The Difference Between Hormonal Therapy and Chemotherapy for Breast Cancer

DR. CHRISTINA NG VAN TZE
March 22, 2025

Understanding Hormonal Therapy and Chemotherapy for Breast Cancer

Breast cancer treatment includes many treatment options, but two main ones are the difference between hormonal therapy and chemotherapy for breast cancer. While both aim to destroy breast cancer cells, they work in different ways. Hormonal therapy helps slow down the growth of cancer that depends on hormones. In contrast, chemotherapy uses strong medicine to kill cancer cells throughout the body.

Hormonal Therapy and Chemotherapy for Breast Cancer work in different ways to treat the disease. Hormonal therapy blocks these hormones or prevents them from attaching to cancer cells. By doing this, it can help lower the chances of cancer coming back.

What Is Hormonal Therapy for Breast Cancer?

Hormonal therapy for breast cancer is a treatment for breast cancer that grows due to hormones like estrogen or progesterone. It helps slow or stop the growth of hormone receptor-positive breast cancer. This type of cancer relies on hormones to grow.

Hormonal therapy works by blocking these hormones or preventing them from attaching to cancer cells. By doing this, it can help lower the chances of cancer coming back.

How Hormonal Therapy Works

✔ Blocks hormone production or stops hormones from attaching to breast cancer cells.
✔ Used for early-stage breast cancer, advanced breast cancer, and breast cancer that has spread.
✔ Helps reduce the risk of cancer returning after surgery.

Side Effects of Hormone Therapy

Like any treatment, hormonal therapy has side effects that vary from person to person. Some common side effects include:

Hot Flashes: Many patients experience sudden feelings of warmth that spread over the body, often accompanied by sweating and redness. These hot flashes can occur during the day or night and may disrupt sleep patterns, leading to further fatigue.
Bone Thinning: Hormonal therapy can lead to a decrease in bone density, making bones more fragile and increasing the risk of fractures. Regular check-ups and lifestyle changes, such as a balanced diet and weight-bearing exercises, can help manage this side effect.
Fatigue: Patients often report feeling unusually tired and lacking energy during hormonal therapy. This fatigue can impact daily activities, making it essential for patients to prioritize rest and engage in light exercise to help boost energy levels.

What Is Chemotherapy for Breast Cancer?

Chemotherapy is a treatment that uses strong drugs to destroy breast cancer cells. It is often used for aggressive types of cancer or when the disease has spread. This treatment attacks cancer cells throughout the body.

Chemotherapy can be given alone or with other treatments. It is usually done in cycles, with rest periods in between. Many people experience side effects, but doctors help manage these to make the treatment easier.

How Chemotherapy Works

Attacks and destroys breast cancer cells throughout the body.
Used alone or combined with other types of treatment for advanced breast cancer.
Can be part of a clinical trial for new treatment options.

Side Effects of Chemotherapy

The side effects of chemotherapy can vary widely depending on the specific drugs used and how each individual responds to treatment. Some common side effects include:

Hair Loss: Many patients experience hair thinning or complete hair loss during chemotherapy, which can be temporary and usually regrows after treatment ends.
Nausea: Chemotherapy can cause nausea and vomiting, which may occur shortly after treatment or several days later. Doctors often prescribe medications to help manage these symptoms.
Fatigue: Fatigue is a frequent side effect, leaving patients feeling unusually tired and weak. This can impact daily activities and may last for some time after treatment is complete.

Comparing Effectiveness, Side Effects, and Use Cases

Both hormonal therapy for breast cancer and chemotherapy are effective treatments for breast cancer, but they are used in different situations. The choice between these treatments depends on various factors, including cancer type, stage, and the overall health of the patient.

Hormonal Therapy

Effectiveness: Hormonal therapy is most effective for hormone receptor-positive cancers, meaning the cancer cells have receptors that allow them to grow in response to hormones like estrogen and progesterone. It helps slow or stop the growth of these cancers and reduces the risk of recurrence after surgery.
Use Cases: This therapy is typically recommended for early-stage breast cancer, particularly in postmenopausal women. It is also used for some advanced cases where the cancer is hormone receptor-positive.
Side Effects: Hormonal therapy can lead to long-term hormonal changes, which may result in side effects such as hot flashes, bone thinning, and fatigue. These side effects are generally less severe than those caused by chemotherapy.

Chemotherapy

Effectiveness: Chemotherapy is a stronger treatment that is often necessary for fast-growing or aggressive cancers, including those that are hormone receptor-negative. It targets and destroys cancer cells throughout the body, making it effective for metastatic breast cancer.
Use Cases: Chemotherapy is frequently used for early-stage breast cancer that is high-risk or has spread to lymph nodes. It can also be part of a treatment plan for advanced breast cancer, either alone or in combination with other therapies.
Side Effects: The side effects of chemotherapy can be more severe and may include hair loss, nausea, vomiting, fatigue, and an increased risk of infection. These side effects vary depending on the specific drugs used and the patient’s overall health.

How Age, Hormone Receptor Status, and Menopausal Status Affect Treatment Choice

Several factors determine the best treatment approach, including the patient’s age, hormone receptor status, and menopausal stage.

Age: Older patients may prefer hormonal therapy due to fewer severe side effects.
Hormone receptor status: If the cancer is hormone receptor-positive, hormonal therapy is preferred.
Menopausal status: Postmenopausal women often take aromatase inhibitors, while premenopausal women may need other treatment options, including chemotherapy.

Conclusion

Choosing between hormonal therapy and chemotherapy for breast cancer is an important decision that depends on several factors. Each patient’s situation is unique, including the type of breast cancer, its stage, and personal health conditions. Because of these differences, it is essential to work closely with a healthcare specialist who understands these treatments.

A specialist can provide valuable insights and help explain the benefits and risks of each treatment option. Hormonal Therapy and Chemotherapy for Breast Cancer are two primary approaches that specialists consider when developing a personalized treatment plan. They can also take into account your preferences and lifestyle to create a plan that achieves the best possible results while minimizing side effects. By having an open conversation with your healthcare team, you can feel more confident in your treatment choices and work together toward a successful outcome.