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Breast Cancer and HRT
Breast Cancer and HRT
The Problem
Many women have been told that if they have had breast cancer,
they cannot go on HRT. Why is this?
The Reason
Hormone Replacement Therapy (HRT) usually contains
replacement estrogen. Estrogen is known to help promote breast
cancer growth when the cancer is already present. Consequently,
HRT containing estrogen is not usually prescribed for women who
have had breast cancer, as it is feared that it may trigger a cancer
recurrence. High doses of estrogen can stimulate growth of
estrogen sensitive cancer and several studies have linked
increased breast cancer risk to estrogen replacement therapy.
However, new evidence suggests that there may be some cases
where HRT is appropriate, even in cases of previous breast
cancer.
On the Other Hand&
However, cancer treatment itself induces premature menopause in
the vast majority of women. Thus, women are exposed to the risks
of menopause related disease for many more years than the
average woman. This creates a dilemma. Some breast cancer
survivors may be at greater risk of dying from heart disease or
osteoporosis than for recurrence of their cancer.
Each year, 233,000 American women die of cardiovascular
disease, 65,000 die from complications of hip fractures
(commonly as a result of osteoporosis) and 43,000 die of breast
cancer. Although breast cancer is the more feared of these three
health issues, it is actually a less serious problem than either
cardiovascular disease or osteoporosis. When doctors are
deciding whether to put a patient on estrogen replacement
therapy, they need to carefully weigh the risks that the patient has
for each of these health issues.
Doctors are cautiously moving from the old position of "no
hormones" for breast cancer survivors. Whether or not the
woman's cancer had estrogen receptors, the results of future
clinical trials, and the development of selective hormone
replacements (pills that give the effects you want without those you
do not want) will all effect the decision.
A Note of Caution
One word of caution is in order. Many herbal estrogen
supplements contain phytoestrogens, which are estrogens derived
from plants. Phytoestrogens are known to be linked to endometrial
hyperplasia, which is an overgrowth of cells in the uterus that can
increase the risk of cancer. If you want to be on estrogen therapy
and you have had breast cancer, you must speak to your doctor to
carefully weigh the pros and cons of prescription estrogen.
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