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Hormone therapy for cancer |
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Many tumours (cancers) are stimulated by the body's own hormones (usually the female hormone
oestrogen or the male hormone testosterone). Some of these cancers can be
stimulated by female hormones taken deliberately such as HRT or hormone
replacement therapy. Cancers with hormone receptors can also be promoted and
stimulated to grow by ingested chemicals which have oestrogenic properties (see xenoestrogens
and metaloestrogens)
Stopping the body's hormones reaching the nucleus of the cell cause the cancer cells to stop growing and in some cases shrivel up and die (self destruct - apoptosis). Most of the successful therapies in this category are for breast and prostate cancer but they have been used with limited success in uterine, kidney cancer and melanoma.
Hormone therapies
work in three main ways:
The first way
is to block the production of the bodies own hormones. One
straightforward way is to surgically
remove the ovaries or
testes. Some drug therapies chemically do the
same thing by blocking the signal from the brain to the ovaries or testes - these include
goserelin (Zoladex), leuproelin (Prostap) collectively called LHRH blockers. Other drugs in
this category work by stopping the production of oestrogen from the adrenal glands. These
only work in post menopausal women and the three most commonly used in the UK are
anastrazole (Arimidex), exemestane (Aromasin) and
letrozole (Femara).
The second way
hormone therapies work is to fool the signal pathway between the
brain (pituitary) and the
ovaries or testes by increasing the blood levels of another hormone produced in the
ovaries so in turn the brain thinks they are producing too many hormones including
oestrogen and as a consequence switches off the driving signal by itself - this results in
reducing the blood level of oestrogen. Drugs which act in this way include
Medroxyprogesterone acetate (Provera), Megestrol acetate
(Megace), stilboestrol and
cyproterone acetate.
The third way
to stop the bodies hormones stimulating cancer cells to grow is to block
the cells ability
to read the signal from the hormones in the blood stream. Cancer cells have
receptors which when blocked they cannot be influenced by
the bodies hormones, despite often normal levels in the blood stream. The most well known
is called oestrogen receptor and can be blocked with tamoxifen and
toremifene (selective oestrogen receptor modifiers -SERM's). These receptors can be
measured by performing a special
test on the tissue removed from the tumour (oestrogen receptor positive). In prostate cancer
the receptors are called androgen receptors, Although they are not easy measured they can
be blocked with drugs such as bicalutamide (casodex), Flutamide (Drogenil) and Buserelin
(suprefact).
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