Hormonal Therapy for Uterine (Endometrial) Cancer
Hormones are chemical messengers that regulate specific body functions. They are produced by various glands in the body and enter the blood stream, where they travel to other tissues and exert their influence. Hormonal therapy is used in cancer treatment to augment or interfere with the activity of certain hormones that can influence the growth of tumors.
Hormonal therapy is often used to treat uterine cancer if the cancer has spread, or if it recurs.
Type of Hormonal Therapy Used for Uterine Cancer
The progestin
megestrol acetate
(Megace) is the primary hormone treatment used for advanced or recurrent uterine cancer. This hormone is most effective in patients whose tumors are well-differentiated (low grade), and where the tumor cells have receptors for the hormones estrogen and progesterone (determined through a test that is routinely done on the tumor). Exactly how this drug works to inhibit cancer cells is not known. Megace is taken by mouth at home. Typical doses are 160 to 320 milligrams per day. It may take several weeks for a response to occur.
Medical scientists are investigating the use of
tamoxifen
(Nolvadex) in combination with megestrol acetate. Also under investigation are aromatase inhibitors as treatment for uterine cancer.
Effectiveness
Between 10%-30% of patients with advanced or recurrent uterine cancer respond to hormone therapy. The difference in the response rate may be attributed to the sensitivity of the tumor to hormones, the grade of the tumor, and other factors.
Side Effects and Possible Complications
Megestrol may cause the following side effects:
- Weight gain
- Thrombophlebitis
(blood clots)
- Heart failure
- Nausea and vomiting
- Edema
- Shortness of breath
References
American Cancer Society website. Available at:
http://www.cancer.org/
.
Bast R, Kufe D, Pollock R, et al, eds.
Cancer Medicine.
5th ed. Hamilton, Ontario: BC Decker Inc; 2000.
National Cancer Institute website. Available at:
http://www.nci.nih.gov/
.
Rakel R. Bope E, ed.
Conn's Current Therapy.
54th ed. St. Louis, MO: WB Saunders; 2002: 1094-1096.