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Flashcards in Hormonal Therapy Deck (44)
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1

What are hormones?

Substances produced naturally in the body which act as chemical messengers and influence the growth and activity of cells

2

What system does hormonal therapy aim to manipulate?

The endocrine system

3

How can the endocrine system be manipulated as part of cancer therapy?

- External administration of specific hormones
- Hormone antagonists
- Surgical removal of endocrine organs

4

What type of hormones are commonly externally administered as part of hormonal therapy?

Steroid hormones

5

How can drugs act as hormone antagonists?

- Inhibit hormone production
- Inhibit hormone activity

6

What endocrine organs can be removed as part of some hormonal therapy regimes?

- Orchiectomy
- Oophorectomy

7

How can changing the levels of certain steroid hormones lead to cancer cell death (or cessation of growth) in some cancers?

Steroid hormones are often powerful drivers of gene expression in certain cancer cells

8

What types of cancers are commonly treated with hormonal therapy?

Those derived from hormonal responsive tissues

9

What specific cancers are commonly treated with hormonal therapy?

- Breast
- Prostate
- Endometrium
- Adrenal cortex

10

What non-specific cancer complications can be treated with hormonal therapies?

- Paraneoplastic syndromes
- Chemotherapy-related symptoms e.g. anorexia

11

What are some types of hormone synthesis inhibitors used in hormonal cancer therapy?

- Aromatase inhibitors
- GnRH analogues

12

How doe inhibitors of hormone synthesis work to treat cancer?

They starve tumour cells of growth and survival-producing hormones by inhibiting their production

13

What type of cancer are aromatase inhibitors used to treat?

Breast cancer in post-menopausal women

14

What is the normal role of aromatase?

Produce oestrogen from androgens made by the adrenal glands in post-menopausal women

15

What is the effect of aromatase inhibitors in post-menopausal women?

Oestrogen levels drop to extremely low

16

Why are aromatase inhibitors not used in pre-menopausal women?

Oestrogen is still produced by the ovaries in pre-menopausal women so oestrogen levels won’t drop (ngl I’ve inferred this - it’s probably because it induces early menopause or something but it makes sense logically and helps me remember that they’re for post-menopausal women :) )

17

How can the drop in oestrogen caused by aromatase inhibitors treat breast cancer?

Extremely low oestrogen levels can cause growth arrest and/or apoptosis in hormone-responsive cancer cells

18

What are some examples of aromatase inhibitors?

- Anastrozole
- Letrozole

19

What do GnRH analogues aim to do in hormonal therapy?

Induce chemical castration

20

What is meant by chemical castration caused by GnRH analogues?

Complete suppression of production of oestrogen and progesterone in females and testosterone in males

21

How do GnRH analogues induce chemical castration?

Prolonged activation and subsequent desensitisation of pituitary gonadotrophs (cells that release LH and FSH) to natural GnRH

22

What is an example of a GnRH analogue used to treat cancer?

Goserelin

23

What is goserelin used to treat?

Hormone-responsive prostate cancer

24

How do hormone receptor antagonists work to treat cancer?

Bind to the normal receptor for a given hormone and prevent its action

25

What are some types of hormone receptor antagonists used to treat cancer?

- Selective-Oestrogen Receptor Modulators (SERMS)
- Anti-androgens

26

What is the action of SERMs

Act as antagonists of the oestrogen receptor

27

What are SERMs used to treat?

Treatment and chemo prevention of breast cancer

28

What is an example of a SERM used to treat breast cancer?

Tamoxifen

29

Who is tamoxifen used in to treat breast cancer?

Nearly all post-menopausal women with hormone receptor positive breast cancer

30

What is the mechanism of action of anti-androgens as a cancer therapy?

Bind and inhibit the androgen receptor, blocking the growth and survival-promoting effects of testosterone on certain prostate cancers