Side Effects of Hormone Treatment for Breast Cancer

• Hormone therapies for hormone receptor-positive breast most cancers can result in unwanted effects similar to sizzling flashes, vaginal dryness, ache, and nausea.
• A spread of methods might help you handle many unwanted effects and enhance your high quality of life throughout hormonal remedy.

In hormone receptor (HR)-positive breast most cancers, the most cancers cells comprise receptors to estrogen or progesterone — or each — and depend on indicators from these hormones to assist them develop. By lowering these indicators, hormone therapies for HR-positive breast most cancers work very successfully.

Although hormonal therapies — additionally referred to as endocrine therapies — could also be crucial for treating HR-positive breast most cancers, they usually have undesirable unwanted effects. There are many methods for managing these unwanted effects and feeling your finest whereas taking hormone therapies for HR-positive breast most cancers.

Common Side Effects of Hormone Therapy

The ovaries produce estrogen and progesterone and management the menstrual cycle. Menopause happens naturally when the ovaries produce fewer hormones, inflicting menstrual intervals to cease. Because hormone therapies for HR-positive most cancers scale back hormone signaling, they’ll additionally cause menopausal symptoms, particularly for individuals who haven’t already skilled menopause.

Common menopausal signs embrace:

• Hot flashes or evening sweats
• Vaginal dryness
• Mood swings

Hormone therapies may trigger different unwanted effects, which fluctuate based mostly on the sort of treatment.

Selective Estrogen Receptor Modulators

Medications referred to as selective estrogen receptor modulators to incorporate tamoxifen (Nolvadex, Soltamox), raloxifene (Evista), and toremifene (Fareston). Rare unwanted effects embrace:

• Cataracts (clouding of the lens in your eye)
• Blood clots within the legs (deep vein thrombosis), lungs (pulmonary embolism), or mind (stroke)
• Endometrial or uterine most cancers

Because of the danger of cataracts, it is best to see a watch physician earlier than you begin remedy, and comply with up each six months. It’s additionally vital to inform your most cancers care crew about any uncommon ache, redness or swelling within the legs, shortness of breath, confusion, or issue shifting, which may be signs of a blood clot. Unusual vaginal bleeding is usually a symptom of endometrial or uterine most cancers and must also be rapidly reported to your physician.

Selective Estrogen Receptor Degraders

Fulvestrant (Faslodex), a selective estrogen receptor degrader, could trigger unusual unwanted effects together with:

• Headache
• Dizziness or weak point
• Pain within the bones, joints, or muscle tissues
• Flu-like signs
• Digestive adjustments, similar to constipation, diarrhea, nausea, or loss of urge for food

Some uncommon unwanted effects are extra critical. Tell your physician immediately if you happen to expertise hives, respiration issues, fever, elevated bleeding or bruising, swelling, or adjustments in psychological well being.

Aromatase Inhibitors

Aromatase inhibitors embrace letrozole (Femara), anastrozole (Arimidex), and exemestane (Aromasin). A typical aspect impact of aromatase inhibitors is bone, joint, and muscle ache.

This ache may be so extreme that individuals cease taking the drugs. If you might be discovering unwanted effects very troublesome to handle, ask your physician about different options, similar to painkillers or a distinct sort of hormonal remedy. Don’t cease taking any treatment with out first speaking to your physician.

Ovarian Suppression

Doctors could advocate varied ovarian suppression therapies to cease the ovaries from producing hormones. The solely everlasting methodology is to surgically take away the ovaries (oophorectomy). Luteinizing hormone-releasing hormone (LHRH) agonist drugs like goserelin (Zoladex) and leuprolide (bought underneath model names together with Lupron, Eligard, and Viadur) may be prescribed to suppress ovarian perform.

This sort of remedy will trigger menopause signs to develop out of the blue. Although surgical procedure results in everlasting menopause, LHRH medicine could trigger menopause solely quickly, and these unwanted effects could disappear as soon as you might be completed with remedy.

Managing Side Effects of Hormone Therapy

You can take cost to handle the unwanted effects of your remedy. Options embrace drugs, different therapies, dietary supplements, and way of life adjustments, similar to adjusting your weight-reduction plan.

Coping With Menopausal Symptoms

One frequent means of dealing with signs of pure menopause is hormone alternative remedy (HRT), which entails taking hormones to make up for the decreased manufacturing that happens with age.

HRT will not be the identical as hormonal remedy taken as a breast most cancers remedy — hormonal remedy lowers hormone ranges and HRT raises them. HRT will not be an possibility for individuals with HR-positive breast most cancers as a result of it might trigger most cancers cells to develop. However, nonhormone prescription drugs and different therapies might help relieve menopausal signs.

Hot Flashes and Night Sweats

Your physician could prescribe medicines like venlafaxine (Effexor) or gabapentin (Neurontin) for sizzling flashes or evening sweats. Alternative approaches like dietary supplements and acupuncture are additionally standard methods to deal with these signs.

In a 2016 study, researchers discovered {that a} course of as much as 20 acupuncture therapies over six months diminished the quantity of sizzling flashes and evening sweats members skilled. In another study, menopausal girls skilled fewer sizzling flashes after 5 weekly hypnosis classes. There is proscribed proof for different approaches, similar to taking dietary supplements.

MyBCTeam members have discovered aid utilizing these methods. One wrote, “I was miserable when chemo threw me into immediate menopause. They finally tried gabapentin, and it was the only thing that worked for me.” Another member added, “My oncologist prescribed venlafaxine for hot flashes. It did help. I also had acupuncture.” A 3rd member steered, “Try evening primrose oil and sage tablets. It doesn’t take them away completely, but it does help.”

Some dietary supplements, like black cohosh, might make breast most cancers therapies much less efficient, so remember to talk about different medication approaches and dietary supplements together with your oncologist earlier than attempting them.

Vaginal Dryness

Treatments for menopause-related vaginal dryness often contain moisturizing, which might imply merely utilizing a private lubricant throughout intercourse or masturbation. For vaginal dryness that causes discomfort on a regular basis, a longer-acting vaginal moisturizer, like Replens, could also be used.

Your OB-GYN could prescribe a topical estrogen cream, however verify together with your oncologist to see if this can be a protected possibility for your most cancers. Energy-based vaginal treatments, which use radiofrequency (Geneveve by Viveve and ThermiVa) or lasers (MonaLisa Touch, FemTouch, and FemiLift), could also be one other medical possibility. These therapies are usually a bit costlier, however they’re hormone-free and have longer-lasting results.

Members have additionally shared a number of options and success tales for dealing with vaginal dryness:

• “My gynecologist prescribed topical estradiol cream for my vaginal dryness, and it worked well.”
• “In my case, we’re trying to avoid hormone solutions, but my vaginal dryness is terrible. The best suggestion I’ve had so far is olive oil.”
• “MonaLisa Touch was the game changer for me. It’s a bit pricey, but I think it was so worth it.”

Mood Swings

Tips for coping with temper swings embrace the next:

• Avoid consuming caffeine, alcohol, and spicy meals.
• Eat a balanced weight-reduction plan that features wholesome meals similar to fruits, greens, and entire grains.
• Get sufficient sleep.
• Engage in common bodily exercise.
• Find constructive methods to handle stress, similar to working towards yoga, meditating, or speaking with a therapist.

Weakened Bones

Over time, hormone therapies may cause bone loss, generally known as osteopenia or osteoporosis. You may have common bone density exams to observe for weakened bones. Ask your physician how usually it is best to get this screening.

Coping With Nausea

Your physician could recommend prescription drugs similar to ondansetron (Zofran) to stop nausea and vomiting. As one member defined, “I had a lot of nausea, so I took the Zofran they gave me and never threw up.”

Other methods for dealing with nausea embrace:

• Hydrating by consuming a lot of clear liquids
• Eating smaller meals extra regularly
• Avoiding meals and drinks that may irritate your digestive tract, similar to spicy meals, high-fat meals, dairy merchandise, alcohol, and drinks that comprise caffeine
• Taking probiotics
• Sipping natural teas similar to peppermint, ginger, or chamomile

Coping With Pain

Pain within the bones, joints, or muscle tissues is usually a aspect impact of many therapies, together with surgical procedures, chemotherapy, and hormonal remedy.

Researchers have reported that routine train can considerably reduce pain. One MyBCTeam member who skilled ache and stiffness after taking anastrozole shared, “I walk for one and a half miles every evening, except when it’s raining. I’ve been doing it for nearly six months, and I am now pain-free.”

Pain can be managed with:

• Over-the-counter ache relievers together with acetaminophen and nonsteroidal anti-inflammatory medicine (NSAIDs) similar to ibuprofen and naproxen
• RICE (relaxation, ice, compression, elevation) to scale back irritation
• Heat to chill out muscle tissues
• Hands-on therapies (together with therapeutic massage, chiropractic care, and acupuncture)
• Cognitive behavioral remedy that can assist you cope mentally and emotionally with ache
• Biofeedback or stress administration strategies that can assist you management how your physique responds to ache

Talk With Your Health Care Team

Always converse together with your oncology care crew about your signs and considerations. Your oncologist might help pinpoint the supply of your unwanted effects and signs and supply choices for managing them. If you’re discovering the unwanted effects insupportable, you can too discuss together with your physician about different remedy choices.

Never cease or change your breast most cancers remedy with out speaking to your physician first. Also, remember to talk together with your care crew earlier than you attempt any new dietary dietary supplements as a result of some can have extreme interactions together with your drugs or trigger different unwanted effects.

Talk With Others Who Understand

On MyBCTeam, the social community for individuals with breast most cancers and their family members, greater than 58,000 members come collectively to ask questions, give recommendation, and share their tales with others who perceive life with breast most cancers.

Have you discovered efficient methods to handle the unwanted effects of hormonal remedy to deal with breast most cancers? Share your experiences within the feedback beneath, or begin a dialog by posting on MyBCTeam.