How Do Hormones Fight Breast Cancer?

So far I've figured out that if I'm too busy spreading my energy all over the place I won't have enough for myself.  But this whole cancer thing sure doesn't end with a mastectomy as I was led to believe.

It's all an interconnected puzzle as far down the road as I can see. And now enters the H word . .  hormones.

When I think hormone therapy I think hot flashes and adding hormones via pill to replace the ones we lose during menopause.

But when being treated for breast cancer Hormone therapy doesn't actually involve using hormones themselves. In fact it should perhaps be called anti-hormone therapy because it uses drugs or surgery to block the hormones that are being used by cancer cells to stimulate their growth.

"estrogen and progesterone circulate in the bloodstream. They can attach to breast cancer cells and stimulate tumor growth. Estrogen is the major promoter of cell growth in hormone dependent breast cancer.

"The goal of hormone therapy is to deprive the cancer tissue of estrogen, .. halting or slowing of cancer cell growth.

"Unlike chemotherapy, hormone therapy, also called endocrine therapy, does not kill the cancer cell. (it) acts by either blocking estrogen from reaching cancer cells or reducing the production of estrogen. cancerfacts

Tamoxifen is a hormone blocker that a lot of us have heard of somehow. It's been used for years in both North America and Europe.  

For women before or after menopause it has been considered first-line therapy because it a.) blocks estrogen's action at the tumor but b.) acts like estrogen in other areas of the body.

For example, it has estrogen-like effects on the bone and supports bone health while blocking actual estrogen from reaching tumors or cancer cells that have metastisized.

Aromatase inhibitors on the other hand sound like an option for a shower. Not so I'm learning. They're used to block Estrogen's feeding of the tumor cells but in a different way than Tamoxifen. 

Memo that I didn't get earlier: After menopause adrenal glands take over producing Estrogen when the ovaries no longer do so. I had no clue.

But with aromatase inhibitors the idea now is to block the chemical aromatase,an estrogen precursor made by adrenal glands.

In other words the aromatase inhibitor stops Estrogen from running around my blood stream before estrogen ever actually BECOMES estrogen.

It used to be that AIs were only used only as first-line therapy for for advanced breast cancer in women who were past menopause. Then sometimes they were used in other patients as second-line therapy after tamoxifen stopped working & cancer cells started regrowing.

Now however that's changing - or at least some cancer docs feel that Aromatase inhibitors should be my first line of defense instead of tamoxifen.

But I find it interesting - and good news too - to learn that some patients have responded to multiple forms of endocrine treatment by using one, then a second, and then a third drug months or years later.

Today I'm betting on at least a good five year run with smart docs on the case. Tomorrow maybe I'll decide that's bunk but that's how I feel today. It could be a year - it could be eleven - it's all a roller coaster ride though. Maybe crossing my fingers could help.

Still, my real fear is the fatigue. if I'm too exhausted to deal with it all I won't do well.  How do we manage treatment and living and all the rest? That's another challenge that maybe even smart docs can't solve for me.