The role of hormone therapy in patients with advanced cancer

Abstract

In majority of cancer patients in an advanced stage of the disease dissemination develop and in consequence numerous symptoms appear that may be indication for systemic treatment (chemotherapy, hormone, molecular and cytokines therapies). The most frequent indication for palliative hormone therapy comprises patients whose tumours growth depend on hormones: estrogens and progestogens in females with breast cancer and uterus cancer and testosterone in males with prostate cancer. A decrease of the impact of hormones on tumour cells may be achieved through the inhibition of the formation of sex hormones when administering analogues of releasing hormones of the luteinizing hormone (goserelin, leuprorelin) and aromatase inhibitors or through a direct inhibition of the peripheral hormone influence on tumour cells receptors (antyestrogenes, antyandrogenes). In contrast to chemotherapy which induces many adverse effects hormone therapy is much better tolerated and often continued until the end of patients’ life. However, several limitations of hormone therapy should be kept in mind such as a delayed therapeutic response, possible drug interactions and adverse effects. In case of a lack of response to hormone treatment provided patients are in a good general condition and willing to undertake therapy other methods of systemic treatment most commonly chemotherapy may be considered. In the case of a single tumour location surgery or radiotherapy may be considered. A skillful use of oncology treatment allows enhancing effectiveness of symptomatic treatment and slowing down tumour progression and in consequence improving quality of life and prolong survival of advanced cancer patients. In this article the most frequent indications for hormone therapy of advanced cancer patients were discussed; attention was paid to adverse effects drug interactions and benefits for patients.