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Hormone therapy

What is hormone therapy?

Hormone therapy is also one of the most frequently used drug treatments for cancer. This is one of Institut Curie's cutting-edge fields. Hormone therapy almost exclusively concerns breast cancer in women and prostate cancer in men. These cancers involve sex hormones. Estrogens in women and androgens in men, these hormones have a proliferation function. From a biological point of view, they promote tissue renewal. 
Breast and prostate tumor cells may have receptors that are sensitive to the action of these hormones, encouraging them to multiply. The objective of hormone therapy treatment for breast and prostate cancers is to block the action of sex hormones on the cancerous tissue and thereby stop the expansion of tumors. Two types of treatment are then possible: either they temporarily block the production of hormones in both men and women; or they block the tumor cells' receptors for these hormones. These treatments can be combined depending on the situation.
Prior to making a decision on the treatment to be followed, the teams at Institut Curie carry out a biological analysis of the tumor in order to verify the persistence of estrogen and androgen receptors in the tumor or metastases. At times, tumor cells might not have hormone receptors. In this case, hormone therapy will be ineffective. If the receptors are present, this suggests that hormone therapy can be beneficial.

Possible side effects of hormone therapy

The side effects of hormone therapy treatment are not the same for women and men. For women, the closest clinical situation is that of menopause. At this time of life, estrogen production decreases significantly, causing hot flashes, vascular effects, joint problems and reduced libido. 
Hormone therapy treatment is aimed at reducing the production of estrogen. Apart from the cancerous tumor, many cells present in women’s bodies have hormone receptors. Since hormone therapy is not a specific therapy, it will affect all the cells of the body with these receptors, thus generating side effects similar to menopause. The same principle applies to men. A deficiency of testosterone, which is the most active androgen and whose production is stopped by hormone therapy, can lead to erectile dysfunction and sometimes hot flashes. 
The individual dimension of these side effects is very important. For some patients, treatment consequences can be difficult to bear. In general, it is recommended to engage in regular physical activity as much as possible during hormone therapy treatment. This helps reduce fatigue, reduce pain, and improve libido. Patients must always be aware of the temporary nature of these side effects. They will only appear during treatment.

Hormone therapy research

Research into hormone therapy at Institut Curie focuses on two main avenues. In breast cancers, the goal is to make the targeting of cancer cell receptors more precise. Some of them have variants of hormone receptors, making them more resistant to conventional hormone therapies. Researchers continue to contribute to the development of classes of drugs capable of targeting these rare forms of receptors.
Another avenue of research: combination with targeted therapies. Should the hormonal blockade generated by the treatment be only partially effective, targeted therapy will intervene to reinforce the inhibitory action. Models have produced very encouraging results, and a first class of cell cycle inhibitors is already available for these new treatments.