Hormone treatments are important in treating hormone-sensitive breast cancers, especially estrogen-receptor-positive (ER-positive) tumors that account for 70% of all breast cancer cases. Post-surgical administration of tamoxifen, or one of the aromatase inhibitors (AIs) to lower estrogen levels and/or block estrogen receptors are standard therapy to prevent cancer recurrence. Yet as transformative and lifesaving as these therapies can be, their toll on mood and mental health is equally profound — if under-recognized.
In this blog, we will look at the psychological side effects that clients taking hormonal treatments may experience and how they impact mood states due to changing biological processes alongside strategies for dealing with mental health issues. That the discourse will shift about cancer care not only being about physical recovery but also recognizing that there are long term mental and emotional affects and we need to begin giving fair time toward survivorship.
Hormonal Treatments for Breast Cancer
Patients with hormone-sensitive breast cancers may got hormonal therapies including tamoxifen or aromatase inhibitors (such as letrozole, anastrozole, or exemestane) Such therapies reduce estrogen, a fuel for hormone receptor-positive cancers. While Tamoxifen blocks the estrogen receptors on breast cancer cells and can keep some endometrial tissue from growing, AIs decrease overall estrogen in postmenopausal women.
While these treatments lower the risk of recurrence and death, they are typically taken over extended periods (5-10 years) and can substantially affect a patient’s quality of life, particularly psychological health.
Biological Mechanisms Behind Mood Changes
Estrogen is commonly linked to reproductive role, however it can regulate mood and supports emotional stability. It works on production of neurotransmitters such as serotonin, dopamine and norepinephrine that are associated with reward behaviour, pleasure and mood leveling. A decrease in the estrogen can disturb this balance and result into the symptoms of depression, anxiety, mood swings etc.
