Hormone Therapy for Uterine Sarcomas
Hormone therapy is the use of hormones or hormone-blocking drugs to fight cancer. It is mainly used to treat patients with endometrial stromal sarcomas and is rarely used for the other types of uterine sarcomas.
Progestins are drugs that act like the hormone progesterone. The progestins used most often to treat uterine sarcoma are megestrol (Megace®) and medroxyprogesterone (Provera®). Side effects can include increased blood sugar levels in patients with diabetes. Hot flashes, night sweats, and weight gain (from fluid retention and an increased appetite) also occur. Rarely, serious blood clots are seen in patients taking progestins.
Gonadotropin-releasing hormone agonists
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, these drugs can weaken bones, sometimes leading to osteoporosis.
After the ovaries are removed, or are not functioning, estrogen is still made in fat tissue. This becomes the body's main source of estrogen. Drugs called aromatase inhibitors can stop this estrogen from being formed. Examples of aromatase inhibitors include letrozole (Femara®), anastrozole (Arimidex®), and exemestane (Aromasin®). These drugs are most often used to treat breast cancer, but they also might be helpful in treating endometrial stromal sarcoma. Because they don’t affect estrogen production by the ovaries, they are only useful in women whose ovaries have been removed or no longer work (like after menopause). Side effects can include any of the symptoms of menopause, such as hot flashes and vaginal dryness, as well as joint/muscle pain. If they are taken for a long time (years), these drugs can weaken bones, sometimes leading to osteoporosis.
Last Medical Review: May 12, 2014 Last Revised: February 15, 2016