Hormone Therapy
Topics covered on this page:
Why might I experience hormone therapy symptoms after cancer treatment?
Hormones are naturally made chemicals that help control different activities of certain cells or organs in the body. Some of their roles include growth, sexual function and reproduction.
Hormone therapy is treatment that can either add, block, or remove hormones. This is done to slow or stop the growth of cancer cells that need these hormones to grow. Hormone therapy changes the levels of hormones in the body by either: preventing the body from making a hormone, changing how a hormone acts in the body or blocking a hormone from attaching to cancer cells. Hormone therapy can include surgery, radiation or medications.
How does it affect me?
Certain types of cancer use the body’s sex hormones (such as estrogen in women and testosterone in men), to help the tumours grow and spread. These types of cancers are called ‘hormone-dependent cancers. By changing the level of hormones in the body with hormone therapy, post-hormone treatment symptoms are caused by the lack of the hormone that is being blocked or inactivated. These changes are what cause hormone-related symptoms to develop.
Will it get better?
Side effects of hormone therapy can happen during, immediately after, or weeks after treatment has ended. Late side effects may also develop months or even years after treatment. Most symptoms will go away on their own with time, however depending on the type of treatment, some side effects may be permanent.
What are the signs of hormone therapy symptoms after cancer treatment?
In women
For women, hormone therapy removes estrogen from the body or block estrogen’s effect on cancer cells. Symptoms will be similar to those experienced with menopause, the body’s natural drop of estrogen levels with age.
Symptoms can include:
- Hot flashes
- Night sweats
- Weight gain
- Vaginal dryness
- Mood changes
- Depression
- Headache
- Osteoporosis
- Tumour flare reaction
Osteoporosis is a loss of bone density and can be a long-term side-effect of hormone therapy. You may need a bone density test before starting your therapy, so your healthcare team can know your starting point. A scan will help to keep track of any changes during or after treatment
Tumour flare reaction is a temporary symptom that usually goes away on its own after a few weeks. It is a sudden worsening of tumour-related symptoms. You may feel bone pain or a skin rash for example.
Other symptoms could be breast tenderness, irregular menstrual periods, a loss of interest in sex, nausea, hair loss or thinning of hair, muscle aches and joint pain, fatigue and sometimes blood clots.
In men
Hormone therapy removes testosterone from the body or blocks the effect of the hormone on cancer cells. Hormone therapy can lead to sexual problems; however, this usually goes away a few months after therapy has stopped.
Symptoms can include:
- Hot flashes
- Tiredness
- Breast tenderness
- Enlargement of the breasts
- Nausea
- Low sex drive
- Depression
- Osteoporosis
- Tumour flare reaction
- Erectile dysfunction (ED)
Erectile dysfunction or impotence can be either a short-term or long-term side-effect, depending on the type of hormone therapy you had. Erectile dysfunction is usually permanent if the testicles were removed during surgery. For hormone drug therapy, it can take several months (between 3-12) after therapy has stopped for erectile function to come back.
Other symptoms could be fatigue, mood changes, weight gain, diarrhea, muscle aches and pains, loss of muscle and physical strength and fertility problems.
When should I get help for hormone therapy symptoms after cancer treatment?
Everyone’s experience with side effects will be different. This is because your recovery after hormone therapy depends on: the type of hormone therapy received, your health and how well you tolerated the therapy (and other treatments) and the side effects you experienced.
It is important to talk about your symptoms with your healthcare team. They can make a personal plan based on your situation. Post-hormone therapy symptoms can often be treated or managed with various strategies. For more information on learning to speak with your healthcare team, see Communicating with your healthcare team.
Talk to someone in your healthcare team immediately if:
- You feel like you are in a state of crisis.
- You think about harming yourself and others.
- You have suicidal thoughts or plans.
If you are having suicidal thoughts and you can’t reach someone on your healthcare team, please call your local mental health services helpline or call 9-1-1.
For residents of Quebec, call Suicide Action Montreal at 1-866-277-3553 or call 9-1-1.
What can I do to help manage hormone therapy symptoms after cancer treatment?
There are a number of strategies you can use to manage your hormone therapy symptoms on your own. The chart below provides general guidelines; however, your healthcare team is in the best position to give you a more specific and personalized plan based on your treatment history.
Symptoms:
Who is affected: Men and Women
Management Strategies:
- Wear loose-fitting clothes for comfort
- Wear form-fitting clothes under your outer layers to decrease visibility
- Consider counselling for advice on how to cope with this change
Who is affected: Men and Women
Management Strategies:
- Multiple strategies are available for you to help manage cancer-related depression, for more information, see Depression.
- Talk to your doctor if you think you may be depressed. Your doctor can help with other treatment options.
- Talk to someone immediately in your healthcare team if you feel you are in a state of crisis, if you are thinking about harming yourself or others or if you have suicidal thoughts or plans.
Who is affected: Men and Women
Management Strategies:
- Eat a healthy diet (see Looking after yourself)
- Exercise regularly (see Get Moving)
- Get a good night’s sleep
- Manage your stress
- Take breaks during the day
- Use your energy wisely
- For more information (see Tiredness)
Who is affected: Men and Women
Management Strategies:
- Avoid anything that seems to trigger a hot flash (such as alcohol, caffeine, spicy foods)
- Wear loose-fitting clothes
- Dress in layers so you can remove some clothes easily
- Drink lots of cold water throughout the day
- Exercise regularly (see Get Moving)
- Lower the room temperature
- Use a cold-water spray
- Practice stress reduction techniques such as meditation and yoga (see Relaxation Strategies)
- For more information, see Hot Flashes.
Who is affected: Men and Women
Management Strategies:
- Speak with your doctor about having a bone density test.
- Calcium and vitamin D supplements may be prescribed.
- Bone density loss can also be managed with physical activity (see Get Moving)
Who is affected: Women*
Management Strategies:
- Have tampons or pads available.
- Report if there is any heavy bleeding and soaked pads.
*Premenopausal women
Who is affected: Men and Women
Management Strategies:
- Multiple strategies are available to help you recover your sex life. (see Sexual Matters)
- Also, ask your doctor about other options available to you.
- For more information, see this booklet
Who is affected: Men
Management Strategies:
- Ask to see a physiotherapist to review ways to build your muscles.
- Physical strength can also be managed with activity (see Get Moving)
Who is affected: Men and Women
Management Strategies:
- Get a good night’s sleep
- Eat well (see Looking after yourself)
- Exercise regularly (see Get Moving)
- Find ways to relax and reduce stress
- Face your feelings. Talk to someone you trust about how you feel. It might help to keep a journal of your feelings.
Who is affected: Men and Women
Management Strategies:
- There are medications and creams for the skin, that can reduce inflammation.
- Ask your doctor or pharmacist for recommendations for pain relief.
For more information, see Pain
Who is affected: Men and Women
Management Strategies:
- Avoid spicy, sweet, and greasy foods
- Drink 6 to 8 glasses of liquid during the day, especially water
- Eat bland foods such as toast, crackers, and cereal
- Eat frequent, small meals daily instead of 3 large meals
- Eat slowly and take the time to digest your food
- Try carbonated beverages such as soda water or ginger ale to help settle your stomach.
- Ask your doctor about alternative therapies like acupuncture, guided imagery, and other relaxation techniques.
For more information, see Nausea
Who is affected: Women
Management Strategies:
- Avoid hair straighteners and curling irons
- Comb and brush hair gently to prevent breakage
- If you colour your hair, use a natural dye rather than a chemical one
- Let your hair dry naturally or use the cool setting on a hair dryer
- Protect your hair with a hat when out in the sun
- Use a gentle shampoo and conditioner
Who is affected: Women
Management Strategies:
- Use a non-hormonal vaginal moisturizer to help relieve dryness, itching, and irritation.
- Avoid using perfumed soaps or lotions
Who is affected: Men and Women
Management Strategies:
- Monitor your weight, review your diet and report your progress to your health care team, when necessary for follow-up.
Cannabis
Information about cannabis
Some patients use cannabis to help them manage cancer-related symptoms. However, overall, the research is still unclear. It is important to talk to your doctor before trying cannabis. For more information on what cancer patients should know about cannabis, go to: http://www.bccancer.ca/health-info/coping-with-cancer/medical-cannabis.
Available services
Below is a list of resources that offer various services to support the self-management of hormone therapy symptoms after cancer treatment.
The Quebec Cancer Foundation supports people with cancer and their loved ones throughout Quebec, through services suited to their needs and daily concerns.
Services offered for burden
Several services and activities offered by the Quebec Cancer Foundation can be useful to help you manage your burden including psychological support such as guided meditation, art therapy, and telephone peer-matching. Other services such as wellness workshops, yoga and massage therapy are also featured.
The Quebec Cancer Foundation also has many documentary resources on the subject. Via the Info-cancer library, their documentalists specialized in oncology can guide you in your search for information and give you suggested readings.
Contact
1-800-561-0063
The mission of the Quebec Breast Cancer Foundation is to promote the well-being of cancer patients and their families through research, innovation, support and awareness.
It is committed to offering a range of services, including a hotline for information and resources adapted to the needs of people living with cancer.
Services offered for burden
Psychosocial support and family counselling: The Quebec Breast Cancer Foundation offers a psychosocial support service to support and accompany people affected by breast cancer and their families during and after treatment.
You can also share your experience with others who have been there on our online communities:
Parlons cancer du sein Facebook group
Club stade 4 Facebook group
Service locators
Below is a list of organizations that can help identify local support services for you and those that support you. The quality of the services has not been verified by e-IMPAQc. Before using these services, verify with your healthcare practitioner.
The Regroupement des Organisations Communautaires en Oncologie (ROCO) offers a service locator resource specific to the province of Quebec. It lists support resources available by region.
Contact
514-506-3503
The Quebec Cancer Foundation offers a resources directory of community, association and public resources by region or postal code.
The foundation also has a document lending service. Their materials (books, web resources, online articles, webcasts) cover a wide range of topics related to cancer. It is free to borrow and materials are sent by mail or email anywhere in Quebec.
Contact
1-800-363-0063 (Monday to Friday, 9 AM to 5 PM EST)
Resources
You can find more information on managing feelings of worry, uncertainty, and stress in the resources below.
Canadian Cancer Society – Coping with anxiety and stress
Acknowledgement of sources
The content of this document has been adapted from the following sources:
- Canadian Cancer society. Side Effects of Hormonal Therapy
- Cancer.Net. What Is Hormone Therapy
- Looking Forward, Chapter 2. What to expect after treatment
- OncoLink. Hormone Therapy: The Basics
- Cancer Care Alberta. Systemic Treatment: Chemotherapy, Targeted Therapy and Hormone Therapy
- Canadian Cancer Survivor Network. Impotence
Healthcare professional endorsement
The content of this document has been reviewed and approved by a team of healthcare professionals and clinical experts.
Disclaimer
Please note that this fact sheet is not intended as a substitute for consultation with a healthcare professional. Rather, it was designed to complement interventions by your treating team. If you have questions about your health, or any medical issue, you should contact a healthcare professional right away. You should not delay seeking medical advice, or disregard professional medical advice, because of information in this fact sheet. Before beginning any health treatment, always consult your doctor. All care has been taken to ensure that the information contained in this document is accurate at the time of publication. e-IMPAQc is not responsible for any injury or damage to persons or property arising out of, or related to, any use of the fact sheet, or because of any errors or omissions.
Reproduction and copyright
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