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Hormonal therapy is used to prevent the growth, spread, or recurrence of breast cancer. If lab tests show that your tumor depended on your natural hormones to grow, it will be described as estrogen-positive or progesterone-positive in the lab report. This means that any remaining cancer cells may continue to grow when these hormones are present in your body. Hormonal therapy can block your body's natural hormones from reaching any remaining cancer cells.

Research has proven that hormonal therapy can extend the lifespan of a breast cancer patient who has cancer cells that depend on hormones to grow. Tamoxifen has been used for nearly 20 years to treat patients with advanced stage breast cancer. Now it is being used also as additional treatment for early stage disease after breast cancer is removed by surgery. Clinical trials show that taking tamoxifen as part of the treatment for breast cancer helps to reduce the chances of recurrence in the treated breast and of new cancer developing in the other breast.

Tamoxifen is taken daily by mouth as a pill. Your oncologist will decide on the dose and length of treatment according to current research findings. Like chemotherapy, hormonal therapy affects cells throughout your body. Studies have shown that there is some increased risk for cancer of the uterus. Blood clots have been reported in the veins of a small percentage of patients who take tamoxifen along with chemotherapy. These risks, however, are much lower than the benefits received from tamoxifen.

Of course, you will have frequent blood tests and physical exams while you are on hormonal therapy. Be sure your gynecologist and primary care doctor know you are taking this drug. You should have yearly pelvic exams while taking tamoxifen, and you should notify your doctor about any unusual bleeding or pain.

POSSIBLE PROBLEMS: Side effects could include hot flashes, nausea, vaginal spotting (small amounts of blood), or increased fertility in younger women. Less common side effects include depression; vaginal itching, bleeding, or discharge; loss of appetite; eye problems; headache; and weight gain.

QUESTIONS TO ASK YOUR ONCOLOGIST ABOUT HORMONAL THERAPY

• What benefit might I get from hormonal therapy?
• Which would be better for me, hormone medication or surgery to remove my ovaries? Why?
• What drug will I be taking?
• How will I know it is working?
• What are the side effects and how can I manage them?
• What side effects should I report to you?
• How long will I be on hormonal therapy?
• Will I need follow-up care?
• What if I don't have hormonal therapy?