Cancer drug hormone therapy
It is applied in patients expressing tumoral hormone receptors ER - estrogen receptor and PGR - progesteron receptor. It is possible that HER2 human epitelial growth factor receptor 2 to have an influence cancer drug hormone therapy the response or resistance to hormonal treatment.
This article presents the main classes of drugs used in hormonal treatment and their indication, improvements obtained and future perspectives of research. El este aplicat la pacientele la care se identifică în ţesutul tumoral prezenţa receptorilor hormonali ER - receptor estrogen şi PGR - receptor progesteron. Este posibil ca şi statusul HER2 receptorul 2 al factorului de creştere epidermal uman să aibă influenţă asupra răspunsului şi rezistenţei la tratamentul hormonal.
Articolul are drept scop prezentarea principalelor clase de medicamente folosite în tratamentul hormonal şi a prinicipalelor indicaţii, progrese înregistrate şi perspective de viitor. Cuvinte cheie tratament hormonal cancer drug hormone therapy de sân modulatori selectivi cancer drug hormone therapy receptorului de estrogen inhibitori de aromatază Introduction Hormones are molecules that act like chemical messengers in the human body.
Pharmacology - CANCER DRUGS - HORMONAL THERAPY (MADE EASY) cancer de san avansat simptome
Their main circulating path is through the blood stream. Estrogen and progesteron are made in the ovaries in premenopausal women, and in other tissues including fat in postmenopausal women.
Apart cancer drug hormone therapy their classic role female sex characteristics, pregnancy etc. To determine the hormonal status, tissue from the tumour is needed.
It can be obtained either by biopsy, or by surgery.
Main hormone therapy classes Blocking ovarian function - ovaries are the main production site of estrogen in premenopausal women. Blocking of their function cancer de piele in gura be achieved by either removing ovaries surgically, or by radiation both being definitive methods or, most frequently used today, inhibiting their function temporarily by using gonadotropin releasing hormone GnRH agonists or luteinizing hormone releasing hormone LH-RH agonists.
Examples: goserelin and leuprolide.
The main side effects of these therapies are bone loss, mood swings, depression, and loss of libido. Blocking estrogen production - aromatase inhibitors AI are used to block the production of estrogens from fat and other tissues. They can be given alone in postmenopausal women or in association with ovarian suppression in premenopausal setting. Examples: anastrozole, letrozole - both inactivate temporarily the aromatase enzyme non-steroidal AI - or exemestane, which inactivates the enzyme permanently steroidal AI.
The main side effects are: risk of heart attack, angina, heart failure, and hypercholesterolemia, bone loss, joint pain, mood swings and depression. Blocking estrogens effects - two drugs block the action of estrogen on the breast tumour cells. Selective estrogen receptor modulating agents SERMs : they bind to the receptor, blocking it, thus preventing the binding of estrogen. Examples: tamoxifen and toremifen. They act like antagonists in some tissues tumour cells and agonists in other cancer drug hormone therapy, boneinfluencing their safety profile.
Common adverse reactions: risk of blood clots, especially in the lungs and legs, stroke, cataract, endometrial cancer, bone loss in premenopausal women. Other antiestrogen drugs, like fulvestrant: they act similarly to tamoxifen, but without the agonist effect.
Terapia hormonala - Totul despre acest tratament oncologic - Cancer drug hormone therapy
Furthermore, after binding to the estrogen receptor, they programme it for destruction. This explains the better safety profile and side effects: gastrointestinal symptoms, elevated liver functional tests, loss of strength and pain Taking into account the medical history of patients and other treatments they are undergoing, we must be careful for interactions.
For tamoxifen, caution must be taken for patients in treatment with antidepressants from the class of selective serotonin reuptake inhibitors SSRI like paroxetine, which inhibits enzyme CYP2D6. They slow down tamoxifen metabolization and reduce its effects. Safer alternatives are available, like sertraline, venlafaxine or even considering changing tamoxifen with AI.
Treatment protocols Prevention. The same indication for AI is still under investigation 8. There have been several studies investigating this option, mainly using AI.
Cancer drug hormone therapy
The purpose is to obtain tumour shrinkage in order to allow breast conserving surgery. Although there are promising results, currently such therapies are not approved for this indication 9. Some studies show that patients with positive ER levels even with low count benefit from at least 5 years of therapy.
Newer studies extend cancer de colon gatos period to 7 or even 10 years.
Tratamentul pentru cancerul de sân la barbati este de obicei un mastectomia. His department's not going breast cancer hormonal therapy find the cure for breast cancer. It is applied in patients expressing tumoral hormone receptors ER - estrogen receptor and PGR - progesteron receptor.
In premenopausal patients at high risk young age, high grade tumour, lymph node involvmentaromatase inhibitor with associated ovarian suppression or tamoxifen for 5 years can be considered based on SOFT and TEXT trials results. There are different strategies, involving either starting with tamoxifen for years, then switching to AI or tamoxifen for 5 years and switching afterwards, or starting with AI plus ovarian suppression.
Cancer hormonal drugs
Also, we must bear in mind the adverse reactions profile. For tamoxifen, the cardiovascular risk and of uterine cancer requiring anual echographic monitoringand for AI, mainly the risk for bone health annual DEXA and supplements of calcium, vitamin D and even agents like zoledronic acid or denosumab Endocrine therapy is fairly well supported, with tolerable side effects, and should be given in patients with non-visceral or asymptomatic, and with not high-volume visceral tumours, especially in patients with suggestive factors for good response indolent disease, old age, long disease free interval.
There is also the option of fulvestrant, after progression after antiestrogen therapy.