Hormone therapy for cancer

The cost of hormone therapy depends on your individual circumstances. At the time of your appointment your consultant will discuss all options with you and ensure all your questions are answered.

Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.

Our flexible payment options help you spread the cost of your payment across a time period that suits you.

Hormones are substances produced by various glands in your body. They act as chemical messengers between different parts of your body and tell them how to function. Some cancers are hormone-sensitive and use hormones to grow and develop.

Hormone therapy may be an effective treatment for some types of hormone-sensitive cancers such as:

• Breast cancer
• Womb (endometrial) cancer
• Prostate cancer 

Hormone therapy is an effective treatment for certain types of cancer and can stop or slow the cancer's growth and reduce the risk of it coming back.

Hormone therapy can also help ease symptoms of prostate cancer in men who cannot have radiotherapy or surgery.

The type of hormone therapy you have will depend on several factors including the type and stage of your cancer, your general health, any other treatments you are having, and whether or not you have been through menopause.

Hormone therapies for breast cancer

Some types of breast cancer are affected by the female sex hormones oestrogen and progesterone and may be classified as oestrogen receptor-positive (ER+), progesterone receptor-positive (PR+) or both. There are several types of hormone therapies for breast cancer that work in different ways to prevent the cancer from growing and spreading. In early-stage breast cancer, hormone therapy can be used to reduce the chance of the cancer coming back.

Your consultant may prescribe more than one type of hormone therapy to treat your breast cancer.

Some types of hormone therapies to treat breast cancer include:

Aromatase inhibitors

After menopause, you no longer make oestrogen in your ovaries, but your body continues to produce small amounts by converting other hormones (called androgens) into oestrogen. Aromatase inhibitors work by blocking the enzyme (aromatase) that turns androgens into oestrogen.

Aromatase inhibitors may be prescribed for women who have been through the menopause. Types of aromatase inhibitors include:

• Anastrozole (Arimidex)
• Exemestane (Aromasin)
• Letrozole (Femara)

Tamoxifen

Tamoxifen is one of the most common hormone therapies for treating breast cancer. It works by blocking oestrogen receptors and preventing oestrogen from driving the cancer cells to grow. Tamoxifen can be taken by both pre-menopausal and post-menopausal women and by men with hormone-sensitive male breast cancer.

Luteinising hormone-releasing hormone (LHRH) agonists

Luteinising hormone (LH) is secreted by a gland in your brain called your pituitary gland. Its job is to regulate the amount of sex hormones produced by your body. In breast cancer, luteinising hormone-releasing hormone (LHRH) agonists or LH blockers block the signal from your pituitary gland to your ovaries, preventing them from producing luteinising hormone, which stops the production of oestrogen and progesterone. LHRH agonists are only effective if you are still having periods (have not been through menopause).

Some LHRH agonists used to treat breast cancer include goserelin (Zoladex) and leuprorelin (Lutrate Prostap).

Fulvestrant (Faslodex)

Fulvestrant is a type of hormone therapy called an oestrogen receptor antagonist. It works by blocking oestrogen receptors on cancer cells which can slow or stop the growth of some types of breast cancer that need oestrogen to grow.

Chemoprevention

Chemoprevention is a type of preventative treatment that may be used to prevent breast cancer in people at high risk of developing the disease. It may include drugs such as raloxifene, tamoxifen, or aromatase inhibitors such as anastrozole.

Hormone therapies for prostate cancer 

Hormone therapy for prostate cancer works by blocking or reducing the amount of the male sex hormone testosterone that the cancer needs to grow. It can slow the growth of advanced prostate cancer and reduce the risk of early prostate cancer coming back. Some types of hormone therapies used to treat prostate cancer include: 

Luteinising hormone-releasing hormone (LHRH) agonists or LH blockers

In addition to oestrogen and progesterone, luteinising hormone (LH) also controls the amount of the male sex hormone testosterone. Luteinising hormone therapy for prostate cancer works by blocking the signal from the pituitary gland which stops the production of luteinising hormone and stops the testicles from producing testosterone.

Some LH blockers used to treat prostate cancer include goserelin (Zoladex), triptorelin (Decapetyl), leuprorelin (Prostap), and buserelin (Suprefact). 

Anti androgens

Hormones called androgens such as testosterone attach to receptors on prostate cancer cells, stimulating them to divide and spread. Anti-androgens work by attaching themselves to these receptors, preventing testosterone from attaching and inhibiting the growth of cancer cells. Anti androgens for prostate cancer include: bicalutamide (Casodex), cyproterone acetate (Cyprostat), flutamide (Drogenil), enzalutamide (Xtandi), apalutamide (Erleada), and darolutamide (Nubeqa).

Gonadotrophin-releasing hormone (GnRH) blockers

Gonadotrophin-releasing hormone (GnRH) blockers directly block the signals from the hypothalamus that tell the pituitary gland to produce luteinising hormone. This causes the testicles to stop producing testosterone. GnRH blockers include the drug degarelix (Firmagon).

Hormone therapies for endometrial (womb) cancer 

The main hormone therapy for endometrial cancer is progesterone or synthetic versions called progestins which work by slowing the growth of cancer cells. The main progestins used to treat or manage endometrial cancer are medroxyprogesterone acetate (Provera), and megestrol acetate (Megace). A levonorgestrel-releasing intrauterine device (LNG-IUD) such as Mirena can also be used to treat endometrial cancer, particularly early-stage or low-risk cancers that haven’t spread beyond the womb. This type of treatment is known as fertility-sparing and is a good option for women who may want to have children in the future. 

Surgery

In some cases, surgery to remove your ovaries (oophorectomy) or testicles (orchidectomy) may be performed to reduce or stop the production of cancer-driving hormones.

At your first consultation, you will be seen by a consultant oncologist, a doctor specialising in treating cancer. Your first appointment is important as it’s where you’ll meet your consultant, the doctor responsible for your care. At your appointment, your consultant will ask you about your symptoms, diagnosis, medical history, any other treatments you have had, and your general health. They may perform a physical examination. Your consultant may ask to see the results of any previous tests or scans you have had or arrange them on the day. These may include blood tests, or imaging scans such as an X-ray, CT scan, ultrasound, or MRI.

During your appointment, your consultant will take time to get to know you and talk to you about your diagnosis and the impact it has had on your life as well as your expectations for treatment and any questions you may have. At Circle Health Group, we want you to be as well-informed and comfortable as possible during your time with us, so please discuss any questions or concerns with your consultant during your appointment.

Your consultant will tell you everything you need to do to prepare for your hormone therapy. If there’s anything you’re not sure about, or if you have any questions, please feel free to discuss this with your consultant or a member of your healthcare team.

Some ways you can prepare for your hormone therapy include:

• Make sure you understand your treatment plan, the type of hormone therapy you’ll receive and any potential side effects 
• Follow a healthy, nutritious diet with plenty of fruit, vegetables, lean protein and whole grains 
• Take regular light exercise such as walking, swimming and gentle cycling 
• Manage and reduce stress with activities such as relaxation techniques, meditation, yoga, or breathwork
• Get plenty of rest 
• Make sure you get enough sleep 
• Reach out for emotional support from loved ones, support groups or counsellors 

Before starting your hormone therapy, you’ll need to sign a consent form to say that you agree to have the treatment and are aware of what it entails and all the possible risks and complications.

How is hormone therapy given?

 Hormone therapy can be administered in several ways:

• As pills or capsules that you swallow
• By injection into the muscle or under the skin 
• Through the skin (transdermal) as patches, gels or creams 
• As pellets under the skin (subdermal)
• As a vaginal ring or pessary
• Via surgery to remove your hormone-producing organs such as your ovaries or testicles

Where will I receive my hormone therapy?

Where you have your treatment depends on the type of hormone therapy you are having and how it is given. You may take your hormone therapy at home, or you may need to attend the hospital as an outpatient to receive your treatment.

Recovering from hormone therapy for cancer varies depending on the type and stage of your cancer, your general health, the type of hormone therapy you are having and whether or not you experience side effects. Your healthcare team will be on hand to support you throughout your recovery, help you manage any side effects, and provide emotional and practical support.

You’ll have regular checkups with your consultant to monitor your progress, address any side effects, see how well your hormone therapy is working and make any necessary adjustments to your treatment.

As with all medications, hormone therapy for cancer can cause side effects in some people. Your consultant will discuss all the possible side effects with you before your treatment and advise you on how best to manage them.

Common side effects of hormone therapy may include:

• Fatigue
• Hot flashes and sweating 
• Hair loss
• Depression
• Weight gain
• Headaches or migraines 
• Nausea or vomiting 
• Diarrhoea 
• Difficulty with short-term memory
• Mood changes such as mood swings, depression and irritability 
• Muscle cramps 
• Loss of muscle mass 
• Vaginal bleeding or spotting 
• Breast tenderness or swelling 
• Erectile dysfunction 
• Reduced libido (sex drive) 
• Liver problems 
• Menopause-related side effects: may include vaginal dryness, hot flashes, loss of bone density, urinary incontinence

Hormone therapy for cancer can sometimes cause long-term side effects that may persist after your treatment has finished. These may include:

• Increased risk of blood clots
• Increased risk of heart problems 
• Osteoporosis
• Changes in your vision 
• Memory problems 
• Mood changes

Rarely, hormone therapy for cancer can cause serious side effects. Seek immediate medical attention if you experience:

• Severe allergic reaction: may include hives, itching, rash, difficulty breathing or swallowing, swelling of your face, throat, tongue, lips, and around your eyes
• Itchy skin, dark-coloured urine, jaundice (yellowing of your skin or the whites of your eyes) or pain in the upper right part of your abdomen 
• Sudden, severe headache
• Sudden changes in vision
• Pain, swelling or redness in one of your legs
• Unusual vaginal bleeding 
• Breast changes such as a lump, changes to your nipple, or dimpling of the skin

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about hormone therapy for cancer, book your appointment online today or call a member of our team directly on 0808 189 5499.

Hormone therapy for cancer - Cancer Research UK

Hormone Therapy to Treat Cancer - National Cancer Institute

Hormonal therapy - Macmillan Cancer Support

Hormone Therapy - American Cancer Society