Currently, hormone therapy for breast cancer is one of the most effective methods of dealing with neoplasms that depend on the hormonal background of the patient. Often, the course is called anti-estrogen, since the main task of the drug program is to minimize the effect of estrogen on atypical cell structures.
Will it help?
Before prescribing hormonal therapy for breast cancer, it is important to carefully examine the patient's condition. From medical statistics it is known that hormonal drugs can achieve a pronounced effect in approximately 75% of situations. This is due to the nuances of pathological formations in the female breast: the main percentage of tumors depends on the hormonal background. The selection of therapy is carried out based on the nuances of the disease, the general condition of the body, the spread of the process. A special approach is needed during menopause. When choosing a treatment, the doctor evaluates how the tumor develops, how aggressive the pathological process is.
The choice of the scheme for the use of hormone therapy for breast cancer in a particular case is the responsibility of the doctor who leads the case. The patient's task is to carefully follow all the recommendations, observe the timing and schedule of taking the drugs. If you neglect a well-thought-out program, the probability of inefficiency of even the most modern means and procedures is high.
When will it help?
Hormone therapy for breast cancer is prescribed if the disease proceeds according to a non-invasive scenario, it is necessary to minimize the risk of recurrence of the pathology. If the patient underwent surgery, treatment with radiation or chemicals, as well as a combined, hormonal course, the risk of relapse, the formation of a new focus of cell degeneration, can be reduced.
With a high probability of developing cancer, a hormonal course can be prescribed as a method of preventing pathology. In an invasive cancer process, hormonal agents are used to reduce the size of the affected area. Hormonal drugs used for breast cancer are widely used in the treatment of complicated cases accompanied by metastasis.
Is it necessary?
Doctors often call hormone replacement therapy for thyroid cancer or breast cancer a kind of safety net option. This course of treatment is used in combination with the main program of surgery, radiation, drug treatment. All of them, even when combined, cannot guarantee the absolute probability of a successful outcome with no relapse in the future. Hormonal treatment helps to adjust the body as a whole, inhibits the aggressive effect of estrogen. Such agents can show a positive effect only if the tumor process depends on the hormonal background.
To understand how much hormone therapy is needed in a particular case with breast cancer after surgery or before the intervention, the patient's condition is carefully examined using modern equipment. To maintain the patient during the hormonal course, antibiotics and chemotherapy drugs will have to be used.
Varieties and types
There are three main categories of the course: prophylactic, therapeutic and neoadjuvant. Hormone therapy for breast cancer after surgery is a preventative approach. Practice this after a course of exposure, treatment of cancer with drugs. The main task is to prevent a relapse of the disease. The duration of the course varies from five years to a decade. Typically, patients are attributed medications that inhibit the activity of aromatase, as well as Tamoxifen.
The neoadjuvant course is aimed at improving treatment predictions. It is practiced before surgery, radiation. The duration of the program is from a quarter to half a year. If the results are completely satisfactory, the course can be extended for a longer period - for example, for 2 years. Hormone therapy for breast cancer of the neoadjuvant type is indicated in order to reduce the size of the formation, the correction of metastases. The program allows you to simplify the upcoming operation, reduce its volume, increase the chances of survival and the absence of relapse in the future. Hormone treatment helps to assess the sensitivity of atypical cells to cytostatic therapy, as well as to check how effective the latest drugs are. According to the results of the neoadjuvant course, in approximately 80% of cases, the neoplasm becomes smaller, and in 15% morphological remission is observed.
Treatment: how long, how short?
If the process is generalized, the patient’s condition does not allow for surgery, and a treatment course with hormonal drugs is indicated. It is prescribed if metastases are detected in the respiratory system, liver, the patient is a young woman. A similar treatment is shown in the remission step.
Determining which drug is best for hormone replacement therapy for breast cancer, a specialist evaluates a number of factors. The hormonal type of neoplasm, the status of the patient (reproductive stage, menopause) are taken into account. When choosing a course of treatment, it is necessary to collect information about previously practiced measures and their outcomes, to assess the presence of somatic diseases. To select the optimal program, take into account the stage of the disease, the likelihood of relapse.
Status and Age
Hormone therapy for breast cancer in premenopause, menopause, young age are completely different things. The choice of drugs is always based on the preservation of the menstrual cycle. If the cycle is constant, the condition is premenopause, it is recommended to take it with the five-year Tamoxifen program, if the disease is at an early stage. Additionally, ovarian removal is indicated. After they are removed or to inhibit the functionality of this organ, medications that inhibit aromatase should be used.
At the menopause stage, during menopause and after it, you must first send the patient for surgery, prescribe a course of radiation, chemical treatment. After this, the patient is prescribed aromatase inhibitory drugs. If before the start of menopause, a woman used Tamoxifen for a five-year course, the drug is changed to Femara. If the use of “Tamoxifen” was accompanied by the formation of a new pathological tumor process or relapse of the case, the medication is replaced with inhibitory aromatase compounds.
Relapse is possible with aromatase inhibitors. In this case, the drugs are changed to Tamoxifen. Possible alternatives are Faslodex or other similar drugs. Often prescribed "Anastrozole." Hormone therapy for breast cancer is adjusted based on the reaction of the body, progress, regression.
Types of disease, course
Highlight benign, malignant tumor processes. With the first type of formation, the probability of malignancy of the tumor remains. The therapeutic course laid in this condition is only Tamoxifen. In clinical practice, this tool is used if ductal carcinoma is detected.
In a HER2-positive case, as can be seen from medical reviews, hormone replacement therapy for breast cancer gives the best effect if you choose drugs that inhibit aromatase. They resort to if Tamoxifen does not give the desired result.
Tamoxifen
The product belongs to the class of antiestrogens. Getting into the patient's body, the active component prevents the reaction of combining estrogen, atypical cell structures; pathological formations cannot increase. The agent gives the best effects if used in the active reproductive period against the background of stable menstruation, at the initial step of the pathology. According to reviews, hormone replacement therapy for breast cancer using Tamoxifen is well tolerated by patients, although side effects cannot be dispensed with.
You can find a tablet form on sale, in pharmacies presented under the name "Tamoxifen-Nolvadex". It was noted that some patients during the treatment program complained of active vaginal discharge or excessive dryness of the mucous membranes of this area. Possible activation of the sweat glands. Sometimes patients gained weight, others were worried about flushing of the skin.
Aromatase inhibitors
These drugs inhibit the generation of estrogen in the female body. They are recommended to be used after menopause, during menopause and after it. From medical practice, there are many cases of complete cure of the pathology in question, using "Aromazin", "Femaru". Very good responses can be found on the drug "Arimidex". Each of the mentioned medicines is prescribed in a specific situation. For example, if the tumor cells have just been removed and the pathology started to be treated at an early stage, Arimidex will be most effective.
"Aromasin" is indicated at the beginning of the development of a malignant disease. It is prescribed to patients who previously used Tamoxifen for years. "Femara" is also suitable if the disease is established early, the patient has already undergone surgery. Femaru is prescribed if the patient has used Tamoxifen for five or more years.
Side effects of hormone replacement therapy for breast cancer with aromatase inhibiting compounds are rare. In a relatively small percentage of cases, patients feel sick, joints respond with discomfort and pain. Dry vaginal mucous membranes are possible. Prolonged use of medications can provoke fragility of the skeletal system. To prevent an undesirable effect, a complex therapeutic course is supplemented with calcium, calciferol.
Goserelin
This synthetic product is similar to LHRH produced in the female body. A medication is common to control the activity of the pituitary gland. Under its influence, the number of generated hormonal compounds decreases. It was found that as the therapeutic course is completed, the pituitary activity not only returns to normal, but becomes higher. The optimal course of treatment involves taking "Goserelin" for several months, after which the patient is sent for ovariectomy. The removal of the ovaries is possible through irradiation or as part of surgery.
Side effects of hormone replacement therapy for breast cancer when using Goserelin include weakening of intimate activity, skin hyperemia. Some complain of increased activity of the sweat glands, others are faced with sudden changes in insistence. The head may hurt.
The drug is administered strictly injectively. The procedure is repeated monthly, putting an injection in the wall of the abdominal cavity, in the lower part.
Treatment and its consequences
Hormone therapy has many positive properties and qualities, but not without drawbacks. On average, every second patient is faced with any undesirable consequence of the course. Some become more weight, others note dry vaginal mucous membranes, others suffer from edema, sweating. Against the background of the therapeutic course, menopause may come ahead of time. With a high degree of probability, hormonal treatment can cause a depressed psycho-emotional status. Patients are prone to mood swings.
Tamoxifen, currently used so actively in the treatment of cancer, can cause blood clots to form. Against the background of its use, the risk of fertility in the future increases, as well as the risk of cancerous processes in the uterus. Anti-aromatase inhibitors, thereby reducing estrogen levels in the body, can cause osteoporosis and the accumulation of cholesterol in the circulatory system. Against the background of their intake, the risk of gastrointestinal pathologies increases.
If the course of treatment is accompanied by undesirable symptoms, side effects are worrying, you should consult your doctor. As a rule, funds are canceled, the course is adjusted, choosing safer and more effective compounds.
Daily routine and treatment: nutrition rules
If a hormone-dependent tumor is detected, you will have to carefully consider your lifestyle, including making a menu. A correctly selected diet is the key to well-being, reducing the risk of progress of pathology. With cancer, a balanced diet is necessary, providing the body with the necessary amount of vitamins, irreplaceable microscopic elements. You should eat often, in small portions.
The menu should have a lot of bright, colored, vitamin-rich foods - pumpkin, tomatoes, cranberries. Patients benefit from cereals - bran and wheat. The menu should contain brown, brown rice. Calories are determined by assessing the weight of the patient. For excess mass through diet, this indicator should be adjusted. Whenever possible, animal fats exclude or reduce their concentration, replacing vegetable fats. The most useful foods containing calciferol, calcium, but foods rich in phytoestrogens are prohibited.