Sex hormones and cancer
This page tells you about sex hormones and cancer. There is information about
Hormones are natural substances made by the glands of our hormone system and carried in the blood. They act as messengers, carrying signals between one part of the body and another. There are many different types of hormones. Each one controls the growth and activity of particular cells and organs.
Some cancers or cancer treatments can change the amount of hormones the body produces.
Also, some cancer cells produce hormones that cause symptoms. When cancer treatments change hormone levels, they usually lower the amount of particular hormones. They may do this by blocking the action of hormones, or by reducing the amount of the hormone the body makes. Sometimes, treatments can stop the body making a particular hormone altogether. Treatment related changes in hormone levels may be temporary or permanent.
Treatments for breast cancer and prostate cancer are most likely to affect hormone levels in the body. But treatment for other types of cancer can affect them too. The sex hormones are the type of hormone most commonly affected by cancer and its treatment.
Whether you are likely to have changes in sex hormone levels depends on the type of cancer and the type of treatment you have. There is information about the causes of hormone symptoms below.
Sex hormones include
Oestrogen is a female hormone. The ovaries make most of the oestrogen a woman needs. The adrenal glands also make a small amount. These are small glands just above the kidneys. Body fat also produces some oestrogen.
During puberty oestrogen promotes the sexual development of girls, including breast growth. Oestrogen also helps to control periods (the menstrual cycle) and the release of eggs.
Men produce some oestrogen, but much less than women. In men, the testes and adrenal glands make a small amount, which helps sperm to mature and boosts sex drive (libido).
Progesterone is another female hormone made by the ovaries. During pregnancy the placenta also makes progesterone. Progesterone helps to control the menstrual cycle. It also plays a part in maintaining pregnancy and in breast feeding.
Testosterone is a male hormone. The testes make most of the testosterone a man needs. The adrenal glands also make a small amount of a similar male hormone which the body changes into testosterone. Men need testosterone to make sperm. It also helps to maintain muscle and contributes to sex drive. It plays a part in the sexual development of boys during puberty, such as a deeper voice, growth of facial hair, and muscle growth.
In women the ovaries and adrenal glands make small amounts of testosterone which helps to maintain muscle and contributes to sex drive (libido).
If cancer treatment lowers the level of these hormones or stops your body making them it is likely that you will have some of the symptoms below.
Changes to sex hormone levels in the body cause particular symptoms. These vary from person to person. The symptoms may be mild but for some people can be severe and need treatment. Symptoms can last for only a few weeks or months. But in some people they may last for many months or years.
Symptoms may include
- Hot flushes and sweats
- Memory and concentration problems
- Decreased or loss of interest in sex (loss of libido)
- Mood changes
- Difficulty in sleeping
- Aches and pains
- Weight changes
- Bone loss
- Heart problems due to increased cholesterol levels
Women may also have
Men may also have
Hormone symptoms can be difficult to cope with. Finding out about ways you can manage them can make it easier to cope. There is detailed information about individual symptoms and possible treatments in the coping with hormone symptoms section.
Cancer treatments that can cause sex hormone symptoms include
- Surgery to remove the ovaries
- Surgery to remove the testes
- Radiotherapy to the pelvic area
- Hormone therapy (endocrine therapy)
Surgery to remove the ovaries
Because the ovaries make sex hormones, surgery to remove them lowers your sex hormone levels.
Women with cancer of the ovary may have both ovaries removed. This operation is called oophorectomy (pronounced oo-for-ek-toe-mee). If you have had your menopause this won’t cause symptoms. But if you are premenopausal, having your ovaries removed will make you go into menopause within a few days. Most women who have ovarian cancer have had their menopause. So most women having this type of surgery will not have hormone symptoms. There is more information about early menopause in the section sex and cancer for women
Some breast cancers are hormone sensitive and need oestrogen to grow. So stopping oestrogen production can slow down or stop cancer cell growth. Women who are premenopausal may take medicines to switch off their ovaries. But some women may opt to have their ovaries removed. Either way, you will have a sudden menopause and will have symptoms.
Surgery to remove the testes
Because the testicles make testosterone, surgery to remove them is bound to lower your sex hormone levels. This is a treatment for testicular cancer and sometimes prostate cancer. The operation is called an orchidectomy (pronounced or-kid-ek-toe-mee).
For most men testicular cancer only affects one testicle. Removing one testicle doesn’t have much effect on testosterone levels because the remaining testicle then makes enough. Very rarely a man develops cancer in both testicles and has both removed. You will then need testosterone replacement treatment to prevent hormone symptoms.
In prostate cancer, stopping testosterone production can slow down or stop cancer cell growth. Most men have medicines to switch off testosterone production rather than having their testicles removed.
Chemotherapy is the use of anti cancer drugs (cytotoxics) to destroy cancer cells.
For women who haven’t been through the menopause, chemotherapy may stop the ovaries working normally. This depends on
- The type and dose of chemotherapy drugs you have
- Your age
Your periods may stop temporarily. But if you are close to the age when you would naturally have your menopause, the chemotherapy may start it off and your periods may stop permanently.
Girls treated with chemotherapy may have an earlier menopause than if they had not had chemotherapy. Your doctor will tell you if there is a risk of this happening. You may need to think about planning a family at a younger age because of the risk of early menopause.
For men there is less information about how chemotherapy affects testosterone levels. There is some evidence that it may lower testosterone during treatment. This can cause symptoms such as a reduced sex drive and tiredness. Researchers have looked into sexual function after treatment for lymphoma. They found that the men who had treatment for lymphoma had lower sexual function.
Lower sexual function included a reduced sex drive, and lower ability to have and maintain an erection. The researchers were unsure if this was due to lower testosterone levels or other factors such as increasing age, emotional distress or poorer physical health. We need research to find out more about how chemotherapy affects testosterone. After chemotherapy treatment has finished, testosterone levels are usually normal.
Radiotherapy to the pelvic area
Radiotherapy is the use of X-rays to treat cancer. The pelvis is the area between your hip bones and contains the ovaries or testes, as well as the womb, bladder and prostate. Radiotherapy to this area of the body can affect sex hormone levels.
You may have pelvic radiotherapy for cancers of the rectum, bladder, womb, cervix or prostate. Whenever possible your radiotherapy specialist will plan treatment to reduce the risk of lowered sex hormone levels.
Hormone therapy (endocrine therapy)
Hormone therapy is a treatment for prostate, breast and womb cancer. Hormone treatments can work in one of two ways
- Stopping the body making the hormone
- Preventing the hormone from reaching receptors in the cancer cell
Whichever way the hormone therapy works, it can cause hormone symptoms.
There is more information in each of the treatment sections for these cancer types.
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