests including bone density scans, cholesterol levels, and liver function tests before starting treatment. These help your doctor monitor how the therapy affects your body over time.

Consider discussing side effect management strategies with your healthcare team before you start. Having a plan for common issues like hot flashes, joint pain, or mood changes can help you feel more prepared and confident about your treatment journey.

How to read your hormone therapy results?

Your doctor tracks hormone therapy success through regular imaging scans, blood tests, and physical exams rather than a single test result. The goal is seeing stable or shrinking tumors if you have active cancer, or simply staying cancer-free if you're in prevention mode.

Blood tests monitor your hormone levels to ensure the medication is effectively blocking estrogen and progesterone. Your doctor will also check liver function since these medications are processed through your liver.

Bone density scans become important because hormone therapy can weaken bones over time. Your doctor may recommend calcium and vitamin D supplements or bone-strengthening medications if needed.

How to manage hormone therapy side effects?

Managing side effects involves working closely with your healthcare team to find solutions that keep you comfortable while continuing your important cancer treatment. Most side effects are manageable with the right approach.

Common side effects and management strategies include:

• Hot flashes: Dress in layers, use cooling fans, try relaxation techniques, or ask about medications that can help
• Joint pain and stiffness: Regular gentle exercise, physical therapy, warm baths, or anti-inflammatory medications
• Mood changes: Counseling, support groups, stress management techniques, or antidepressants if needed
• Fatigue: Pacing activities, regular sleep schedule, light exercise, and energy conservation techniques
• Vaginal dryness: Moisturizers, lubricants, or prescription treatments your doctor can recommend

Never stop your hormone therapy without talking to your doctor first, even if side effects feel challenging. Your medical team can usually adjust your treatment or add supportive medications to help you feel better.

What is the best hormone therapy approach?

The best hormone therapy depends on whether you've gone through menopause, your cancer's specific characteristics, and your overall health. There's no one-size-fits-all approach because everyone's situation is unique.

Premenopausal women often benefit from ovarian suppression combined with medications like tamoxifen or aromatase inhibitors. Postmenopausal women typically do well with aromatase inhibitors alone, though some may use tamoxifen.

Your oncologist considers factors like your cancer stage, other health conditions, family history, and personal preferences when creating your treatment plan. The "best" therapy is the one that effectively treats your cancer while maintaining your quality of life.

What are the risk factors for needing hormone therapy?

You'll likely need hormone therapy if your breast cancer tests positive for hormone receptors, regardless of other factors. This accounts for about 70% of all breast cancer cases.

Several factors influence your treatment plan and duration:

• Cancer stage and size when diagnosed
• Whether cancer has spread to lymph nodes
• Your age and menopausal status
• Family history of breast or ovarian cancer
• Previous hormone replacement therapy use
• Other health conditions like osteoporosis or heart disease

Women with higher-risk cancers often continue hormone therapy for longer periods, sometimes up to 10 years. Your doctor will regularly reassess whether continuing treatment provides more benefits than risks.

Is it better to have hormone-positive or hormone-negative breast cancer?

Hormone-positive breast cancer often has better long-term outcomes because it responds well to hormone therapy treatments. Having treatment options available gives you and your doctor more tools to fight the cancer effectively.

Hormone-positive cancers tend to grow more slowly than hormone-negative ones, which can mean more time to detect and treat them successfully. The 5-year survival rates are generally higher for hormone-positive breast cancers.

However, hormone-negative cancers often respond better to chemotherapy and may be completely eliminated with treatment. Both types can be successfully treated when caught early, so focus on following your doctor's recommended treatment plan rather than worrying about which type you have.

What are the possible complications of hormone therapy?

Most people tolerate hormone therapy well, but like all medications, it can cause side effects that range from mild to more serious. Understanding these helps you know what to watch for and when to contact your doctor.

Common complications that affect many patients include:

• Bone thinning (osteoporosis) that increases fracture risk
• Joint pain and stiffness, especially in hands and knees
• Hot flashes and night sweats
• Mood changes including depression or anxiety
• Weight gain and changes in body composition
• Sleep disturbances and fatigue

Less common but more serious complications include:

• Blood clots, particularly with tamoxifen
• Endometrial cancer risk with long-term tamoxifen use
• Liver function changes requiring monitoring
• Severe bone loss leading to fractures
• Heart rhythm changes with some medications

Your doctor monitors you carefully throughout treatment to catch any complications early. Regular check-ups and blood tests help ensure your treatment remains safe and effective.

When should I see a doctor during hormone therapy?

You should contact your doctor immediately if you experience chest pain, shortness of breath, severe leg pain, or signs of blood clots. These symptoms require urgent medical attention and shouldn't wait for your next appointment.

Schedule an appointment within a few days if you have persistent severe hot flashes, joint pain that interferes with daily activities, mood changes that concern you, or unusual vaginal bleeding.

Regular monitoring appointments typically happen every 3 to 6 months during treatment. Your doctor will also want to see you if you're considering stopping your medication or if side effects are significantly affecting your quality of life.