Hormonal therapy in oncology is hormone therapy for cancer. It's one of the main types of medical oncology (pharmacotherapy for cancer), along with cytotoxic chemotherapy and targeted therapy (biotherapeutics). It basically involves tweaking the endocrine system by introducing specific hormones, particularly steroid hormones, or drugs that stop the production or activity of such hormones (hormone antagonists). Steroid hormones are powerful drivers of gene expression in certain cancer cells, so changing the levels or activity of certain hormones can stop certain cancers from growing or even cause them to die. Another way to use hormones as a form of therapy is to remove endocrine organs, such as the testicles or ovaries.
Hormonal therapy is used for several types of cancers that originate in tissues that respond to hormones, including breast, prostate, endometrium, and adrenal cortex cancers. Hormonal therapy can also be used to treat paraneoplastic syndromes or to help with certain cancer- and chemotherapy-related symptoms, such as anorexia. One of the best-known examples 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, are now playing an increasingly important role in that disease.
Non-medical hormonal treatments
As well as using medication to make tumours less active, we can also remove endocrine organs through surgery or radiation therapy. Surgical castration, which is removing the testes in males and ovaries in females, has been used a lot in the past to treat hormone-responsive prostate cancer and breast cancer respectively. However, these invasive methods have been largely replaced by the use of GnRH agonists and other forms of pharmacologic castration.
There are still some cases where surgical castration may be beneficial, such as in special cases for women with high-risk BRCA mutations.
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