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Side effects of hormonal therapy
Side effects can happen with any type of treatment for cancer, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.
If you develop side effects, they can happen any time during, immediately after or a few days or weeks after hormonal therapy. Sometimes late side effects develop months or years after hormonal therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.
Side effects of hormonal therapy will depend mainly on the type of hormonal therapy, the dose of a drug or combination of drugs and your overall health.
It is important to report side effects and your concerns about side effects to the healthcare team. Doctors may measure how severe certain side effects are. Sometimes hormonal drug therapy may need to be adjusted if side effects are severe.
The following are the most common side effects that people tend to experience with hormonal therapy.
Fatigue is a general tiredness and lack of energy that can occur with hormonal therapy. It makes a person feel more tired than usual and can interfere with daily activities and sleep. It tends to be worse when you are having other treatments, such as chemotherapy or radiation therapy. Fatigue may get better as time goes by, but it can sometimes last for a long time after hormonal treatment.
Nausea and vomiting
Nausea and vomiting can occur with some hormonal therapy drugs. These side effects usually get better as the body gets used to the drug. Taking hormonal therapy drugs with food or at bedtime may help relieve these side effects.
Nausea and vomiting can also occur a few hours after radiation therapy to the abdomen.
Weight gain often occurs with hormonal therapy. It is caused by increased appetite, less activity and fluid retention. It is often difficult to control weight when you are having hormonal therapy but changes in diet and exercise may help. You can ask to see a dietitian about managing your weight.
Less or loss of interest in sex
Less or loss of interest in sex can occur with some hormonal therapies. It may continue as long as hormonal drug therapy is taken, but sometimes can be a long-term side effect. It can be a permanent side effect if surgery or radiation therapy is done to stop hormone production.
Find out more about sexuality and cancer.
Treatment-induced menopause can be permanent in women who have their ovaries surgically removed or have radiation therapy to the ovaries. Treatment-induced menopause in women who have had hormonal drug therapy may be temporary. For some women, it can be permanent, especially if they are near natural menopause when hormonal drug therapy starts.
Symptoms of treatment-induced menopause are the same as symptoms of natural menopause, but they may be more severe because treatment-induced menopause happens quickly.
Some hormonal therapies can cause hot flashes and sweating in both men and women. These side effects usually get better as the body gets used to the treatment or when the hormonal drug therapy is stopped.
There are ways to manage hot flashes. Taking hormonal therapy drugs at night may help some people cope with hot flashes. If hot flashes are worse at night, take the drugs in the morning.
Check with your doctor or healthcare team before taking herbal products to treat hot flashes because some may have hormonal properties that can affect a hormone-related cancer.
Breast swelling or tenderness
Some hormonal drug therapies can cause breast swelling or tenderness in men and women.
Erectile dysfunction (ED) is also called impotence. ED is when a man cannot keep an erection sufficient for sexual intercourse. This may be a long-term side effect of hormonal therapy. Some men may experience ED as a result of certain hormonal treatments for prostate cancer.
- ED can be temporary with hormonal drug therapy. It can take 3 to 12 months after hormonal drug therapy stops to regain erectile function. If erectile function does not come back on its own, several treatments are available, including prosthetic penile implants, vacuum devices and medicines.
- ED is usually permanent if both testicles are removed.
Fertility problems can be temporary or permanent. A permanent loss of fertility (infertility) can be caused by surgical removal of the testicles or ovaries. Hormonal drug therapy and radiation therapy can also cause a temporary or permanent loss of fertility.
Tumour flare reaction
A tumour flare reaction or a tumour flare response, such as bone pain, may worsen when certain hormonal drug therapies are first used. A tumour flare reaction is a temporary side effect and usually goes away after a few weeks. Sometimes anti-androgens are given before or along with LHRH agonists for several weeks to reduce the chance of tumour flare reaction.
Diarrhea is an increase in the number and looseness of stools. It occurs because some hormonal therapy drugs affect the cells that line the gastrointestinal (GI) tract. Factors that increase the risk of diarrhea include the type and dose of hormonal drug therapy used.
Muscle or joint pain
Muscle or joint pain may occur a few days after hormonal drug treatment begins. Taking medicines such as acetaminophen (Tylenol, Atasol) can help reduce this side effect.
A blood clot may develop in your leg or lung during hormonal therapy. Symptoms include calf tenderness, a hardened vein, pain or swelling in the legs, trouble breathing and chest pain. If you have any of these symptoms, see your doctor or go to the nearest emergency department immediately. A blood clot is treated with a blood-thinning medicine.
Osteoporosis is a loss of bone density. It is a long-term side effect that may occur with some hormonal drug therapies. You may have a bone mineral density test before starting hormonal drug therapy. This test gives a baseline for comparison with follow-up tests. Bone loss can be prevented and managed with calcium and vitamin D supplements, physical activity and other drug therapy.
Information about specific cancer drugs
Other side effects may occur with hormonal drug therapy. Find out more about sources of drug information and where to get details on specific drugs.
Referring to or having to do with the digestive organs.
The gastrointestinal (GI) tract, or digestive tract, includes the mouth, pharynx (throat), esophagus, stomach, small intestine and large intestine.
I’m extremely grateful to the Canadian Cancer Society for funding my research with an Innovation Grant.
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