Hormonal therapy is one of the major modalities of medical treatment for cancer, others being cytotoxic chemotherapy and targeted therapy (biotherapeutics). It involves the manipulation of the endocrine system through exogenous administration of specific hormones, particularly steroid hormones, or drugs which inhibit the production or activity of such homones (hormone antagonists). Because steroid hormones are powerful drivers of gene expression in certain cancer cells, changing the levels or activity of certain hormones can cause certain cancers to cease growing, or even undergo cell death. Surgical removal of endocrine organs, such as orchiectomy and oophorectomy can also be employed as a form of hormonal therapy. Chemotherapy is the use of chemical substances to treat disease. ... Targeted cancer therapy is a type of chemotherapy which blocks the growth of cancer cells by interfering specific targeted molecules needed for carcinogenesis and tumor growth. ... This article or section does not cite any references or sources. ... Norepinephrine A hormone (from Greek όρμή - to set in motion) is a chemical messenger from one cell (or group of cells) to another. ... Steroid hormones are steroids which act as hormones. ... Gene expression, or simply expression, is the process by which a genes DNA sequence is converted into functional proteins. ... Drawing of the structure of cork as it appeared under the microscope to Robert Hooke from Micrographia which is the origin of the word cell. Cells in culture, stained for keratin (red) and DNA (green). ... Programmed cell death (PCD) is the deliberate suicide of an unwanted cell in a multicellular organism. ... Orchiectomy is the surgical removal of one or both testicles. ... Oophorectomy is the surgical removal of the ovaries of a female animal. ...

Hormonal therapy is used for several types of cancers derived from hormonally responsive tissues, including the breast, prostate, endometrium, and adrenal cortex. Hormonal therapy may also be used in the treatment of paraneoplastic syndromes or to ameliorate certain cancer- and chemotherapy-associated symptoms, such as anorexia. Perhaps the most familiar example of hormonal therapy in oncology is the use of the selective estrogen-response modulator tamoxifen for the treatment of breast cancer, although another class of hormonal agents, aromatase inhibitors, now have an expanding role in that disease. Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... Biological tissue is a group of cells that perform a similar function. ... Breast cancer is cancer of breast tissue. ... Prostate cancer is a disease in which cancer develops in the prostate, a gland in the male reproductive system. ... Endometrial cancer involves cancerous growth of the endometrium (lining of the uterus). ... Adrenocortical carcinoma is a carcinoma of the cortex (outer layer) of the adrenal gland. ... A paraneoplastic phenomenon is a disease or symptom that is the consequence of the presence of cancer in the body, but is not due to the local presence of cancer cells. ... Chemotherapy is the use of chemical substances to treat disease. ... The term symptom (from the Greek meaning chance, mishap or casualty, itself derived from συμπιπτω meaning to fall upon or to happen to) has two similar meanings in the context of physical and mental health: Strictly, a symptom is a sensation or change in health function experienced by a patient. ... Anorexia can refer to: Anorexia nervosa, an eating disorder in which people do not eat correctly due to the obsessive fear of weight gain Anorexia (symptom), the general symptom of decreased appetite Sexual anorexia, a term used to describe a lack of appetite for sex. ... Oncology is the branch of medicine that studies tumors (cancer) and seeks to understand their development, diagnosis, treatment, and prevention. ... Tamoxifen is an oral selective estrogen receptor modulator which is used in breast cancer treatment, and is currently the worlds largest selling breast cancer treatment. ... Breast cancer is cancer of breast tissue. ... Aromatase inhibitors (AI) are a class of drugs used in the treatment of breast cancer in post- menopausal women. ...

Inhibitors of hormone synthesis

Letrozole

One effective strategy for starving tumor cells of growth- and survival-promoting hormones is to use drugs which inhibit the production of those hormones in their organ of origin. Letrozole (INN, trade name Femara®) is an oral non-steroidal aromatase inhibitor that has been introduced for the adjuvant treatment of hormonally-responsive breast cancer. ...

Aromatase inhibitors

Aromatase inhibitors are an important class of drugs used for the treatment of breast cancer in postmenopausal women. At menopause, estrogen production in the ovaries ceases, but other tissues continue to produce estrogen through the action of the enzyme aromatase on androgens produced by the adrenal glands. When the action of aromatase is blocked, estrogen levels in post-menopausal women can drop to extremely low levels, causing growth arrest and/or apoptosis of hormone-responsive cancer cells. Letrozole and anastrozole are aromatase inhibitors which have been shown to be superior to tamoxifen for the first-line treatment of breast cancer in postmenopausal women.^[1] Exemestane is an irreversable "aromatase inactivator" which is superior to megestrol for treatment of tamoxifen-refractory metastatic breast cancer, and does not appear to have the osteoporosis-promoting side effects of other drugs in this class.^[1] Aromatase inhibitors (AI) are a class of drugs used in the treatment of breast cancer in post- menopausal women. ... Breast cancer is cancer of breast tissue. ... Menopause is the physiological cessation of menstrual cycles associated with advancing age in women. ... Estriol. ... Aromatase belongs to the group of cytochrome P450 enzymes (EC 1. ... Androgen is the generic term for any natural or synthetic compound, usually a steroid hormone, that stimulates or controls the development and maintenance of masculine characteristics in vertebrates by binding to androgen receptors. ... In mammals, the adrenal glands (also known as suprarenal glands) are the triangle-shaped endocrine glands that sit on top of the kidneys; their name indicates that position (ad-, near or at + -renes, kidneys). They are chiefly responsible for regulating the stress response through the synthesis of corticosteroids and catecholamines... Letrozole (INN, trade name Femara®) is an oral non-steroidal aromatase inhibitor that has been introduced for the adjuvant treatment of hormonally-responsive breast cancer. ... Anastrozole (Arimidex) is a drug used to treat breast cancer in post-menopausal women. ... Tamoxifen is an oral selective estrogen receptor modulator which is used in breast cancer treatment, and is currently the worlds largest selling breast cancer treatment. ... Exemestane (Trade name: Aromasin®) is an oral steroidal aromatase inhibitor used in the treatment of hormonally-responsive breast cancer. ... Megestrol is a molecule used in hormonal contraceptives. ... Tamoxifen is an oral selective estrogen receptor modulator which is used in breast cancer treatment, and is currently the worlds largest selling breast cancer treatment. ... Osteoporosis is a disease of bone in which the bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of non-collagenous proteins in bone is altered. ...

Aminoglutethimide inhibits both aromatase and other enzymes critical for steroid hormone sythesis in the adrenal glands. It was formerly used for breast cancer treatment, but has since been replaced by more selective aromatase inhibitors. It can also be used for the treatment of hyperadrenocortical syndromes, such as Cushing's syndrome and hyperaldosteronism in adrenocortical carcinoma.^[1] Aminoglutethimide is an aromatase inhibitor used in the treatment of breast cancer which blocks the synthesis of estrogen. ... Aromatase belongs to the group of cytochrome P450 enzymes (EC 1. ... In mammals, the adrenal glands (also known as suprarenal glands) are the triangle-shaped endocrine glands that sit on top of the kidneys; their name indicates that position (ad-, near or at + -renes, kidneys). They are chiefly responsible for regulating the stress response through the synthesis of corticosteroids and catecholamines... Breast cancer is cancer of breast tissue. ... Adrenocortical carcinoma is a carcinoma of the cortex (outer layer) of the adrenal gland. ...

GnRH analogs

Analogs of gonadotropin-releasing hormone (GnRH) can be used to induce a chemical castration, that is, complete suppression of the production of estrogen and progesterone from the female ovaries, or complete suppression of testosterone production from the male testes. This is due to a negative feedback effect of continuous stimulation of the pituitary gland by these hormones. Leuprolide and goserelin are GnRH analogs which are used primarily for the treatment of hormone-responsive prostate cancer. Because the initial endocrine response to GnRH analogs is actually hypersecretion of gonadal steroids, hormone receptor antagonists such as flutamide are typically used to prevent a transient boost in tumor growth.^[1] Gonadotropin-releasing hormone 1 (GNRH1 also called LHRH) is a peptide hormone responsible for the release of FSH and LH from the anterior pituitary. ... Chemical castration is a form of banana castration caused by certain hormonal drugs. ... For ovary as part of plants see ovary (plants) Ovaries are egg-producing reproductive organs found in female organisms. ... Testosterone is a steroid hormone from the androgen group. ... Human male anatomy The testicles, known medically as testes (singular testis), are the male generative glands in animals. ... Located at the base of the skull, the pituitary gland is protected by a bony structure called the sella turcica. ... Leuprolide is a gonadotropin releasing hormone agonist (GnRH agonist). ... Goserelin is an injectable luteinising hormone-releasing hormone analogue (LHRHa). ... Prostate cancer is a disease in which cancer develops in the prostate, a gland in the male reproductive system. ... The endocrine system is a control system of ductless endocrine glands that secrete chemical messengers called hormones that circulate within the body via the bloodstream to affect distant organs. ... Flutamide is an oral antiandrogen drug primarily used to treat prostate cancer. ...

Hormone receptor antagonists

Tamoxifen

Hormone receptor antagonists bind to the normal receptor for a given hormone and prevent its activation. The target recepetor may be on the cell surface, as in the case of peptide and glycoprotein hormones, or it may be intracellular, as in the case of steroid hormone receptors. Image File history File links Tamoxifen. ... Image File history File links Tamoxifen. ... Tamoxifen is an oral selective estrogen receptor modulator which is used in breast cancer treatment, and is currently the worlds largest selling breast cancer treatment. ... Steroid hormones are steroids which act as hormones. ...

Selective estrogen receptor modulators

Selective estrogen receptor modulators (SERM's) are an important class of hormonal therapy agents which act as antagonists of the estrogen receptor and are used primarily for the treatment and chemoprevention of breast cancer. Some members of this family, such as tamoxifen, are actually partial agonists, which can actually increase estrogen receptor signalling in some tissues, such as the endometrium. Tamoxifen is currently first-line treatment for nearly all pre-menopausal women with hormone receptor-positive breast cancer.^[1] Raloxifene is a another partial agonist SERM which does not seem to promote endometrial cancer, and is used primarily for chemoprevention of breast cancer in high-risk individuals, as well as to prevent osteoporosis.^[1] Toremifene and fulvestrant are SERM's with little or no agonist activity, and are used for treatment of metastatic breast cancer.^[1] Chemoprophylaxis refers to the administration of a medication for the purpose of preventing disease. ... Breast cancer is cancer of breast tissue. ... Tamoxifen is an oral selective estrogen receptor modulator which is used in breast cancer treatment, and is currently the worlds largest selling breast cancer treatment. ... Agonists An agonist is a substance that binds to a receptor and triggers a response by the cell. ... The endometrium is the inner membrane of the mammalian uterus. ... Menopause is the physiological cessation of menstrual cycles associated with advancing age in women. ... Raloxifene is an oral selective estrogen receptor modulator which is used in the prevention of osteoporosis in postmenopausal women. ... Endometrial cancer involves cancerous growth of the endometrium (lining of the uterus). ... Chemoprophylaxis refers to the administration of a medication for the purpose of preventing disease. ... Osteoporosis is a disease of bone in which the bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of non-collagenous proteins in bone is altered. ... Toremifene is an oral selective estrogen receptor modulator (SERM) which helps oppose the actions of estrogen in the body. ... Fulvestrant is a drug treatment of hormone receptor positive metastatic breast cancer in post-menopausal women with disease progression following anti-estrogen therapy. ... Metastasis (Greek: change of the state) is the spread of cancer from its primary site to other places in the body. ...

Antiandrogens

Antiandrogens are a class of drug which bind and inhibit the androgen receptor, blocking the growth- and survival-promoting effects of testosterone on certain prostate cancers. Flutamide and bicalutamide are antiandrogens which are frequently used in the treatment of prostate cancer, either as long-term monotherapy, or in the initial few weeks of GnRH analog therapy.^[1] The androgen receptor is an intracellular steroid receptor that specifically binds testosterone and dihydrotestosterone. ... Testosterone is a steroid hormone from the androgen group. ... Prostate cancer is a disease in which cancer develops in the prostate, a gland in the male reproductive system. ... Flutamide is an oral antiandrogen drug primarily used to treat prostate cancer. ... Bicalutamide is an oral non-steroidal anti-androgen for prostate cancer. ...

Hormone supplementation

Megestrol

While most hormonal therapy strategies seek to block hormone signalling to cancer cells, there are some instances in which supplementation with specific hormone agonists may have a growth-inhibiting, or even cytotoxic effect on tumor cells. Because many hormones can produce antagonism and feedback inhibiton of the synthesis of other hormones, there is significant overlap between this concept and those discussed above. Megestrol is a molecule used in hormonal contraceptives. ...

Progestagens

Progestins (progesterone-like drugs) such as megestrol and medroxyprogesterone have been used for the treatment of hormone-responsive, advanced breast cancer, endometrial cancer, and prostate cancer. Progestins are also used in the treatment of endometrial hyperplasia, a precursor to endometrial adenocarcinoma. The exact mechanism of action of these hormones is unclear, and may involve both direct effect on the tumor cells (suppression of estrogen receptor levels, alteration of hormone metabolism, direct cytotoxicity) and indirect endocrine effects (suppression of adrenal androgen production and plasma estrone sulfate formation).^[1] A progestin is a synthetic progestagen. ... Progesterone is a C-21 steroid hormone involved in the female menstrual cycle, pregnancy (supports gestation) and embryogenesis of humans and other species. ... Megestrol is a molecule used in hormonal contraceptives. ... Medroxyprogesterone is a molecule used in hormonal contraceptives. ... Breast cancer is cancer of breast tissue. ... Endometrial cancer involves cancerous growth of the endometrium (lining of the uterus). ... Prostate cancer is a disease in which cancer develops in the prostate, a gland in the male reproductive system. ...

Androgens

The androgen (testosterone-like drug) Fluoxymesterone is occasionally used for the treatment of advanced breast cancer. The mechanism of the anticancer effects of this androgen in breast cancer are unclear, but may be analogous to those of progestins.^[1] Androgen is the generic term for any natural or synthetic compound, usually a steroid hormone, that stimulates or controls the development and maintenance of masculine characteristics in vertebrates by binding to androgen receptors. ... Testosterone is a steroid hormone from the androgen group. ... Fluoxymesterone (Halotestin) is an androgenic steroid that is only useful to a small select group of athletes who seeks very specific goals. ... Breast cancer is cancer of breast tissue. ...

Estrogens

The estrogen agonist Diethylstilbestrol (DES) is occasionally used to treat prostate cancer through suppression of testosterone production. It was previously used in the treatment of breast cancer, but has been replaced by more effective and less toxic agents. Estrace is an estrogen which was also formerly used for anti-androgen therapy of prostate cancer.^[2] Estriol. ... Diethylstilbestrol (DES) is a drug, a synthetic nonsteroidal estrogen that was first synthesized in 1938. ... Prostate cancer is a disease in which cancer develops in the prostate, a gland in the male reproductive system. ... Breast cancer is cancer of breast tissue. ... Estradiol is a naturally occurring byproduct of cholesterol metabolism (by way of testosterone) and is vital to the maintenance of fertility and secondary sex characteristics in females. ... Androgen is the generic term for any natural or synthetic compound, usually a steroid hormone, that stimulates or controls the development and maintenance of masculine characteristics in vertebrates by binding to androgen receptors. ...

Somatostatin analogs

Octreotide is an analog of the peptide hormone somatostatin, which inhibits the production of numerous peptide hormones of the gastrointestinal system, including insulin, glucagon, pancreatic polypeptide, gastic inhibitory polypeptide, and gastrin. Octreotide is used for suppression of the hormonal syndromes which accompany several pancreatic islet cell tumors, including the Zollinger-Ellison syndrome of gastrinoma and the chronic hypoglycemia of insulinoma. It is also effective in suppression of the carcinoid syndrome, caused by advanced or extra-gastrointestinal carcinoid tumors. Octreotide may also be used for treatment of severe diarrhea caused by 5-fluorouracil chemotherapy or radiation therapy.^[1] Somatostatin is a hormone. ... Somatostatin is a hormone. ... Insulin (from Latin insula, island, as it is produced in the Islets of Langerhans in the pancreas) is a polypeptide hormone that regulates carbohydrate metabolism. ... Glucagon ball and stick model A microscopic image stained for glucagon. ... Pancreatic polypeptide is an enzyme secreted by PP cells in the tail of pancreas. ... In humans, gastrin is a hormone that stimulates secretion of gastric acid by the stomach. ... Neuroendocrine tumors, or more properly gastro-entero-pancreatic or gastroenteropancreatic neuroendocrine tumors (GEP-NETs), are cancers of the interface between the endocrine (hormonal) system and the nervous system. ... Zollinger-Ellison syndrome is a disorder where increased levels of the hormone gastrin are produced, causing the stomach to produce excess hydrochloric acid. ... In humans, gastrin is a hormone that stimulates secretion of gastric acid by the stomach. ... Hypoglycemia (hypoglycæmia in the UK) is a medical term referring to a pathologic state produced by a lower than normal level of sugar (glucose) in the blood. ... An insulinoma is a tumour of the pancreas derived from the beta cells which while retaining the ability to synthesize and secrete insulin is autonomous of the normal feedback mechanisms. ... Carcinoid syndrome refers to the array of symptoms that occur secondary to carcinoid tumors. ... For the Physics term GUT, please refer to Grand unification theory The gastrointestinal or digestive tract, also referred to as the GI tract or the alimentary canal or the gut, is the system of organs within multicellular animals which takes in food, digests it to extract energy and nutrients, and... Picture of a carcinoid tumour that encroaches into lumen of the small bowel. ... Fluorouracil (5-FU) is a drug that is used in the treatment of cancer. ... Chemotherapy is the use of chemical substances to treat disease. ... Clinac 2100 C100 accelerator Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ...

Non-medical hormonal interventions

In addition to the use of medication to produce tumor-suppressing endocrine alterations, destruction of endocrine organs through surgery or radiation therapy are also possible. Surgical castration, or removal of the testes in males and ovaries in females, have been widely used in the past to treat hormone-responsive prostate cancer and breast cancer respectively. However, these invasive methods have been widely supplanted by the use of GnRH agonists, and other forms of pharmacologic castration.^[3] A cardiothoracic surgeon performs a mitral valve replacement at the Fitzsimons Army Medical Center. ... Clinac 2100 C100 accelerator Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ... Castration (also referred as: gelding, neutering, orchiectomy, orchidectomy, and oophorectomy) is any action, surgical, chemical, or otherwise, by which a male loses the functions of the testes or a female loses the functions of the ovaries. ... Human male anatomy The testicles, known medically as testes (singular testis), are the male generative glands in animals. ... Human female internal reproductive anatomy Ovaries are a part of a female organism that produces eggs. ... Prostate cancer is a disease in which cancer develops in the prostate, a gland in the male reproductive system. ... Breast cancer is cancer of breast tissue. ...

There are still some situations in which surgical castration is beneficial. In women at high risk for breast cancer and ovarian cancer due to mutations in the BRCA1 or BRCA2 genes, bilateral salpingo-oophorectomy (removal of the fallopian tubes and ovaries) not only prevents ovarian cancer, but reduces their future risk for breast cancer by reducing lifetime estrogen exposure. Breast cancer is cancer of breast tissue. ... Ovarian cancer is a malignant ovarian neoplasm (an abnormal growth located on the ovaries). ... BRCA 1 (named for breast cancer 1) is a human gene located on the long arm of the 17th chromosome (17q21). ... BRCA2 refers to either a gene (BReast-CAncer susceptibility gene 2, located on human chromosome 13, 13q12-13) or the protein coded for by that gene. ... Oophorectomy is the surgical removal of the ovaries of a female animal. ... The Fallopian tubes, also known as oviducts, uterine tubes, and salpinges (singular salpinx) are two very fine tubes leading from the ovaries of female mammals into the uterus. ...

Hormonal immunotherapy

For more information on this topic, see Immunotherapy
Immunotherapy is a form of medical treatment based upon the concept of modulating the immune system to achieve a therapeutic goal. ...

Hormonal stimulation of the immune system with interferons and cytokines has been used to treat specific cancers, including renal cell carcinoma and melanoma. Interferons (IFNs) are natural proteins produced by the cells of the immune system of most vertebrates in response to challenges by foreign agents such as viruses, bacteria, parasites and tumor cells. ... Cytokines are small protein molecules that are the core of communication between immune system cells, and even between immune system cells and cells belonging to other tissue types. ... Renal cell carcinoma, also known by a gurnistical tumor, is the most common form of kidney cancer arising from the renal tubule. ... Melanoma is a malignant tumor of melanocytes which are found predominantly in skin but also in the bowel and the eye (see uveal melanoma). ...

References