Progestin hormone therapy for endometrial cancer

Examples

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Brand Name	Chemical Name
Provera	medroxyprogesterone

Brand Name	Chemical Name
Megace	megestrol

How It Works

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A woman's body makes the hormone progesterone. Progestin is the man-made form of progesterone.

Estrogen makes the lining of the uterus (endometrium) grow thicker. Late in your menstrual cycle, a drop in progesterone plays a part in the thick lining shedding away.

When there is too much estrogen in the body, progesterone can't do its job. The endometrium gets thicker and thicker. If the endometrium builds up and stays that way, cancer cells can start to grow.

Progestin hormone therapy is given as treatment for endometrial cancer. It is usually given in pill form.

Why It Is Used

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Progestin hormone therapy may be used to slow the growth of endometrial cancer in:

• Stage IV when cancer has spread to other parts of the body.
• Stage III in the rare cases in which radiation therapy is not recommended.
• Recurrent endometrial cancer.
• Early-stage, low-grade cancer (rarely). This is an option for women who hope to be pregnant in the future and want to avoid a hysterectomy.

Progestin hormone therapy usually is not recommended for women who have diabetes or a history of blood clots.

How Well It Works

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The effectiveness of hormone therapy depends on the presence of proteins called hormone receptors in the cancer cells. Hormones can attach to hormone receptors and then interrupt the way the cancer grows. If tests show that your cancer has receptors for estrogen or progesterone hormones, progestin therapy may be successful in blocking cancer cell growth. Up to 30% of women receiving progestin hormone therapy for advanced endometrial cancer had a significant slowing in cancer cell growth. It is also effective in slowing growth in recurrent endometrial cancer.¹

Side Effects

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Progestin hormone therapy can cause side effects, including:

• Nausea or vomiting.
• Dizziness.
• Mild shortness of breath.
• Weakness.
• Headache.
• Hot flashes or sweating.
• Decreased sex drive.
• Insomnia.

Serious side effects are rare but may include:

• An allergic reaction.
• Sudden severe headache.
• Changes in eyesight.
• Numbness or swelling in an arm or leg.

Progestin hormone therapy is also used as an appetite stimulant. You may experience an increased appetite, which could result in weight gain.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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Progestin hormone therapy may be given to women who are unable to have surgery or radiation therapy.

If you have very early low-grade endometrial cancer and want to be able to have children, progestin hormone therapy may be an option for you rather than a hysterectomy.²

Women who have endometrial cancer that has spread to other parts of the body may have a better prognosis for survival if they receive progestin hormone therapy.¹

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. National Cancer Institute (2006). Endometrial cancer PDQ: Treatment—Health professional version. Available online: http:www.cancer.gov/cancertopics/pdq/treatment/endometrial/healthprofessional/allpages/print.

2. Ramirez PT, et al. (2004). Hormonal therapy for the management of grade I endometrial adenocarcinoma: A literature review. Gynecologic Oncology, 95: 133–138.

Credits

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Author	Kathe Gallagher, MSW
Editor	Alison Allen
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman
Primary Medical Reviewer	Joy Melnikow, MD, MPH - Family Medicine
Specialist Medical Reviewer	Ross Berkowitz, MD - Obstetrics and Gynecology
Last Updated	November 27, 2006