Hormone therapy is the use of hormones or hormone-blocking drugs to fight cancer. This type of systemic therapy is rarely used to treat epithelial ovarian cancer, but is more often used to treat ovarian stromal tumors.
Gonadotropin-releasing hormone (GNRH) agonists switch off estrogen production by the ovaries. These drugs are useful in lowering estrogen levels in women who are premenopausal. Examples of GNRH agonists include goserelin (Zoladex®) and leuprolide (Lupron®). These drugs are injected every 1 to 3 months. Side effects can include any of the symptoms of menopause, such as hot flashes and vaginal dryness. If they are taken for a long time (years), these drugs can weaken bones (sometimes leading to osteoporosis).
Tamoxifen is an anti-estrogen drug that is often used to treat breast cancer. It can also be used to treat ovarian stromal tumors and is rarely used to treat advanced epithelial ovarian cancer. The goal of tamoxifen therapy is to prevent any estrogens circulating in the woman’s body from stimulating growth of the cancer cells. Even though tamoxifen may prevent estrogen from nourishing the cancer cells, it acts like a weak estrogen in other areas of the body. It does not cause bone loss, but can cause hot flashes and vaginal dryness. People taking tamoxifen also have an increased risk of serious blood clots in the legs.
Aromatase inhibitors are drugs that block an enzyme (called aromatase) that turns other hormones into estrogen in post-menopausal women. They don’t stop the ovaries from making estrogen, so they are only helpful in lowering estrogen levels in women after menopause. These drugs are mainly used to treat breast cancer, but can also be used to treat some ovarian stromal tumors that have come back after treatment. They include letrozole (Femara®), anastrozole (Arimidex®), and exemestane (Aromasin®). These drugs are pills that are taken once a day.
Common side effects of aromatase inhibitors include hot flashes, joint and muscle pain, and bone thinning. The bone thinning can lead to osteoporosis and bone that break easily.
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