Hormones have been implicated in the development and behaviour of many malignant tumours (including vaginal, ovarian, laryngeal, pancreatic, gastrointestinal, melanomas, and meningiomas). The best evidence that hormones maintain the growth of cancers relates to sex steroid hormones and tumours of their target organs, namely oestrogens and progestins in breast and endometrial cancer and androgens in prostatic cancer.
The effects of endocrine therapy are generally confirmed to target organs, and there are side-effects outside these sites. This accounts for the increased tolerability of this treatment in comparison with cyto-toxic chemotherapy. However, many tumours appear resistant to endocrine therapy, even at first presentation, and more become insensitive during the selective pressure of treatment and progression. Thus, most patients with breast and prostate cancers die with hormone-independent disease. With this background it is important to outline:
♦ Different types of endocrine strategies and their relative advantages/ disadvantages.
♦ Predictive indices of response.
♦ Mechanisms of resistance.
♦ Controversies and future expectations.
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