Hormone Replacement Therapy after Breast Cancer
by Michael Russell
Generally speaking, a great deal has already been discussed on the issue of hormone replacement therapy. However, less is known specifically about this form of therapy for breast cancer survivors. One reason for this is that physicians are concerned about prescribing any of these drugs to their patients for fear that it might increase the risk of cancer recurrence. But along with this, blanket statements regarding hormone replacement therapy are quite inappropriate. Each individual woman should be given the chance to consider the risks and benefits of hormone replacement based on their personal situation. Every woman experiences menopause differently, with varying degrees of symptoms. Some women go through menopause with little difficulty and without increased risk of osteoporosis or heart disease. For others, menopause is traumatic and can introduce increased chances of illness into their lives.
Professional practice in medicine has endorsed allowing women to replace ovarian hormones with hormone replacement therapy once the ovaries begin to fail. Evidence and clinical experiences indicate that the benefits clearly outweigh the risk and expense of such therapy. However, evidence has yet to be found with regards to the risks to women surviving beast cancer. Most concerns are based on speculation and anecdotal experience alone.
For most women, the question lies in the correlation between hormone replacement therapy and an increased risk of breast cancer. Does hormone therapy contribute to breast cancer? Before starting such treatment, physicians often require their patients to get a baseline screening mammogram and because women receiving treatment are under a physician's surveillance, they are more likely to get annual screenings. Although there is no difference between women who are not on hormone replacement and those who are on it for less than ten years, once the duration exceeds the ten-year benchmark, there is a slight increase in breast cancer incidence, but the numbers are insignificant. There also appears to be anecdotal data that women with breast lobular neoplasm may have an increased risk for recurrence with hormone replacement therapy. However, with or without this form of therapy, these women are still at an increased risk of recurrence.
On the other end of the spectrum, how does one know that one is cured of breast cancer? Unfortunately, there is no absolute way to know. Statistical probabilities can be given based on the cancer's characteristics. If one is destined to relapse, it will usually happen in the first five years after the diagnosis. Regrettably, late recurrences do rarely occur. Breast cancer patients are advised that once treatment is complete, they should consider themselves cured, move on.
Medical research shows that low dose hormone replacement therapy for less than 10 years does not significantly contribute to the development of breast cancer in the general population, but the question is, does this apply to the population of women cured of breast cancer? Sadly, there are no studies to confirm this and no evidence has yet surfaced from past studies to answer this. The safest way to think about it though, is that for women with a high probability of cure, the benefits of this treatment far outweigh the risks.
Michael Russell
Your Independent guide to Breast Cancer.
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