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Breast Cancer Hormone Therapy Side Effects

What Is The Most Common Medication Used For Premenopausal Women

Hormone Therapy for Breast Cancer and the Side Effects of Tamoxifen

Traditionally these drugs are only used in premenopausal women. The most commonly used SERMs include: Tamoxifen : This medicine prevents estrogen from binding to cells so that the cancer cant grow and divide. People who take tamoxifen for 10 years following breast cancer treatment are less likely to have the cancer return

Side Effects Of Aromatase Inhibitors Versus Side Effects Of Tamoxifen

Although both aromatase inhibitors and tamoxifen can cause menopausal symptoms such as hot flashes, many of their side effects differ .

Your health care provider can treat many of these side effects.

Figure 5.11: Side effects of aromatase inhibitors versus side effects of tamoxifen

Learn more about the side effects of tamoxifen.

Joint And Muscle Pain

Joint pain and muscle pain are common side effects of aromatase inhibitors . The pain may be in the hands and wrists, feet and ankles, knees, back or other parts of the body. Joint and muscle pain are most common after youve been sleeping or inactive.

Almost half of women taking aromatase inhibitors have joint pain and about 15 percent have muscle pain .

Joint and muscle pain can mimic carpal tunnel syndrome. In rare cases, aromatase inhibitors can cause carpal tunnel syndrome .

Although aromatase inhibitors can cause joint and muscle pain, they dont cause permanent joint or muscle damage.

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Hormone Therapy For Breast Cancer

Some types of breast cancer are affected by hormones, like estrogen and progesterone. The breast cancer cells have receptors that attach to estrogen and progesterone, which helps them grow. Treatments that stop these hormones from attaching to these receptors are called hormone or endocrine therapy.

Hormone therapy can reach cancer cells almost anywhere in the body and not just in the breast. It’s recommended for women with tumors that are hormone receptor-positive. It does not help women whose tumors don’t have hormone receptors .

What Is Unique About Receiving Hormone Therapy At Rocky Mountain Cancer Centers

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At Rocky Mountain Cancer Centers, your cancer care team will design a personalized cancer treatment plan that provides the ideal combination of therapies for the best possible outcome. Under our care, you will be monitored closely to determine if your hormone therapy is working. This involves regular PSA tests for prostate cancer treatment and regular checkups for breast cancer treatment.

Rest assured, you are in good hands with Rocky Mountain Cancer Centers. We believe in treating the whole person, not just the disease, which is why we will work hard to create the best cancer treatment plan for you.

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Association Of Antihormonal Therapy With Long

Compared to patients who did not receive endocrine therapy, those who used antihormonal drugs more often reported hot flashes and vaginal dryness , while hair loss was less common . Dry eyes and visual disturbances were experienced by roughly one-third of patients taking these drugs.

Among the subclasses of antihormonal drugs, aromatase inhibitors were associated with a relatively high prevalence of joint pain, whereas loss of libido was prevalent with gonadotropin-releasing hormone analogs .

Coping With The Side Effects

Side effects can affect everyone differently. If youre experiencing significant side effects, talk with your treatment team about things you can do to help minimize them.

Home remedies that can help ease some potential effects of cancer treatment include:

  • Take short naps to ease fatigue.
  • Light exercise can reduce fatigue .
  • Eat small snacks throughout the day to keep energy up.
  • Dont be shy about asking others for assistance or help to conserve your energy.
  • Get anti-nausea medication from your treatment team if youre nauseous.
  • Eat smaller, more frequent meals instead of three bigger ones.
  • Practice stress management.
  • Use over-the-counter medication for constipation or diarrhea if necessary.
  • Avoid acidic, spicy, greasy, or salty foods to help with nausea and mouth sores.
  • Avoid extreme temperatures with food.
  • Talk with your treatment team about any issues with intimate relationships they can provide suggestions, depending on your specific concerns.

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Joint Discomfort And Pain

Joint symptoms related to hormone therapy for breast cancer do not tend to improve with the use of medications that you might take for typical arthritis, like acetaminophen or ibuprofen, Mayer says.

What helps: Acupuncture and activity both show promise. âWe do have evidence that acupuncture can be helpful for joint pain,â Mayer says. âRegular exercise can also help reduce joint pain as well as helping you sleep better at night.â

Less Common Types Of Hormone Therapy

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Some other types of hormone therapy that were used more often in the past, but are rarely given now include:

  • Megestrol acetate , a progesterone-like drug
  • Androgens , like testosterone

These might be options if other forms of hormone therapy are no longer working, but they can often cause side effects.

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Side Effects Of Hormonal Therapy

Side effects can happen with any type of treatment for cancer, but everyones experience is different. Some people have many side effects. Other people have few or none at all.

If you develop side effects, they can happen any time during, immediately after or a few days or weeks after hormonal therapy. Sometimes late side effects develop months or years after hormonal therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of hormonal therapy will depend mainly on the type of hormonal therapy, the dose of a drug or combination of drugs and your overall health.

It is important to report side effects and your concerns about side effects to the healthcare team. Doctors may measure how severe certain side effects are. Sometimes hormonal drug therapy may need to be adjusted if side effects are severe.

The following are the most common side effects that people tend to experience with hormonal therapy.

Why Do We Need Hormone Therapy For Breast Cancer

Hormone therapy for breast cancer is often used after surgery to reduce the risk that the cancer will return. Hormone therapy for breast cancer may also be used to shrink a tumor before surgery, making it more likely the cancer will be removed completely. If your cancer has spread to other parts of your body, hormone therapy for breast cancer may

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Talk With Your Health Care Team

Always speak with your oncology care team about your symptoms and concerns. Your oncologist can help pinpoint the source of your side effects and symptoms and provide options for managing them. If youre finding the side effects intolerable, you can also talk with your doctor about other treatment options.

Never stop or change your breast cancer treatment without talking to your doctor first. Also, be sure to communicate with your care team before you try any new dietary supplements because some can have severe interactions with your medications or cause other side effects.

Heart Disease And Strokes

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HRT does not significantly increase the risk of cardiovascular disease when started before 60 years of age, and may reduce your risk.

Taking HRT tablets is associated with a small increase in the risk of stroke, but the risk of stroke for women under age 60 is generally very low, so the overall risk is still small.

Page last reviewed: 09 September 2019 Next review due: 09 September 2022

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Breast Cancer Survivors Lived Experience Of Adjuvant Hormone Therapy: A Thematic Analysis Of Medication Side Effects And Their Impact On Adherence

  • 1School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
  • 2School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, United Kingdom

Objectives: Side effects from Hormone Therapy impact medication adherence in breast cancer survivors. Understanding the most distressing HT side effects and their impacts may inform the development and implementation of interventions to alleviate these side effects and maximise HT adherence. This study aimed to explore the lived experience of adjuvant HT and understand the impact of HT side effects on adherence in a sample of breast cancer survivors.

Methods: Twenty-five female breast cancer survivors who were currently taking adjuvant HT participated in the study. One-to-one, online, semi-structured interviews were conducted to explore specific side effects from HT and the impact of these side effects on HT adherence. Data were analysed using Thematic Analysis.

Results: The most commonly reported side effects were sleep disturbance, hot flashes, anxiety, and joint pain. Data exploring the impacts of these side effects on HT adherence were thematically synthesised into four analytical themes: A bitter pill to swallow,Seeking relief,Taking control, and The only way out is through. These themes encompass 14 sub-themes that encapsulate participants daily struggle with HT side effects and the coping strategies developed to manage these.

How Hormone Therapy Works

Oestrogen and progesterone are hormones which are naturally produced in the human body. Before menopause, oestrogen is mostly produced by the ovaries. After menopause, when the ovaries are no longer active, a small amount continues to be produced in other tissues such as fat, muscle and adrenal glands.

Normal breast cells contain receptors that are able to recognise these hormones and allow them to access the cells, where they release signals encouraging growth and development. All breast cancers are tested for the presence of these oestrogen and progesterone receptors, using tissue taken at the time of biopsy or surgery. Approximately 70% of breast cancers retain these receptors, and rely on these hormones to grow. These hormone-sensitive cancers are described as oestrogen receptor positive and/or progesterone receptor positive .

Hormone therapy is also used to shrink or slow the growth of a breast cancer when surgery is not appropriate, for example in an older person with other major health issues. It is also used to help shrink advanced stage breast cancers or slow their growth.

Hormone therapy for breast cancer is not the same as HRT . HRT raises the level of oestrogen +/- progesterone in the body and is not used in the treatment of breast cancer.

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Side Effects Of Hormone Therapy

Like any treatment, hormone therapy can cause side effects. Everyone reacts differently to drugs and some people have more side effects than others.

Side effects can often be managed and those described here will not affect everyone.

Some side effects are common to all hormone therapies, while others are specific to certain drugs. You can read about specific side effects on our individual drug pages .

If youre concerned about any side effects, whether or not they are listed here, talk to your treatment team as soon as possible.

Selective Estrogen Receptor Modulators

Hormonal Therapy for Breast Cancer: We Teach You

Medications called selective estrogen receptor modulators to include tamoxifen , raloxifene , and toremifene . Rare side effects include:

  • Blood clots in the legs , lungs , or brain
  • Endometrial or uterine cancer

Because of the risk of cataracts, you should see an eye doctor before you start treatment, and follow up every six months. Its also important to tell your cancer care team about any unusual pain, redness or swelling in the legs, shortness of breath, confusion, or difficulty moving, which can be symptoms of a blood clot. Unusual vaginal bleeding can be a symptom of endometrial or uterine cancer and should also be quickly reported to your doctor.

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Association Of Chemotherapy With Long

Overall, chemotherapy was associated with increased prevalence of all reported symptoms. Specifically, concentration deficits , nail changes , hair loss , tingling of hands , numbness and tingling of feet were increased by 20% versus adjuvant therapy without the use of antineoplastic chemotherapeutics .

Table 3

Long-term side effects in patients without and with chemotherapy

Fig. 1

Long-term prevalence of side effects in patients who received adjuvant therapies with or without the use of chemotherapeutic drugs .

Among all patients who reported taxane-containing therapies, the prevalences of neuropathic long-term effects such as numbness, tingling, and pain of hands or feet were substantially higher than in those who received no taxanes.

How To Get Rid Of Cancer Cells

Hormone therapy may help make these hormones less available to growing cancer cells. Hormone therapy is available via pills, injection or surgery that removes hormone-producing organs, namely the ovaries in women and the testicles in men. Its typically recommended along with other cancer treatments. If hormone therapy is part of your treatment

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Selective Estrogen Receptor Degraders

Fulvestrant , a selective estrogen receptor degrader, may cause uncommon side effects including:

  • Pain in the bones, joints, or muscles
  • Flu-like symptoms
  • Digestive changes, such as constipation, diarrhea, nausea, or loss of appetite

Some rare side effects are more serious. Tell your doctor right away if you experience hives, breathing problems, fever, increased bleeding or bruising, swelling, or changes in mental health.

What Hormones Stimulate Cancer Cells

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In certain breast cancers, the female hormones estrogen and progesterone can stimulate cancer cell growth. Cancers that are hormone receptor-positive grow when hormones attach to the cancer cell receptors. Approximately two-thirds of all breast cancers are hormone receptor-positive, according to the American Cancer Society.

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Drugs That Lower Estrogen Levels

Some drugs, called aromatase inhibitors , stop the body from making estrogen in tissues such as fat and skin. But, these drugs do not work to make the ovaries stop making estrogen. For this reason, they are used mainly to lower estrogen levels in women who have been through menopause . Their ovaries no longer make estrogen.

Premenopausal women can take AIs if they are also taking drugs that stop their ovaries from making estrogen.

Aromatase inhibitors include:

What Is Hormone Therapy For Cancer

Also referred to as hormonal or endocrine therapy, this cancer treatment is different from menopausal hormone replacement therapy , which refers to the prescription of supplemental hormones to help relieve the symptoms of menopause.

Certain cancers rely on hormones to grow. In these cases, hormone therapy may slow or stop their spread by blocking the bodys ability to produce these particular hormones or changing how hormone receptors behave in the body.

Breast and prostate cancers are the two types most commonly treated with hormone therapy. Most breast cancers have either estrogen or progesterone receptors, or both, which means they need these hormones to grow and spread. By contrast, prostate cancer needs testosterone and other male sex hormones, such as dihydrotestosterone , to grow and spread. Hormone therapy may help make these hormones less available to growing cancer cells.

Hormone therapy is available via pills, injection or surgery that removes hormone-producing organs, namely the ovaries in women and the testicles in men. Its typically recommended along with other cancer treatments.

If hormone therapy is part of your treatment plan, discuss potential risks or side effects with your care team so that you know what to expect and can take steps to reduce them. Let doctors know about all your other medications to avoid interactions.

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Association Of Taxane Chemotherapy With Long

Compared to non-taxane-based adjuvant therapies, the use of taxanes was associated with a strongly increased prevalence of nail changes , hair loss , and neuropathic symptoms: numbness and tingling of feet, numbness and tingling of hands, as well as tingling plus pain in feet and hands . The neuropathic symptoms in taxane recipients tended to be more prevalent in those with triple-negative versus receptor-positive tumors .

Table 4

Long-term prevalence of neuropathic side effects in patients who received adjuvant therapies with taxanes.

Fig. 4

Long-term prevalence of side effects in patients who received adjuvant therapies without chemotherapeutics versus those treated with taxanes, shown by receptor status.

How Will I Get Hormone Therapy

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The goal of hormone therapy, sometimes called endocrine therapy, is to starve the cancer of the hormones it needs to keep growing. Hormone therapy usually involves taking medications that either stop, block, or add hormones to slow the cancer cells growth. Hormone therapy may take place in many ways, which can include:

  • Oral: Hormone therapy comes in pills that you swallow.
  • Injection: The hormone therapy can be given by a shot in a muscle in your arm, thigh, or hip, or right under the skin in the fatty part of your arm, leg, or belly.
  • Surgery: You may have surgery to remove the hormone-producing organs. In women, the ovaries are removed. In men, the testicles are removed. However, medications are more common than surgery.

There are various hormone therapy drugs that treat common cancer types however, the type of hormone therapy you receive will be determined by your oncologist based on multiple factors.

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Side Effects Of Hormone Treatment For Breast Cancer

  • Hormone therapies for hormone receptor-positive breast cancer can lead to side effects such as hot flashes, vaginal dryness, pain, and nausea.
  • A variety of strategies can help you manage many side effects and improve your quality of life during hormonal treatment.

In hormone receptor -positive breast cancer, the cancer cells contain receptors to estrogen or progesterone or both and rely on signals from these hormones to help them grow. By reducing those signals, hormone treatments for HR-positive breast cancer work very effectively.

Although hormonal therapies also called endocrine therapies may be necessary for treating HR-positive breast cancer, they often have unwanted side effects. There are many strategies for managing these side effects and feeling your best while taking hormone treatments for HR-positive breast cancer.

Types Of Hormone Therapy For Prostate Cancer

Hormone therapy may be part of prostate cancer treatment if the cancer has spread and cant be cured by surgery or radiation therapyor if the patient isnt a candidate for these other types of treatment. It may also be recommended if cancer remains or returns after surgery or radiation therapy, or to shrink the cancer before radiation therapy.

Additionally, hormone therapy may be combined with radiation therapy initially if theres a high risk of cancer recurrence. It can also be given before radiation therapy to shrink the cancer and make other treatments more effective. Other types of hormone therapy for prostate cancer include:

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