At a glance
- Which hormone(s) will be used?
- How long will each of the treatments take, assuming no delays?
- How will it be administered?
- How often will it need to be administered?
- Ask what side effects are expected.
- Ask if there are any side effects that you should be particularly aware of – such as life threatening.
- Ask what to do if you experience side effects.
- Ask what you can do to improve outcome.
- Ask how you can aid recovery/healing.
Hormone therapy is used to change the hormonal balance in your partner’s body in order to change the way her cells behave. This is to reduce the possibility of a recurrence of the cancer. Usually, hormone therapy is used to suppress oestrogen, which will bring about an ‘induced’ menopause if your partner hasn’t already reached it.
This is because oestrogen plays a part in the formation of cancer cells. I won’t pretend to know how this happens at the cellular level, but the research I have done indicates that survival rates can be greatly improved by hormone therapy.
Obviously inducing menopause will have a different impact on different people as it will be happening at different times in different people’s lives. In Jen’s case it was a no brainer because we’d already had our family and Jen was in her mid 40s. So she wasn’t far away from the menopause anyway. But if you were planning to have children and haven’t had them already, this will need to be discussed with your oncologist and GP. It may be possible to preserve your partner’s eggs or protect her ovaries. However, this is a complex issue that is beyond the scope of this book. For example, your partner’s cancer may be hormone receptive and thus use hormones to form and grow. Obviously if that’s the case, you’re probably going to want to take steps to eradicate anything that’s likely to increase the chance of the cancer recurring. As with chemotherapy discuss fertility with your primary care provider as there’s a risk of permanent sterility .
The most commonly used hormone therapy drugs used to treat breast cancer are:
Anastrozole (Arimidex®)*
Arimidex® (Anastrozole)*
Aromasin® Exemestane*
Exemestane (Aromasin®)*
Fareston® (Toremifene)
Faslodex® (Fulvestrant)
Femara® (Letrozole)*
Fulvestrant (Faslodex®)
Goserelin (Zoladex®)
Letrozole (Femara®)*
Medroxyprogesterone acetate (Provera®)
Megace® (Megestrol acetate)
Megestrol acetate (Megace®)
Provera® (Medroxyprogesterone acetate)
Tamoxifen
Toremifene (Fareston®)
Zoladex® (Goserelin)
*Aromatase inhibitor
If your partner is prescribed tamoxifen or an aromatase inhibitor after surgery, she will need to take these for at least five years. Some will be recommended to continue the course for 10 years. This may well impact any long-term travel plans you might have, so do keep this in mind.
How long other hormone drugs are given will vary from person to person.
Dealing with side effects
The possible side effects of hormone therapy are varied but largely revolve around menopausal symptoms, such as hot flushes, night sweats, vaginal dryness, reduced sex drive and mood changes.
These symptoms can often be more intense than when the menopause occurs naturally but it’s fair to say they are manageable and tolerable (I know – easy for me to say).
Other side effects include joint and/or muscle pain and stiffness, headaches, nausea, brittle bones (osteoporosis) and tiredness or fatigue.
Jen gets some of the menopausal symptoms – particularly the hot flushes.
Suffice to say, it’s not pleasant for her, or me, but it’s nothing compared to chemotherapy and surgery and a small price to pay if it’s going to stave off a recurrence.