5.0 Hormone therapies Flashcards
How might cancers be referred to if they are influenced by hormones?
- Hormone dependent
- Hormone sensitive
What type of hormones are typically involved in hormone dependent/sensitive cancers?
- Androgens - Male
- Oestrogens - Female
What is the aim of hormone therapy?
- Block the effect of the hormone circulating in the blood
- Reduce production of hormones entering the blood.
How is hormone therapy administered
- Alone
- Or in combination with other anti cancer treatments
When might hormone therapy be administered?
Neo-Adjuvant
Adjuvant
Palliative
What are the 4 types of hormone therapy?
- Anti androgens
- Aromatase inhibitors
- Gonatrophin Releasing Hormone Agonists
- Selective oestrogen modulators
Which hormones are targted in women?
In women, hormonal therapies typically target oestrogen
Tamoxifen, is used to treat some breast cancers
Tamoxifen competes with oestrogen at receptors in the breast cancer cells, blocking them from getting the oestrogen they need to survive.
What type of hormones are targeted in men?
Androgens
What type of hormonal therapy can be used in both men and women?
Gonadotrophin releasing hormone agonists can be used in:
* Breast cancer, because it reduces the levels of oestrogen produced in the ovaries
* Prostate cancer in men, because it reduces the levels of testosterone produced in the testes
What are the 4 phases of adverse effects which may occur?
- Immediate
- Early
- Delayed
- Late
What are the immediate adverse effects which may occur with hormonal therapy?
Headache
What are the early adverse effects which may occur with hormonal therapy?
- Hot flushes
- Tumour flare reaction
- Hyperglycaemia
- Hyperlipidaemia and hypercholesterolaemia
- Fluid retention and oedema
What are the delayed adverse effects which may occur with hormonal therapy?
- Vaginal atrophy
- Reduced libido and sexual dysfunction
- Arthralgia and myalgia
- Thromboembolism (tamoxifen)
- Ocular changes
What are the late adverse effects which may occur with hormonal therapy?
- Osteoporosis
- Menopausal symptoms
- Endometrial changes and uterine malignancies
What type of cancer are Anti Androgens used to treat?
Prostate cancer
What is the mode of action of Anti Androgens?
Anti Androgens inhibit the binding of androgens at the androgen receptors, blocking thir effect.
What are the two different types of Anti Androgens?
- Steroid Anti Androgens e.g. Cyproterone
- They have a progestogenic effect which reduces the production of testosterone
- Non-Steroidal anti androgens e.g. Flutamide (Other drugs with Suffix MIDE)
- They do not suppress androgen production and may increase testosterone.
What type of cancer are Aromatase Inhibitors used to treat?
Hormone receptor positive (HER2) breast cancer in post menopausal women
What is the mode of action of Aromatase inhibitors?
Aromatase inhibitors reduce tissue oestrogen concentration by inhibiting aromatase
Name two aromatase inhibitors?
- Anastrozole
- Letrozole
What type of cancer are GnRH AGONISTS used to treat?
- Prostate cancer
- Breast cancer
What is the mode of action of GnRH AGONISTS?
Gonadotrophin releasing hormone agonists iniitally….stimulate synthesis of follicle stimulating hormone, luteinizing hormone, transiently increasing testosterone in Males and serum oestrogen in females
In contrast, continuous administration of GnRH agonists inhibit gonadotrophin production, ovarian and testicular steroidogenesis and inhibits the growth of certain hormone dependent tumors.
Name two GnRH AGONISTS?
- Triptorelin
- Leuprorelin
What are the selective oestrogen receptor modulators?
Selective oestrogen receptor modulators compete with oestrogen for receptor sites in breast tissue,
exhibiting an anti-oestrogenic effect
inhibiting tumour growth and may suppress other growth factors and cytokines.38
Name two types of selective oestrogen receptor modulators
- Tamoxifen
- Toremifene
