Hormones and hormone modulators are a group of medications that suppress the function of specific hormones, which slows or stops the growth of hormone-dependent cancers, such as breast, endometrial, and prostate cancers. They can also be used to ease the symptoms caused by certain types of cancer, such as brain or renal cancers.
Now, hormones and hormone modulators can be broadly classified as sex hormones; antiestrogens; aromatase inhibitors; antiandrogens; and gonadotropin-releasing hormone analogs.
Now, some commonly used sex hormones include hydroxyprogesterone, which is administered intramuscularly or subcutaneously for advanced uterine adenocarcinoma; as well as medroxyprogesterone, and megestrol, which are taken orally for endometrial or breast cancer. Once administered, these medications work by suppressing the pituitary gland from releasing gonadotropins, so follicle-stimulating hormone or FSH for short, and luteinizing hormone or LH. As a result, gonadotropins aren’t available to stimulate sex hormone production by the gonads, which ultimately delays the growth of sex hormone-dependent tumors.
There are also antiestrogens, which include selective estrogen receptor modulators, or SERMs for short, such as tamoxifen, raloxifene, and fulvestrant. These medications are administered orally, and work by blocking estrogen receptors on cancer cells, which delays the growth of estrogen-dependent tumors.
Similarly, there’s aromatase inhibitors, which include anastrozole, letrozole, and exemestane. These medications are administered orally, and act by blocking the production of estrogen, which ultimately also helps limit the growth of estrogen-dependent tumors.
Next are antiandrogens, which include flutamide, apalutamide, and bicalutamide. These medications are also administered orally, and they block androgen receptors on cancer cells, ultimately stopping the growth of androgen-dependent tumors like prostate cancer.
Finally, gonadotropin-releasing hormone or GnRH analogs include leuprolide and goserelin. These medications are administered subcutaneously, and leuprolide may also be administered intramuscularly. Once administered, these medications inhibit the release of gonadotropins from the pituitary gland. This blocks the secretion of sex hormones by the gonads, ultimately stopping the growth of sex hormone-dependent tumors like breast or prostate cancers.
Alright, now common side effects of hormones and hormone modulators can include weight gain, myalgia, arthralgia, and even fractures due to decreased bone mineral density, as well as decreased libido, gynecomastia, hot flashes, and vaginal discharge, dryness, or irritation. Additionally, clients may experience gastrointestinal side effects, such as anorexia, nausea, vomiting, or diarrhea. More serious side effects include an increased risk for cardiovascular disease. Finally, tamoxifen and raloxifene have boxed warnings for causing thromboembolic events and stroke; and tamoxifen also has a boxed warning for causing uterine cancers; and flutamide has a boxed warning for severe hepatotoxicity.
