Your Guide for the Cancer Journey by Mark Greener

Author:Mark Greener [Greener Mark]
Language: eng
Format: epub
ISBN: 9781847094407
Publisher: SPCK

Side effects of hormone treatments

Hormones control some very basic aspects of our biology; after all, you cannot get much more basic than reproduction. For example, testosterone increases muscle strength, so blocking testosterone might trigger fatigue and weakness. (Men produce low levels of oestrogen, just as women produce low levels of testosterone.)

While side effects are common, in most people the benefits of hormone treatments outweigh the risks. In many cases some simple steps can help alleviate the discomfort – have a full and frank discussion with your cancer team.

During the natural menopause, for example, oestrogen levels fall. This means that drugs which block oestrogen can cause symptoms similar to the menopause, but, unlike the natural menopause, these symptoms can arise in men. About 7 in 10 women undergoing hormonal treatment for breast cancer and a similar proportion of men taking some drugs for prostate cancer experience hot flushes.

Tamoxifen, for example, might cause hot flushes, vaginal dryness, loss of libido and weight gain.3 In rare cases, tamoxifen seems to increase the risk of endometrial cancer and disorders of blood clotting (thromboembolic disease), so always tell your cancer team if you develop abnormal bleeding, such as from the vagina or gums. As tamoxifen affects blood clotting, you might stop treatment before an operation. In premenopausal women, tamoxifen can also weaken bones, leaving you more vulnerable to fractures.3

You can take steps to manage some of these side effects (see page 113). For example, taking drugs such as tamoxifen in the evening might reduce hot flushes (but never change your dose schedule without speaking to your cancer team first). Your cancer team can also suggest a variety of drugs that might alleviate hot flushes. Some people find hypnosis, acupuncture and yoga reduce flushes. A lubricant may alleviate vaginal dryness. Painkillers, weight loss, exercise and physiotherapy can reduce joint pain.3

In men with prostate cancer, GnRH analogues can cause hot flushes, impotence and weight gain. Some drugs can cause breast tenderness and growth in men (gynaecomastia) or damage your liver. Long-term treatment might weaken bones. Prostate cancer seems to increase the risk of diseases affecting the heart and blood vessels (cardiovascular system). Androgen deprivation appears to further increase the risk. So your cancer team might suggest treatments to protect your bones and cardiovascular system.3

Aromatase inhibitors can cause joint and muscle pains, loss of libido and weaken bones. Taking vitamin D and calcium supplements, and drugs that strengthen the skeleton (bisphosphonates), can help minimize the effect on bones. You might also need bone scans to monitor the effect on your skeleton.3 Other side effects are specific to each treatment, so speak to your cancer team and check out the information provided by cancer charities (see Useful addresses).

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