In France, the number of new cancer cases is estimated at around 320,000 each year. Due to the many forms of this disease, not all treatments can be the same. The main therapies offered are surgery, radiotherapy and drug treatments which include chemotherapy, hormone therapy, targeted therapies and immunotherapy.
“The patients are not necessarily all treated with the three types of treatment but, for some patients, the combination of two or three techniques may give better results than using just one “, explains the League against Cancer.
Chemotherapy, hormone therapy and targeted treatments can attack cells scattered throughout the body, but in a different way. Hormone therapy is indicated in the case of so-called “hormone-dependent” or “hormone-sensitive” cancers, particularly breast and prostate cancer.
These cancers are sensitive to the action of hormones that the body produces naturally because these cancer cells have specific receptors for these hormones on their surface and multiply faster thanks to them. For women, these are estrogen and progesterone, for men androgenic hormones and more particularly testosterone.
This therapy helps block the production of these hormones through the ovaries or testes or their activity in tumors, but not to destroy cancer cells: it is to reduce their growth.
“For this, we have recourse to hormone antagonists, which work by attaching to hormone receptors. Therefore, hormones can no longer act on the multiplication of cancer cells, “says the League against Cancer.
For prostate cancer, the first type of hormone therapy is to prevent the manufacture of testosterone by suppressing the activity of the testes, by surgery or with a medicine (analogues of LH-RH). In addition, patients can also use “antihormones” called antiandrogens which replace testosterone on hormone receptors in cells.
In breast cancer, there are antiestrogens (tamoxifen) which prevent estrogen stimulate cancer cells, antiaromatases (or aromatase inhibitors) which prevent the production of estrogen in postmenopausal women and LH-RH analogues which suppress the production of female hormones by the ovaries in premenopausal women. “The choice of doses used vary from person to person,” said the National Cancer Institute.
Living everyday with hormone therapy
As for its use, hormone therapy is recommended more alone in combination with another therapy to limit the risk of recurrence and before an operation to reduce the tumor. While it has revolutionized the management of hormone-dependent cancers, this treatment, which lasts several years, “often leads to undesirable effects requiring appropriate management and support”, indicates the ARC Foundation.
Thus, while the drugs are generally well tolerated, lack of testosterones or estrogen causes several side effects (weight gain, hot flashes, decreased libido, impotence, ejaculation disorders, irritability). “These side effects, although transient, can be difficult to manage, and some patients may be tempted to stop treatment. However, it is important to keep in mind the major therapeutic impact of hormone therapy,” adds the foundation.
Patients should not hesitate to talk to their doctor because there are medicines to relieve hot flashes and fight against sexual dysfunctions. To minimize weight loss, it is recommended to adopt a healthy lifestyle and regular physical activity, which is also known to limit the risk of recurrence.