Hormonal Therapy Flashcards
Hormone Therapy
- Not chemotherapy but chemoprevention
- Intended to reduce risk or delay the development of hormone sensitive cancer
- 4 Categories: SERMS, AIs, Progesterones, Antiandrogens, LHRH
Hormone Sensitive Cancers
breast, ovarian, prostate
Selective Estrogen Receptor Modulators (SERMS)
- Type of hormonal agent
- SERMS = “Selective Estrogen Receptor Modulators” or “Antiestrogens”
- Decrease growth of estrogen sensitive cells by binding to the estrogen receptor
- Side effects: Menstrual symptoms, fluid retention, thromboembolic issues, weight gain
- Tamoxifen + Toremifene used for breast cancer + raloxifene is used for osteoporosis + post men women @ risk for breast cancer
- Examples: Tamoxifen (Novaldex), Toremifene (Fateston), Raloxifene (Evista)
Tamoxifen
- Brand Name = novaldex.
- SERM Hormone therapy for breast cancer
- Side effects: Menstrual symptoms, fluid retention, thromboembolic issues, weight gain
- Flaxseed may enhance the effects of tamoxifen
- Melatonin: may benefit those taking tamoxifen
4 Types of Hormone Therapies/Agents Using in Cancer Treatment
- SERMS (Selective Estrogen Receptor Modulators)
- AIs (Aromatase Inhibitors)
- Progesterones
- Antiandrogens
- LHRH
Aromatase Inhibitors (AIs)
- Type of hormonal agent
- AIs = “Aromatase Inhibitors”
- Aromatase is the enzyme involved in estrogen synthesis
- Blocks estrogen production in post menopausal only*
- Side effects: hot flashes, N/V, thromboembolic events
- Associated with bone loss - need adequate calcium + vitamin D. This does not apply to SERMs only AIs
- Primarily used in postmenopausal women
- Examples: Femara (Letrozole), Aromasin (Exemestane) + Anastrozole (arimidex) all primarily used in post men breast cancer
AIs Side Effects
- Common side effect is hot flashes, N/V, thromboembolic events.
- Bone loss - will require adequate calcium + vitamin D
- Letrozole can cause high cholesterol
- Alternative therapies (Mind Body Medicine) to help with hot flashes: biofeedback (meditation, relaxation, deep breathing exercises) + acupuncture though biofeedback may be more significant
- Examples: Femara (Letrozole), Aromasin (Exemestane) + Anastrozole (arimidex) which are all primarily used in post men breast cancer
SERMS Side Effects
- Side effects: Menstrual symptoms, fluid retention, thromboembolic issues, weight gain
- Flaxseed may enhance the effects of tamoxifen
- Melatonin: may benefit those taking tamoxifen
Progesterones
-Type of hormonal agent
-Possess anti-estrogenic effects + inhibits the stability/availability/turnover of estrogen receptors
Side effects: weight gain (fluid retention), thromboembolic events, N/V, menstrual symptoms, hyperglycemia*
-Primarily used in breast, endometrial, renal cell cancers
-Can also act as an appetite stimulant in cancers + HIV/AIDS
-Example: megace (magesterol acetate)
Antiandrogen
- Type of hormonal agent
- Bind to androgen receptors + block the effects of testosterone in androgen sensitive prostate cancer cells
- Used for prostate cancer
- Examples: Bicalutamide (Casodex), Flutamide (Eulexin)
- Side effects: weight gain, hot flashes, fatigue, bone pain
Luteinizing hormone-releasing hormone (LHRH) agonist
- Type of hormonal agent
- LHRN = “Luteinizing hormone-release hormone”
- Synthetic proteins similar to naturally-occurring LHRH
- Signal the pituitary gland to stop producing luteinizing hormone. This results in the suppression of testosterone to manage the growth/spread of prostate cancer. Can also suppress the ovaries to stop estrogen proudction
- Used for prostate cancer + breast cancer
- Examples: Leuprolide acetate (Lupron) + Goserelin (Zoladex)
- Side effects: hot flashes, fatigue, bone pain, gynecomastia (enlarged breast tissue in males), muscle weakness
Types of SERMS
Prescribed for breast cancer:
- Tamoxifen citrate (Novaldex)
- Toremifence citrate (Fareston)
Prescribed for osteoporosis or for post men women at risk for breast cancer
-Raloxifene (Evista)
Types of AIs
Prescribed for breast cancer:
- Anastrozole (Arimidex)
- Letrozole (Femara)
- Exemestane (Aromasin)
Types of Progesterones
Can be prescribed for breast, endometrial, renal cell cancers + act as an appetite stimulant
-Megace (Megestrol acetate)
Types of Antiandrogens
Prescribed for Prostate Cancer:
- Bicalutamide (Casodex)
- Flutamide (Eulexin)
