4.2 Hormones and Cancer Flashcards
What are the risk factors for breast cancer>
Early menarche Late menopause Alcohol consumption Post menopausal obesity Hormone replacement therapy
What are the protective factors of breast cancer?
Pregnancy
Young age at first delivery
Prolonged lactation
Exercise
What occurs after menopause in terms of oestrogen production?
ACTH from the pituitary stimulates the adrenals to make androgens which will be converted in the periphery to make oestrogens
What types of breast cancer respond to endocrine therapy?
Hormone Receptor + (Er+ and/or Pg+)
What is the antioestrogen drug for breast cancer and what kind of drug is it and what is the normal dose?
Tamoxifen - Triphenylethylene non-steroidal antioestrogen
20mg daily
What is the treatment for post menopausal women?
Aromatase inhibitors
What increases in risk with tamoxifen use?
thromboembolism and endometrial cancer
What is the mechanism of action of tamoxifen?
Tamoxifen is a nonsteroidal agent that binds to estrogen receptors (ER), inducing a conformational change in the receptor. This makes the ER unavailable to bind oestradiol
What is the role of the aromatase enzyme?
Member of the c-P450 family and converts androgens into oestrogens
How do aromatase inhibitors work and what are the 3 examples?
Prevents the conversion of androgens into oestrogens
Non steroidal type 2: Anastrozole and Letrozole
Steroidal type 1: Exemestane
What is the suggested treatment for early breast cancer in per menopausal women?
Ovarian function suppression and tamoxifen
What are the side effects of AI?
joint pain, decreased bone mineral density - risk of fracture
Who do you give AIs to?
POST MENOPAUSAL
What is fulvestrant?
a pure antioestrogen
What is the mechanism of action of fulvestrant?
Downregulates the estrogen receptor
