Hormonal Adjuvant Therapy and Its Impact on Function
Presented by Nicole L. Stout
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The most prevalent cancers in the United States today, breast and prostate, are commonly treated with a long-term regimen of hormonal drug agents proven to reduce the growth of cancer cells and reduce the risk of disease recurrence. These drug agents also incite significant interactions systemically that contribute to a high rate of functional impairment including bone density loss, pain, increased adiposity, and reduced lean mass in these patients. Guidelines for hormonal therapies recommend treatment for 3–5 years post completion of cancer treatment. The protracted timeline for treatment and the aggregate burden of these side effects increase the risk for long-term disability and frailty in cancer survivors and warrant specific rehabilitative interventions to mitigate their impact.
Meet your instructor
Nicole L. Stout
Dr. Nicole L. Stout is a research assistant professor in the School of Medicine, Department of Hematology/Oncology at West Virginia University Cancer Institute and with the School of Public Health, Department of Health Policy, Management, and Leadership. She also serves as the associate director of the WVU Cancer Institute’s…
Chapters & learning objectives
1. Classes of Hormonal Agents and Their Use in Cancer Treatment
In some types of cancers, cell growth can be accelerated by the presence of sex hormones. Hormone receptors are present on a majority of breast and prostate cancer cells. Adjuvant hormonal agents provide a mechanism to suppress tumor growth by reducing the impact of circulating hormones on the cancer cells.
2. Breast-Cancer-Related Hormonal Therapies: Side Effects and Clinical Management of Impairments
Specific drug classes are used to reduce the impact of estrogen and progesterone on breast cancer cell growth. These drugs, however, reduce the overall impact of hormones systemically and lead to metabolic and endocrine changes, joint arthralgias, weight gain, and loss of bone density. Rehabilitation interventions can minimize the severity of these side effects and their impact on function.
3. Prostate-Cancer-Related Hormonal Therapies: Side Effects and Clinical Management of Impairments
Specific drug classes are used to reduce the impact of androgen and testosterone on prostate cancer cell growth. These drugs, however, reduce the overall impact of hormones systemically and lead to metabolic and endocrine changes, reduced lean mass, and loss of bone density, and negatively impact libido. Rehabilitation interventions can minimize the severity of these side effects and their impact on function.
4. Considerations for Rehabilitation Interventions
The duration of hormonal therapy use is protracted, often over the course of several years, and side effects may be intermittent in onset or progressive over time. Consideration for screening and assessment of emerging impairment, mitigating the functional impact of these known side effects, and promoting evidence-based interventions can guide the rehabilitation plan of care and optimize function.
