Best Hormone Therapy for Breast Cancer

Best Hormone Therapy: Hormone therapy is a type of treatment that can slow or stop the growth of hormone-sensitive breast cancer cells. It can be used to prevent cancer from coming back, reduce the size of cancer before surgery, slow or stop the growth of cancer that has spread, and decrease the risk of cancer developing in other breast tissue. However, hormone therapy also has some risks and side effects that need to be considered. In this article, we will discuss the benefits, risks, and types of hormone therapy for breast cancer, as well as how to use it, monitor it, and cope with it. We will also explore the potential role of the ketogenic diet, a low-carb, high-fat eating plan, in enhancing the effects of hormone therapy and improving the quality of life of breast cancer patients.

Key Takeaways

Topic	Summary
What is hormone therapy for breast cancer?	Hormone therapy is a treatment that blocks or lowers the amount of hormones (such as estrogen and progesterone) that can stimulate the growth of hormone-sensitive breast cancer cells.
What are the benefits of hormone therapy for breast cancer?	Hormone therapy can prevent cancer from coming back, reduce the size of a cancer before surgery, slow or stop the growth of cancer that has spread, and decrease the risk of cancer developing in other breast tissue.
What are the risks and side effects of hormone therapy for breast cancer?	Hormone therapy can cause common side effects such as hot flashes, night sweats, vaginal dryness or discharge, fatigue, joint and muscle pain, and impotence in men with breast cancer. It can also cause less common but more serious side effects such as blood clots, cataracts, endometrial cancer, uterine cancer, stroke, heart disease, and thinning bones.
What are the types of hormone therapy for breast cancer?	Hormone therapy can be classified into three main types: medicines that block hormones from attaching to cancer cells (such as tamoxifen and fulvestrant), medicines that lower estrogen levels (such as aromatase inhibitors and luteinizing hormone-releasing hormone agonists), and surgery to remove the ovaries (ovarian ablation or suppression).
How to use hormone therapy for breast cancer?	Hormone therapy can be administered orally, by injection, or by implant. The duration and timing of hormone therapy depend on the type and stage of breast cancer, the menopausal status of the patient, and the patient’s preferences and overall health. Hormone therapy should be taken as prescribed by the doctor and monitored regularly for effectiveness and side effects.
How to monitor the response to hormone therapy for breast cancer?	The response to hormone therapy can be measured by blood tests for tumor markers, imaging tests for tumor size and spread, and biopsies for tumor characteristics. A good response to hormone therapy is indicated by a decrease in tumor markers, a shrinkage or stabilization of tumor size and spread, and a change in tumor characteristics (such as loss of hormone receptors). If there is no response or resistance to hormone therapy, the doctor may switch to a different type or combination of hormone therapy, add another treatment (such as chemotherapy or targeted therapy), or stop hormone therapy altogether.
What is ketogenic diet and how does it work?	Ketogenic diet is a low-carb, high-fat eating plan that induces ketosis, a metabolic state where the body burns fat instead of glucose for energy. Ketogenic diet may have some benefits for breast cancer prevention and treatment by reducing inflammation, oxidative stress, insulin resistance, angiogenesis (blood vessel formation), and tumor growth.
What are the challenges and limitations of ketogenic diet for breast cancer patients?	Ketogenic diet may be difficult to follow for some people due to its restrictive nature and possible side effects. It may also lack long-term safety data, cause nutrient deficiencies or imbalances, interact with medications or treatments (such as hormone therapy), and vary in response among individuals. Therefore, ketogenic diet should be used with caution and under medical supervision for breast cancer patients.

Benefits of Hormone Therapy for Breast Cancer

Hormone therapy is one of the most effective treatments for breast cancer that is sensitive to hormones (such as estrogen and progesterone). Hormones are substances produced by glands in the body that regulate various functions such as growth, reproduction, metabolism, mood, and behavior. Some breast cancers have receptors (proteins) on their surface that can bind to hormones and use them as signals to grow and divide. These cancers are called hormone receptor-positive (HR-positive) breast cancers.

Hormone therapy works by blocking or lowering the amount of hormones that can stimulate HR-positive breast cancers. This can help prevent cancer from coming back after surgery or other treatments (adjuvant therapy), reduce the size of a cancer before surgery or other treatments (neoadjuvant therapy), slow or stop the growth of cancer that has spread to other parts of the body (metastatic or advanced breast cancer), and decrease the risk of cancer developing in the other breast or in other breast tissue (preventive or prophylactic therapy).

Hormone therapy can be very effective for HR-positive breast cancers. According to the American Cancer Society, hormone therapy can reduce the risk of recurrence by about 50% and the risk of death by about 30% for women with early-stage HR-positive breast cancer. Hormone therapy can also shrink tumors by about 50% or more in about 50% of women with metastatic HR-positive breast cancer. Hormone therapy can also lower the risk of developing breast cancer by about 50% for women who have a high risk of breast cancer due to factors such as family history, genetic mutations, or previous benign breast conditions.

Risks and Side Effects of Hormone Therapy for Breast Cancer

Hormone therapy can cause some side effects that may affect the quality of life of breast cancer patients. These side effects depend on the type and dose of hormone therapy, the duration and timing of treatment, and the individual characteristics of the patient. Some of the common side effects of hormone therapy are:

• Hot flashes: A sudden feeling of warmth that spreads over the face and upper body, often accompanied by sweating, flushing, and palpitations. Hot flashes can occur several times a day and last from a few seconds to several minutes. They can interfere with sleep, mood, and daily activities.
• Night sweats: Excessive sweating during the night that can soak the sheets and pajamas. Night sweats can cause discomfort, insomnia, and fatigue.
• Vaginal dryness or discharge: A lack of moisture or an increase in fluid in the vagina that can cause itching, burning, irritation, or infection. Vaginal dryness or discharge can affect sexual function, intimacy, and self-esteem.
• Fatigue: A feeling of tiredness, weakness, or lack of energy that does not improve with rest. Fatigue can affect physical, mental, and emotional well-being.
• Joint and muscle pain: Aching, stiffness, or inflammation in the joints or muscles that can limit mobility and range of motion. Joint and muscle pain can affect daily activities, exercise, and hobbies.
• Impotence: A difficulty in getting or maintaining an erection that is sufficient for sexual intercourse. Impotence can affect men with breast cancer who take hormone therapy. It can affect sexual function, intimacy, and self-esteem.

Some of the less common but more serious side effects of hormone therapy are:

• Blood clots: A blockage in a blood vessel that can prevent blood flow to a part of the body. Blood clots can cause pain, swelling, redness, or warmth in the affected area. They can also travel to other parts of the body and cause life-threatening complications such as pulmonary embolism (a clot in the lung) or stroke (a clot in the brain).
• Cataracts: A clouding of the lens in the eye that can impair vision. Cataracts can cause blurred vision, glare, halos, or difficulty seeing at night. They may require surgery to remove them.
• Endometrial cancer: A cancer that starts in the lining of the uterus (the endometrium). Endometrial cancer can cause abnormal vaginal bleeding or discharge, pelvic pain, or difficulty urinating. It may require surgery, radiation therapy, chemotherapy, or hormone therapy to treat it.
• Uterine cancer: A cancer that starts in the muscle layer of the uterus (the myometrium). Uterine cancer can cause similar symptoms as endometrial cancer. It may also require surgery, radiation therapy, chemotherapy, or hormone therapy to treat it.
• Stroke: A sudden interruption of blood flow to a part of the brain that can damage brain cells and affect brain function. Stroke can cause symptoms such as weakness or numbness on one side of the body, trouble speaking or understanding speech, vision problems, dizziness, or headache. It may require emergency medical attention and treatment to prevent further damage or complications.
• Heart disease: A condition that affects the heart and blood vessels that supply oxygen and nutrients to the heart muscle. Heart disease can cause symptoms such as chest pain, shortness of breath, irregular heartbeat, or fainting. It may require medication, lifestyle changes, surgery, or other procedures to treat it.
• Thinning bones: A loss of bone density and strength that can increase the risk of fractures. Thinning bones can cause pain, height loss, stooped posture, or spinal deformities. It may require medication, supplements, exercise, or other measures to prevent or treat it.

The risks and side effects of hormone therapy vary among individuals and may change over time. Some people may experience mild or no side effects at all while others may experience severe

Factors that Influence the Choice of Hormone Therapy for Breast Cancer

The choice of hormone therapy for breast cancer depends on several factors, such as:

• The type and stage of breast cancer: Different types and stages of breast cancer may respond differently to hormone therapy. For example, hormone therapy is more effective for HR-positive breast cancers than for HR-negative breast cancers. Hormone therapy is also more effective for early-stage breast cancers than for late-stage or metastatic breast cancers.
• The presence or absence of hormone receptors: The presence or absence of hormone receptors on the surface of breast cancer cells determines whether they are sensitive to hormones or not. Hormone therapy is only effective for breast cancers that have hormone receptors (ER-positive and/or PR-positive). Breast cancers that do not have hormone receptors (ER-negative and PR-negative) or have very low levels of them are not affected by hormone therapy.
• The menopausal status of the patient: The menopausal status of the patient affects the production and availability of hormones in the body. Hormone therapy may have different effects on premenopausal and postmenopausal women. For example, some types of hormone therapy (such as aromatase inhibitors) are only effective for postmenopausal women, while others (such as tamoxifen) can be used by both premenopausal and postmenopausal women.
• The patient’s preferences and overall health: The patient’s preferences and overall health also influence the choice of hormone therapy. Some patients may prefer certain types of hormone therapy over others due to their convenience, cost, or side effects. Some patients may also have other medical conditions or allergies that may limit their options or require adjustments in their dosage or regimen.

Based on these factors, the doctor will recommend the most suitable type and combination of hormone therapy for each patient. Here are some examples of different hormone therapy regimens for different scenarios:

• Tamoxifen for premenopausal women with ER-positive breast cancer: Tamoxifen is a medicine that blocks estrogen from attaching to cancer cells. It can be used by premenopausal women with ER-positive breast cancer to prevent recurrence, shrink tumors before surgery, or treat metastatic disease. Tamoxifen is usually taken orally once a day for 5 to 10 years.
• Aromatase inhibitors for postmenopausal women with ER-positive breast cancer: Aromatase inhibitors are medicines that lower estrogen levels by blocking an enzyme called aromatase that converts other hormones into estrogen. They can be used by postmenopausal women with ER-positive breast cancer to prevent recurrence, shrink tumors before surgery, or treat metastatic disease. Aromatase inhibitors include anastrozole, letrozole, and exemestane. They are usually taken orally once a day for 5 to 10 years.
• Ovarian suppression or ablation for premenopausal women with high-risk ER-positive breast cancer: Ovarian suppression or ablation is a procedure that stops the ovaries from producing estrogen. It can be done by surgery (removal of the ovaries), radiation (damage to the ovaries), or medication (injection of a drug that stops the release of hormones from the pituitary gland that stimulate the ovaries). Ovarian suppression or ablation can be used by premenopausal women with high-risk ER-positive breast cancer (such as those with large tumors, positive lymph nodes, or genetic mutations) to prevent recurrence, shrink tumors before surgery, or treat metastatic disease. Ovarian suppression or ablation can be combined with tamoxifen or aromatase inhibitors for better results.

How to Use Hormone Therapy for Breast Cancer

Hormone therapy can be administered in different ways, such as:

• Orally: Some hormone therapy medicines (such as tamoxifen and aromatase inhibitors) can be taken by mouth as pills or tablets. They are usually taken once a day at the same time every day with or without food.
• By injection: Some hormone therapy medicines (such as luteinizing hormone-releasing hormone agonists) can be given by injection into a muscle or under the skin. They are usually given once a month, once every 3 months, once every 6 months, or once a year depending on the type and dose.
• By implant: Some hormone therapy medicines (such as fulvestrant) can be given by implant under the skin. They are usually given once every 2 weeks, once every month, or once every 3 months depending on the type and dose.

The duration and timing of hormone therapy depend on the type and stage of breast cancer, the menopausal status of the patient, and the patient’s preferences and overall health. Some general guidelines are:

• For early-stage breast cancer: Hormone therapy is usually started after surgery and other treatments (such as chemotherapy or radiation therapy) are completed. It is usually given for 5 to 10 years to prevent recurrence and improve survival.
• For neoadjuvant therapy: Hormone therapy is sometimes given before surgery to shrink the tumor and make it easier to remove. It is usually given for 3 to 6 months before surgery and then continued after surgery for 5 to 10 years.
• For metastatic or advanced breast cancer: Hormone therapy is usually given as the first-line treatment to slow or stop the growth of cancer that has spread to other parts of the body. It is usually given until it stops working or causes unacceptable side effects. Then, another type or combination of hormone therapy or another treatment (such as chemotherapy or targeted therapy) may be tried.

To use hormone therapy safely and effectively, it is important to follow the doctor’s instructions and keep track of doses and appointments. Some tips are:

• Take hormone therapy as prescribed by the doctor. Do not skip, change, or stop doses without consulting the doctor.
• Keep a record of when and how much hormone therapy is taken. Use a calendar, a pillbox, an alarm, or an app to remind when to take the next dose.
• Report any side effects or changes in symptoms to the doctor. Some side effects may be mild and manageable, while others may be serious and require medical attention.
• Avoid certain foods, supplements, or medications that may interact with hormone therapy. For example, grapefruit juice, St. John’s wort, and warfarin may affect how hormone therapy works or increase the risk of side effects. Check with the doctor or pharmacist before taking anything new or different.

Conclusion

Hormone therapy is a treatment that can slow or stop the growth of hormone-sensitive breast cancer cells by blocking or lowering the amount of hormones that can stimulate them. Hormone therapy can have many benefits for breast cancer patients, such as preventing recurrence, shrinking tumors, slowing or stopping metastasis, and reducing the risk of developing new cancers. However, hormone therapy can also have some risks and side effects that need to be considered and managed. The choice of hormone therapy depends on several factors, such as the type and stage of breast cancer, the presence or absence of hormone receptors, the menopausal status of the patient, and the patient’s preferences and overall health. Hormone therapy should be used as prescribed by the doctor and monitored regularly for effectiveness and side effects.

Ketogenic diet is a low-carb, high-fat eating plan that may have some benefits for breast cancer prevention and treatment by inducing ketosis, a metabolic state where the body burns fat instead of glucose for energy. Ketogenic diet may reduce inflammation, oxidative stress, insulin resistance, angiogenesis (blood vessel formation), and tumor growth. However, ketogenic diet may also have some challenges and limitations for breast cancer patients, such as difficulty in adherence, lack of long-term safety data, possible nutrient deficiencies or imbalances, potential interactions with medications or treatments (such as hormone therapy), and individual variability in response. Therefore, ketogenic diet should be used with caution and under medical supervision for breast cancer patients.

Hormone therapy and ketogenic diet are two options that may help improve the outcomes and quality of life of breast cancer patients. However, they are not substitutes for other treatments (such as surgery, chemotherapy, radiation therapy, or targeted therapy) that may be recommended by the doctor. They are also not guaranteed to work for everyone or to cure cancer. Therefore, it is important to consult with a doctor before starting or changing any diet or treatment for breast cancer. It is also important to do your own research and seek reliable sources of information on hormone therapy and ketogenic diet for breast cancer.