Endometrial Cancer: Hormone Therapy

Hormone therapy is a type of cancer treatment that changes the levels or blocks the actions of certain hormones in your body. This can help to control endometrial cancer. It's not the same as the hormone therapy that's used to manage symptoms of menopause.

Hormone therapy is often given by a gynecologic oncologist. This is a specialist who diagnoses and treats female cancer. It may also be done by a medical oncologist, a specialist who treats cancer using medicines.

Hormones are chemicals in your blood. They control how cells grow. The goal of hormone therapy for cancer is to stop cancer cells from getting the hormones they need to grow. The cancer cells may then shrink and die. Estrogen and progesterone are the hormones that help endometrial cancer cells grow.

This cancer treatment uses medicines to keep these hormones from being made. Or the medicines may stop the hormones from helping cancer cells grow. You take the medicines as a pill or get a shot (injection). They affect cancer cells both inside and outside the uterus. Sometimes, endometrial cancer responds to hormone therapy for a while, but the response may not last.

Your healthcare provider may advise hormone therapy for you in any of these cases:

• Surgery and radiation are not good choices for you. This may be because your health is not good.

• The cancer has spread to other parts of your body.

• You've already been treated for endometrial cancer, and it has come back.

• You’re young, want to get pregnant in the future, and your cancer hasn’t spread.

Your healthcare provider will test cancer cells from your biopsy or surgery to see how they respond to hormones. This helps your healthcare provider know if hormone therapy may work for you.

Hormone therapy is often given along with chemotherapy.

These are the types of hormone therapy medicines that might be used:

• Progestins. These are the most common hormone treatment used. They slow the growth of endometrial cancer cells. They're pills or liquid you take at home.

• Tamoxifen. This medicine blocks estrogen from causing the cancer cells to grow. It's taken as a pill or liquid.

• Luteinizing hormone-releasing hormone agonists.  These medicines keep the ovaries from making estrogen, which slows the growth of endometrial cancer cells. They're given as an injection (shot) every 1 to 3 months.

• Aromatase inhibitors. These medicines stop estrogen production in fat tissue after the ovaries have been removed. They're most often used in women who can't have surgery. They're pills you take every day.

Very small (early) endometrial cancers may be treated with an intrauterine device (IUD) that contains progestin.

Side effects are much the same for all types of hormone therapy. But there are some differences with different types of medicines. Many of the side effects are a lot like the symptoms of menopause. Side effects vary from woman to woman and can include:

• Hot flashes

• Night sweats

• Increased appetite

• Weight gain

• Worsening depression

• Vaginal dryness

• Blood clots (a rare but serious side effect)

• Muscle and joint aches

• Weakened bones (osteoporosis), if taken for many years

• Fluid buildup inside the body (fluid retention)

Talk with your healthcare provider about what to expect from your type of hormone treatment. Some of the side effects can be prevented or treated. For instance:

• Weight-bearing exercise and medicine can help decrease bone loss.

• Vaginal moisturizers and lubricants can help overall vaginal health and comfort during sex.

• Regular exercise can help prevent weight gain and muscle loss. It can also help prevent depression.

• Medicine and counseling can help treat depression.

• Ease hot flashes by wearing layers of clothing that you can easily remove, taking care not to get overheated, and staying away from your hot flash triggers.

Talk with your healthcare team about any side effects you have.

It's important to know which medicine you're taking. Write down the name of your medicine and how to take it. Find out if there are any precautions you have to take. Ask your healthcare team how the medicine works and what side effects it might cause. Make sure you know what number to call with questions. Is there a different number for evenings and weekends?

Tell your healthcare team about any side effects, even those that seem minor. Your treatment may be adjusted to reduce these effects.

It may be helpful to keep a diary of your side effects. Write down physical, thinking, and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage your side effects.

Also talk with your healthcare provider about any other therapies you may want to try. Some alternative therapies can affect hormone therapy.