Types of Hormonal Therapy

Hormonal therapyinfo-icon medicines are put into classes based on how they interact with the body’s natural hormones estrogeninfo-icon and progesteroneinfo-icon. Some stop the body from making estrogen, while others prevent estrogen from helping the cancer cellinfo-icon grow.

Your doctor may recommend treatment with one hormonal therapy over another depending on

In this section, you’ll learn more about the classes of hormonal therapies and some common breast cancer medicines within each class.

Estrogen Blockers

Estrogeninfo-icon blockers prevent estogen from causing breast cancer cells to grow. The medicines in this family are selective estrogen receptorinfo-icon modulators, SERMs, or estrogen receptor agonists, ERAs. The two work toward the same goal, but do it slightly different from one another. 

SERMs prevent estrogen signals from getting to breast cancer cells. They are given as daily pills, and are some of the most common given to premenopausalinfo-icon and perimenopausalinfo-icon women with hormone receptorinfo-icon-positive breast cancer. Tamoxifeninfo-icon, a SERMinfo-icon, can be taken daily for 5 to 10 years after other treatment for early-stage breast cancerinfo-icon to prevent recurrenceinfo-icon. Postmenopausalinfo-icon women can also take tamoxifen, usually before treatment with an aromatase inhibitorinfo-icon. In metastaticinfo-icon breast cancer, you may take SERMs as long as they keep the cancer from growing.

The SERMs are:

ERAs stop the activity of estrogen on cancer cells to keep them from growing. ERAs are available for stage IV breast cancerinfo-icon and are given after other hormonal therapies stop working. They are given as an injectioninfo-icon every 4 weeks.

The ERA that is FDAinfo-icon approved for metastatic breast cancer is:


LHRH Agonists

These medicines reduce the amount of estrogeninfo-icon your body makes. They shut down your ovaries temporarily. When the ovaries stop making as much estrogen, hormone receptorinfo-icon-positive breast cancer cells can’t continue to grow. These medicines are usually paired with other forms of hormonal therapyinfo-icon. They may be used with the goal of preserving your fertilityinfo-icon, though this method hasn’t yet been proved.

Medicines in this class are:

Aromatase Inhibitors

After menopauseinfo-icon, your body stops making estradiolinfo-icon, the main estrogeninfo-icon produced by the ovaries. But your body still makes estrone, an estrogen created by converting a male sex hormoneinfo-icon found in the adrenal glands, fat cells and muscle. An enzyme called aromatase converts that hormone into estrogen.

Aromatase inhibitors, or AIs, are a class of medicines that interfere with the enzyme aromatase to reduce the risk of breast cancer returning in postmenopausalinfo-icon women with early-stage breast cancerinfo-icon. They are the standard hormonal therapyinfo-icon for postmenopausal women, and may be the first (primary) hormonal therapy your doctor prescribes. AIs are given as a daily pill, usually after surgeryinfo-icon or chemotherapyinfo-icon. In this setting, they are taken for 5 years as the only hormonal therapy treatment, or for up to 5 years after up to 5 years of tamoxifeninfo-icon.

In metastaticinfo-icon breast cancer, aromatase inhibitors may be the first treatment given if you are postmenopausal and have hormone-positive disease. These medicines may be paired with other therapies or given alone. You may take one medicineinfo-icon for as long as it works at controlling the cancer. Your doctor may then recommend you try a different medicine.

The aromatase inhibitors are:

November 4, 2019
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