Friday, March 9, 2012

Estrogen therapy helps reduce breast cancer risk in some patients

This story was big news earlier this week, appearing on ABC News. Fox, HemOnc Today, Medscape and the L.A. Times to name just a few.

One of the better articles about the use of hormone replacement therapy following a hysterectomy was run by WebMD Health News.  Here's an excerpt:

Estrogen After Hysterectomy Lowers Cancer Risk?

Experts Say the Decision to Use Hormone Replacement Is a Still Complicated One

March 6, 2012 -- There’s good news for women with hysterectomies who are considering taking the hormone estrogen to ease hot flashes and other menopausal complaints.

New results from a long-running government study of the effect of hormones on women’s health show that estrogen-only hormone replacement therapy appears to cut a woman’s risk of getting breast cancer by about 20% and significantly reduces her risk of dying from the disease. Those benefits appear to last for years after the therapy ends.

So far, so good...

In 2002, doctors looking at data from the Women’s Health Initiative sounded the alarm about hormone replacement therapy, warning that the risks of heart attacks, strokes, and breast cancers were higher for women taking the combination of estrogen and progestin than for women taking a placebo. Researchers stopped the trial early after noting increased adverse events in women taking hormones. In response, millions of women stopped their hormone replacement therapy.

But experts say that response probably wasn’t warranted. They say many women can safely take hormones for a short time to quell bad hot flashes, night sweats, and mood swings that can accompany menopause.
“The effects on breast cancer are so different between estrogen and progestin and estrogen alone that we felt it was time to say that women taking estrogen alone may not need to stop at three to five years. Because over that amount of time, no breast cancer showed up in women taking estrogen alone,” says Gass, who is also a co-author on the new study.

So estrogen alone seems to be the key.  This could be good news for my wife, Pattie, who has been struggling the last few years trying to go without any hormone therapy.  The article concludes this way:

Several other important warnings also apply.

The first is that estrogen did not appear to help some women. Those were women at higher risk for breast cancer because they had a family history or history of having benign breast disease. Estrogen may even increase the risk of breast cancer in women who already have other risk factors...

The second important consideration is that the study tested a kind of estrogen called conjugated equine estrogen, which is sold under the brand name Premarin. In recent years, that formulation has become less popular. More women have moved toward using estradiol, which is chemically closer to the body’s own estrogen. But researchers say they aren’t sure if the two kinds of estrogen work the same way.

“Conjugated equine estrogens are very complex pills,” Anderson says. “There are a lot of different estrogen compounds in them. We really don’t know what the active agents are. To make a leap to another form is really hard to say.”

So researchers aren't exactly sure why this protective, anti-breast cancer benefit occurs.  And if you are genetically at risk for developing breast cancer, a woman shouldn't be taking estrogen.  And she would know this how?  Another big news story that really isn't that newsworthy?

CLICK HERE to read more.  Which is a good idea, because I'm confused...

Feel good and keep smiling!  Pat

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