A hormone-sensitive cancer, or hormone-dependent cancer, is a type of

cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...

that is dependent on a

hormone A hormone (from the Greek participle , "setting in motion") is a class of signaling molecules in multicellular organisms that are sent to distant organs by complex biological processes to regulate physiology and behavior. Hormones are required ...

for

growth Growth may refer to: Biology * Auxology, the study of all aspects of human physical growth * Bacterial growth * Cell growth * Growth hormone, a peptide hormone that stimulates growth * Human development (biology) * Plant growth * Secondary growth ...

and/or survival. Examples include

breast cancer Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, milk rejection, fluid coming from the nipple, a newly inverted nipple, or a re ...

, which is dependent on

estrogen Estrogen or oestrogen is a category of sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three major endogenous estrogens that have estrogenic hormonal acti ...

s like estradiol, and

prostate cancer Prostate cancer is cancer of the prostate. Prostate cancer is the second most common cancerous tumor worldwide and is the fifth leading cause of cancer-related mortality among men. The prostate is a gland in the male reproductive system that sur ...

, which is dependent on androgens like

testosterone Testosterone is the primary sex hormone and anabolic steroid in males. In humans, testosterone plays a key role in the development of Male reproductive system, male reproductive tissues such as testes and prostate, as well as promoting secondar ...

Hormone A hormone (from the Greek participle , "setting in motion") is a class of signaling molecules in multicellular organisms that are sent to distant organs by complex biological processes to regulate physiology and behavior. Hormones are required ...

s play important roles in our body, they're also effective in some types of cancer by promoting some tumors grow and spread, which are so-called hormone-sensitive or hormone-dependent cancer. A hormone-sensitive cancer, or hormone-dependent cancer, is a type of

that is dependent on a

for

and/or survival. If a tumor is hormone-sensitive, it means that there are special proteins called

receptor Receptor may refer to: * Sensory receptor, in physiology, any structure which, on receiving environmental stimuli, produces an informative nerve impulse *Receptor (biochemistry), in biochemistry, a protein molecule that receives and responds to a ...

s on cells surface. When the hormone bind the matched receptor, it results in growth and spread of cancer cells.

Mechanism of carcinogenesis

While tumor initiating event for hormone-related cancers can be varied, the promotion event and subsequent proliferation is driven by a sex hormone. Both endogenous and exogenous hormones, by driving

cell proliferation Cell proliferation is the process by which ''a cell grows and divides to produce two daughter cells''. Cell proliferation leads to an exponential increase in cell number and is therefore a rapid mechanism of tissue growth. Cell proliferation re ...

, increased the number of

cell division Cell division is the process by which a parent cell (biology), cell divides into two daughter cells. Cell division usually occurs as part of a larger cell cycle in which the cell grows and replicates its chromosome(s) before dividing. In eukar ...

s and the opportunity for random genetic errors to lead to cancer.

Hormone-sensitive cancer types

The main types of Hormone-sensitive cancers are the following.

Breast cancer

Breast cancer Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, milk rejection, fluid coming from the nipple, a newly inverted nipple, or a re ...

is often hormone responsive, since growth or regression of tumors can often be regulated by appropriate endocrine manipulations.

Estrogen Estrogen or oestrogen is a category of sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three major endogenous estrogens that have estrogenic hormonal acti ...

and

progesterone Progesterone (P4) is an endogenous steroid and progestogen sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans and other species. It belongs to a group of steroid hormones called the progestogens and is the m ...

seem to be main hormones involved in growth of breast cancer.

Ovarian cancer

Ovarian cancer Ovarian cancer is a cancerous tumor of an ovary. It may originate from the ovary itself or more commonly from communicating nearby structures such as fallopian tubes or the inner lining of the abdomen. The ovary is made up of three different c ...

can be affected by

. β-estradiol (E2) can stimulate the growth of some estrogen receptor(ER)-positive

ovarian carcinoma Ovarian cancer is a cancerous tumor of an ovary. It may originate from the ovary itself or more commonly from communicating nearby structures such as fallopian tubes or the inner lining of the abdomen. The ovary is made up of three different cel ...

cells, and these effects may be related with changes in the cellular levels of steroid hormone receptors.

Uterine cancer

Uterine or

endometrial cancer Endometrial cancer is a cancer that arises from the endometrium (the lining of the uterus or womb). It is the result of the abnormal growth of cells that have the ability to invade or spread to other parts of the body. The first sign is most o ...

are activated by

and

are related to this type. The uterine

endometrium The endometrium is the inner epithelial layer, along with its mucous membrane, of the mammalian uterus. It has a basal layer and a functional layer: the basal layer contains stem cells which regenerate the functional layer. The functional laye ...

is extraordinary sensitive to steroid hormones, observation that women who

ovulate Ovulation is the release of eggs from the ovaries. In women, this event occurs when the ovarian follicles rupture and release the secondary oocyte ovarian cells. After ovulation, during the luteal phase, the egg will be available to be fertilized ...

and produce

have an extremely low possibility to get

proves progesterone as a critical inhibitor of carcinogenesis.

Prostate cancer

Prostate cancer Prostate cancer is cancer of the prostate. Prostate cancer is the second most common cancerous tumor worldwide and is the fifth leading cause of cancer-related mortality among men. The prostate is a gland in the male reproductive system that sur ...

is dependent on androgens like

and similar hormones that can help it grow and spread.

Treatment

Treatments for hormone-sensitive-cancers include blocking the synthesis or action of the hormone or surgery to remove the organ that produces the hormone.

Androgen deprivation therapy Androgen deprivation therapy (ADT), also called androgen suppression therapy, is an antihormone therapy whose main use is in treating prostate cancer. Prostate cancer cells usually require androgen hormones, such as testosterone, to grow. ADT red ...

includes treatment with androgen receptor antagonists and/or surgical removal of the testes while

estrogen deprivation therapy Estrogen deprivation therapy, also known as endocrine therapy, is a form of hormone therapy that is used in the treatment of breast cancer. Modalities include antiestrogens or estrogen blockers such as selective estrogen receptor modulators (SERMs) ...

involves treatment with estrogen receptor antagonists and/or surgical removal of the ovaries.

Receptor antagonists

Antiandrogens or antiestrogen are used to block the binding of androgen and estrogen to their respective nuclear hormone receptors and thereby blocks the proliferative effects of these hormone on hormone dependent cancer. For example, the antiestrogen

tamoxifen Tamoxifen, sold under the brand name Nolvadex among others, is a selective estrogen receptor modulator used to prevent breast cancer in women and treat breast cancer in women and men. It is also being studied for other types of cancer. It has b ...

used for the treatment of breast cancer while the antiandrogen bicalutamide alone or in combination with castration is used to treat prostate cancer. Interruption of hormonal stimulus. For example,

can slow the progression until actual hormone independence occurs in the pathway later. In more recent years, evidence in support of this cell proliferation model of hormone responsive cancer etiology has continued to accumulate. Anti-hormone therapies are proved to be effective in stopping progression and thereby increasing the time to

recurrence Recurrence and recurrent may refer to: *''Disease recurrence'', also called relapse *''Eternal recurrence'', or eternal return, the concept that the universe has been recurring, and will continue to recur, in a self-similar form an infinite number ...

or death.

Receptor agonists

Progesterone Progesterone (P4) is an endogenous steroid and progestogen sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans and other species. It belongs to a group of steroid hormones called the progestogens and is the m ...

is regarded as the major endometrial tumor suppressor,

Synthesis inhibitors

Various agents that block key events in the synthesis of hormones are sometimes used to treat hormone dependent cancers. Aromatase inhibitors such as anastrozole block the synthesis of estrogen while

CYP17A1 inhibitor A CYP17A1 inhibitor is a type of drug which enzyme inhibitor, inhibits the enzyme CYP17A1. It may inhibit both of the functions of the enzyme, 17α-hydroxylase and 17,20-lyase, or may be selective for inhibition of one of these two functions (gener ...

s such as

abiraterone Abiraterone acetate, sold under the brand name Zytiga among others, is a medication used to treat prostate cancer. Specifically it is used together with a corticosteroid for metastatic castration-resistant prostate cancer (mCRPC) and metastat ...

block the synthesis of androgen.

Gonadotropin-releasing hormone antagonist Gonadotropin-releasing hormone antagonists (GnRH antagonists) are a class of medications that antagonize the gonadotropin-releasing hormone receptor (GnRH receptor) and thus the action of gonadotropin-releasing hormone (GnRH). They are used in ...

s blocks the signaling that stimulates androgen synthesis.

Surgery

As the growth of hormone dependent cancer is driven by sex hormones, surgical removal of the organs that synthesizes the sex hormone is sometimes performed. In the case of prostate cancer,

orchiectomy Orchiectomy (also named orchidectomy, and sometimes shortened as orchi or orchie) is a surgical procedure in which one or both testicles are removed. The surgery is performed as treatment for testicular cancer, as part of surgery for transgend ...

(surgical castration) of the testes is sometimes performed while oophorectomy (surgical removal of the ovaries) is sometimes performed to prevent breast cancer in high risk women with

BRCA1 Breast cancer type 1 susceptibility protein is a protein that in humans is encoded by the ''BRCA1'' () gene. Orthologs are common in other vertebrate species, whereas invertebrate genomes may encode a more distantly related gene. ''BRCA1'' is a h ...

BRCA2 ''BRCA2'' and BRCA2 () are a human gene and its protein product, respectively. The official symbol (BRCA2, italic for the gene, nonitalic for the protein) and the official name (originally breast cancer 2; currently BRCA2, DNA repair associated) ...

mutations.

References

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