Study summary · research use only
Effects of hormonal treatment on lipids in patients with cancer
Plain-language summary
Paraphrased from the published abstract below — not a verdict on whether anything works.
This review discusses effects of hormonal cancer treatments on lipids in patients (human context). The authors describe that oestrogens usually decrease total and LDL cholesterol, increase HDL cholesterol, and increase triglycerides; progestogens short-term decrease total, LDL, and HDL cholesterol and increase triglycerides, with small long-term impact. Tamoxifen is described as decreasing total and LDL cholesterol, increasing triglycerides, with variable HDL reports. Aromatase inhibitors are said to have variable lipid effects depending on trial design and prior tamoxifen. Gonadorelin analogues increase all lipid variables, with usually non-significant LDL changes, and anti-androgens usually decrease total, LDL, and HDL cholesterol. Somatostatin analogues in acromegaly usually cause no change or decrease in total and LDL cholesterol. The authors advise considering lifestyle changes and hypolipidemic treatment, noting tamoxifen may rarely cause serious triglyceride-related side effects.
Abstract
Patients with malignant disease may need hormonal therapy as primary or adjuvant treatment or for palliation. Oestrogens usually decrease serum levels of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C), increase high density lipoprotein cholesterol (HDL-C) concentration, but induce an elevation in serum triglyceride (TG) levels. Progestogens in the short-term decrease TC, LDL-C and HDL-C concentrations, and increase TG levels. In long-term treatment, progestogens usually have a small impact on lipid profile. Tamoxifen induces a decrease in TC and LDL-C levels, an increase in TG concentration, whereas either an increase, decrease or no change has been reported for HDL-C levels. Aromatase inhibitors induce an elevation, reduction or no change in lipid variables. These results depend mainly on the trial design, i.e. whether patients received prior treatment with tamoxifen or not and the duration of therapy. Gonadorelin analogues increase all lipid variables, but LDL-C alterations are usually non-significant. Anti-androgens usually decrease TC, LDL-C and HDL-C levels, whereas TG alterations vary. Information regarding the effects on lipid profile of somatostatin analogues is available almost exclusively in patients with acromegaly. In these patients somatostatin analogues usually induce no change or a decrease in TC and LDL-C levels, whereas they increase HDL-C and decrease TG serum concentrations. Oncologists should consider the lifestyle changes, and if needed hypolipidemic treatment, used to lower cardiovascular risk in non-cancer patients. Tamoxifen may rarely cause serious TG-related side effects, like acute pancreatitis.
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