Hormonal therapy for uterine cancer

Some women with uterine cancer have hormonal therapy. It is a treatment that adds, blocks or removes hormones. Hormones are substances that control some body functions, including the activity and growth of cells. Changing the levels of or blocking certain hormones can slow the growth and spread of uterine cancer cells. Drugs can be used to change hormone levels or block their effects.

You may have hormonal therapy to:

• treat advanced or recurrent uterine cancer
• control cancer cells left behind after surgery or radiation therapy and reduce the risk of the cancer recurring (called adjuvant therapy)
• relieve pain or control the symptoms of advanced uterine cancer (called palliative therapy)

Your healthcare team will consider your personal needs to plan your hormonal therapy. Hormonal therapy is usually given until the cancer progresses, at which time chemotherapy may be given. You may also receive other treatments.

The following are the most common hormonal therapies used to treat uterine cancer.

Progestins are the main type of hormonal therapy used to treat uterine cancer. They are drugs that act like the hormone progesterone and slow the growth of uterine cancer cells.

The following progestins may be used to treat both endometrial carcinomas and uterine sarcomas:

• medroxyprogesterone (Provera)
• megestrol (Megace, Apo-megestrol, Nu-megestrol, Lin-megestrol)

Tamoxifen (Nolvadex, Tamofen) is an anti-estrogen drug that prevents estrogen in a woman's body from stimulating the growth of cancer cells. It may be used to treat advanced or recurrent endometrial carcinoma.

LHRH agonists turn off estrogen production in the ovaries, which may slow the growth of the cancer. They may be used to treat women who are premenopausal and still have functioning ovaries.

The following LHRH agonists may be used treat both endometrial carcinomas and uterine sarcomas:

• goserelin (Zoladex)
• leuprolide (Lupron, Lupron Depot, Eligard)

After menopause, the body's main supply of estrogen comes from the adrenal glands and fatty tissues, rather than the ovaries. Aromatase is an enzyme that helps the adrenal glands and fatty tissues make estrogen. Aromatase inhibitors stop the estrogen from being formed, which lowers estrogen levels in the body.

The following aromatase inhibitors may be used to treat both endometrial carcinomas and uterine sarcomas:

• letrozole (Femara)
• exemestane (Aromasin)
• anastrozole (Arimidex)

Side effects can happen with any type of treatment for uterine cancer, but everyone's experience is different. Some people have many side effects. Other people have few or none at all.

Side effects can develop any time during, immediately after or a few days or weeks after hormonal therapy. Sometimes late side effects develop months or years after hormonal therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of hormonal therapy will depend mainly on the type of hormonal therapy, the dose of a drug or combination of drugs. Some common side effects of hormonal therapy for uterine cancer are:

• nausea and vomiting
• weight gain
• constipation
• skin problems such as rash or darkening of the skin
• breast swelling or tenderness
• fertility problems

• treatment-induced menopause

• high blood pressure

Tell your healthcare team if you have these side effects or others you think might be from hormonal therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Details on specific drugs change quite regularly. Find out more about sources of drug information and where to get details on specific drugs.

Find out more about hormonal therapy and side effects of hormonal therapy. To make the decisions that are right for you, ask your healthcare team questions about hormonal therapy.