To begin with many people confuse hormonal therapy with hormone replacement therapy and the therapies are completely different. Hormonal therapy (HT) works against estrogen to fight it off. Whereas hormone replacement therapy (HRT) replaces estrogen in menopausal women whose natural estrogen levels are very low. Hormone replacement therapy is unsafe for women with breast cancer and can cause breast cancer in women who do not have it. Hormone Replacement Therapy is not a breast cancer treatment.

Hormonal Therapy

The medicines in hormonal therapy are designed to work on hormone receptor positive breast cancers by lowering the levels of estrogen in the body and by blocking the affects of estrogen upon breast cancer cells. It is also effective as a prevention treatment for women who are at a high risk for breast cancer. Hormonal therapy is also known as antiestrogen therapy.

The ovaries are responsible for providing most of the estrogen in a woman’s body. In breast cancers such as this type, it is the estrogen hormone, which is causing the cancer to grow. Therefore, reducing or blocking the amount of estrogen in the body will slow down the cancer growth and prevent a recurrence of hormone receptor positive breast cancer from coming back after surgery in early stage breast cancer. It can also shrink or slow down the growth and spread of cancer in advanced stages of hormone receptor positive breast cancer. However, hormonal therapy does not work for other types of breast cancers, which are not the result of estrogen binding to cancer cells.

After women enter menopause and beyond, the body produces a hormone called androgen, which is primarily a male hormone also found in women. Androgen is produced by the adrenal glands, which are small glands situated above the kidney.

After the androgen is present in the female body, there is a protein produced by the fat and muscle cells, which is called aromatase. This enzyme is responsible for changing the androgen into estrogen.

The different types of hormonal medications that are used are: aromatase inhibitors, selective estrogen receptor modulators, and estrogen receptor downregulators.

Aromatase inhibitors include: Femara (letrozole), Arimidex (anastrozole) and Aromasin (exemestane).

Estrogen receptor modulators (SERM) include: Fareston (toremifene) Evista (raloxifene), and Tamoxifen.

(Estrogen Receptor Downregulators (ERD) include Faslodex (fulvestrant)

Hormonal therapy sometimes causes the ovaries and or the fallopian tubes to shut down because of the lack of estrogen production in the body. In some breast cancer cases, the ovaries and fallopian tubes must be removed. The reason for the removal is because the ovaries are the main source of estrogen production in premenopausal women.

Again, it must be stressed that hormonal therapy is not hormone replacement therapy. Hormone replacement therapy replenishes estrogen in the body and is used as a medication to relieve the symptoms of menopause such as hot flashes, and mood swings. In Hormone Replacement Therapy the treatment may require the use of other hormones such as testosterone as well.

Roughly 80 percent of all breast cancers are estrogen receptor positive and about 65 percent of breast cancers are also progesterone receptor positive. If a breast cancer has receptors for either estrogen or progesterone it is considered hormone receptive positive.

Which hormonal therapy is right for you?

The answer to this question will depend upon your whether you are pre or postmenopausal, the stage of breast cancer you are in, if you have any blood clots or have had any in the past, your bone density, if you or have had arthritis, if you are at risk for ovarian or uterine cancer, and finally your body’s reaction to hormonal therapy once the treatments commence.

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