Estrogen-Dependent is defined as all those cancers whose onset and growth is promoted or in any case favored by the presence of estrogen hormones.
In particular, some forms of estrogen-dependent tumors are mentioned:
- breast cancer
- cancer of the uterine endometrium (the most superficial layer of the uterus)
- ovarian cancer
Hormone dependence is established by looking for the presence of specific hormone receptors in the removed tumor cells. Most but not all breast cancers, for example, are dependent on estrogen for the proliferation of cancer cells. In addition, the hormonal status of a tumor it can vary over time: for example, early stage breast cancers are frequently hormone-dependent cancers unlike advanced stage breast cancers which are not or are not.
The important role of estrogen hormones in the growth and extension of these cancers has prompted researchers to experiment with the anticancer efficacy of drugs capable of reducing the synthesis of estrogen and / or blocking its biological action, obtaining positive results. especially in the treatment of breast cancer. Among these drugs we remember:
- Tamoxifen (eg Nolvadex, Tamoxifene AUR, Nomafen): prevents, through a mechanism of biological competition, the link between estrogens and their receptor; it is therefore used in the treatment of breast cancer in women of childbearing age, in which the aforementioned hormones are mainly produced by the ovary;
- Exemestane (eg. Aromasin), Anastrozole (Arimidex): by blocking the activity of aromatase (an enzyme that converts androgens into estrogens), they are indicated to treat estrogen-dependent tumors in postmenopausal women, in which the Ovarian estrogen synthesis is minimal and estrogen is produced in minimal quantities in the periphery, especially in the adipose tissue (obese women, for example, run a greater risk of developing endometrial and breast cancer).
At the same time, the important role of estrogen hormones in the growth and extension of these forms of cancer explains the need - in the case of an already manifest estrogen-dependent tumor or family / genetic predisposition to it - to avoid taking long-term use of drugs or preparations that can enhance the synthesis or activity of estrogen hormones:
- combined birth control pill, vaginal ring, birth control patch
- hormone replacement therapy in menopause
- androgenic drugs, anabolic steroids
- caution in the use of some herbal preparations containing phytoestrogens, such as soy, black cohosh and red clover, or essential oils containing compounds with estrogenic activity (eg essential oil of fennel, anise, sage or moscatella)
Late menopause, especially when associated with precocious puberty, is also an important risk factor for the development of estrogen-dependent tumors, especially for breast cancer, since the body's exposure time to endogenous estrogens is longer. report, how the removal of the ovaries and fallopian tubes from still fertile women can stop or slow down the growth of breast and ovarian tumors that need estrogen to grow, although this is obviously not an immediate therapeutic choice.
Regarding colon cancer and prostate cancer, estrogen hormones are sometimes used in therapy as an adjunct to promote tumor regression or increase patient survival, as they seem to have a positive effect in this regard.
Those illustrated in the article are obviously general information, it is in fact up to the doctor to establish the estrogen-dependent nature of a tumor form and the most suitable medical therapy. For example, experimental tests have shown how the administration of estrogen only in hysterectomised women ( which had previously been surgically removed from the uterus) did not cause any increase in the incidence of breast cancer, or even prevented its onset. Even in women with an intact uterus, hormone replacement therapy with estrogen alone does not seem to increase the "incidence of breast cancer; unfortunately it tends to increase the risk of endometrial neoplasms, for which it is generally preferred to associate a progestin (natural or synthetic), although the combination of the two increases the risk of breast cancer.
Furthermore, hormone replacement therapy seems to significantly reduce the incidence of colon cancer, while the use of the combined contraceptive pill seems to represent a protective factor against ovarian cancer.
In general, the relationship between hormonal therapies and the risk of estrogen-dependent tumors remains a rather controversial topic, on which the last to comment can only be the doctor treating the patient.
