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3: Surgery Y3 - Cancer Care [1] (check ILOs) > [15] Hormonal Therapy > Flashcards

[15] Hormonal Therapy Flashcards

1
Q

What are hormones?

A

Substances produced naturally in the body which act as chemical messengers and influence the growth and activity of cells

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2
Q

What system does hormonal therapy aim to manipulate?

A

The endocrine system

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3
Q

How can the endocrine system be manipulated as part of cancer therapy?

A
  • External administration of specific hormones
  • Hormone antagonists
  • Surgical removal of endocrine organs
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4
Q

What type of hormones are commonly externally administered as part of hormonal therapy?

A

Steroid hormones

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5
Q

How can drugs act as hormone antagonists?

A
  • Inhibit hormone production

- Inhibit hormone activity

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6
Q

What endocrine organs can be removed as part of some hormonal therapy regimes?

A
  • Orchiectomy

- Oophorectomy

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7
Q

How can changing the levels of certain steroid hormones lead to cancer cell death (or cessation of growth) in some cancers?

A

Steroid hormones are often powerful drivers of gene expression in certain cancer cells

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8
Q

What types of cancers are commonly treated with hormonal therapy?

A

Those derived from hormonal responsive tissues

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9
Q

What specific cancers are commonly treated with hormonal therapy?

A
  • Breast
  • Prostate
  • Endometrium
  • Adrenal cortex
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10
Q

What non-specific cancer complications can be treated with hormonal therapies?

A
  • Paraneoplastic syndromes

- Chemotherapy-related symptoms e.g. anorexia

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11
Q

What are some types of hormone synthesis inhibitors used in hormonal cancer therapy?

A
  • Aromatase inhibitors

- GnRH analogues

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12
Q

How doe inhibitors of hormone synthesis work to treat cancer?

A

They starve tumour cells of growth and survival-producing hormones by inhibiting their production

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13
Q

What type of cancer are aromatase inhibitors used to treat?

A

Breast cancer in post-menopausal women

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14
Q

What is the normal role of aromatase?

A

Produce oestrogen from androgens made by the adrenal glands in post-menopausal women

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15
Q

What is the effect of aromatase inhibitors in post-menopausal women?

A

Oestrogen levels drop to extremely low

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16
Q

Why are aromatase inhibitors not used in pre-menopausal women?

A

Oestrogen is still produced by the ovaries in pre-menopausal women so oestrogen levels won’t drop (ngl I’ve inferred this - it’s probably because it induces early menopause or something but it makes sense logically and helps me remember that they’re for post-menopausal women :) )

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17
Q

How can the drop in oestrogen caused by aromatase inhibitors treat breast cancer?

A

Extremely low oestrogen levels can cause growth arrest and/or apoptosis in hormone-responsive cancer cells

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18
Q

What are some examples of aromatase inhibitors?

A
  • Anastrozole

- Letrozole

19
Q

What do GnRH analogues aim to do in hormonal therapy?

A

Induce chemical castration

20
Q

What is meant by chemical castration caused by GnRH analogues?

A

Complete suppression of production of oestrogen and progesterone in females and testosterone in males

21
Q

How do GnRH analogues induce chemical castration?

A

Prolonged activation and subsequent desensitisation of pituitary gonadotrophs (cells that release LH and FSH) to natural GnRH

22
Q

What is an example of a GnRH analogue used to treat cancer?

A

Goserelin

23
Q

What is goserelin used to treat?

A

Hormone-responsive prostate cancer

24
Q

How do hormone receptor antagonists work to treat cancer?

A

Bind to the normal receptor for a given hormone and prevent its action

25
Q

What are some types of hormone receptor antagonists used to treat cancer?

A
  • Selective-Oestrogen Receptor Modulators (SERMS)

- Anti-androgens

26
Q

What is the action of SERMs

A

Act as antagonists of the oestrogen receptor

27
Q

What are SERMs used to treat?

A

Treatment and chemo prevention of breast cancer

28
Q

What is an example of a SERM used to treat breast cancer?

A

Tamoxifen

29
Q

Who is tamoxifen used in to treat breast cancer?

A

Nearly all post-menopausal women with hormone receptor positive breast cancer

30
Q

What is the mechanism of action of anti-androgens as a cancer therapy?

A

Bind and inhibit the androgen receptor, blocking the growth and survival-promoting effects of testosterone on certain prostate cancers

31
Q

What are some examples of anti-androgens used as cancer therapy?

A
  • Flumatide

- Bicalutamide

32
Q

How can Hormone supplementation sometimes be used to treat cancer?

A

Some hormones can have a growth-inhibiting or cytotoxic effect on tumour cells

33
Q

How can hormones cause growth-inhibition or death of tumour cells?

A

They can produce antagonism and feedback inhibition of the synthesis of other hormones

34
Q

What are some examples of hormones that are supplemented as part of hormonal cancer therapy?

A
  • Progesterones
  • Androgens
  • Oestrogens
  • Somatostatin
35
Q

What cancers ca progesterones be used to treat?

A
  • Hormone responsive advanced breast cancer
  • Hormone responsive endometrial cancer
  • Hormone responsive prostate cancer
36
Q

What cancers can androgens be used to treat?

A

Advanced breast cancer (rarely)

37
Q

What cancers can oestrogens be used to treat?

A

Occasionally prostate cancer

38
Q

How can oestrogens treat prostate cancer?

A

Suppress tesosterone production

39
Q

What is the role of somatostatin in treating cancers?

A
  • Suppression of hormonal syndromes which accompany pancreatic islet cell tumours
  • Can suppress carcinoid syndrome
40
Q

What is an example of a hormonal syndrome caused by an islet cell tumour of the pancreas?

A

Zollinger-Ellison syndrome in gastrinoma

41
Q

What do the side effects of hormonal therapies depend on?

A

Type of therapy given

42
Q

What are some potential side-effects of hormonal therapies?

A
  • Tiredness
  • GI problems
  • Menopausal symptoms
  • Hair thinning
  • Muscle and bone problems
  • Weight gain
  • Headaches
  • Cognitive impairment
  • Mood swings and depression
  • Thrombosis
43
Q

What sort of GI problems may be caused by some hormonal therapies?

A
  • Nausea
  • Constipation and diarrhoea
  • Anorexia
44
Q

What muscle and bone problems can be caused by some hormonal therapies?

A
  • Arthralgia

- Osteoprosis

3: Surgery Y3 - Cancer Care [1] (check ILOs) (47 decks)

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