Can Breast Cancer Survivors Take Hormones?
Study Suggests Some Forms of Hormone Therapy May Be Safe
"Although it is tempting to speculate that treatment regimens with estrogen and a minimum of [progestin] may be safe, the management of menopausal symptoms and quality of life for patients with breast cancer remains an important unsolved problem," Schoultz and colleagues write.
Hormone therapy expert Rowan T. Chlebowski, MD, tells WebMD there is growing evidence that short-term treatment with estrogen alone may be safe for breast cancer survivors. But he too says it is too soon to recommend any hormone therapy for this high-risk group. The only exception, he says, is women whose hot flashes and other menopausal symptoms are so severe that they are willing to take the risk.
Antidepressants, Chlebowski says, are the only treatment for menopausal symptoms that are widely considered to be safe for use by breast cancer survivors. He adds that they work about half as well as hormone therapy.
Alternatives to hormone therapy, such as black cohosh and soy-based treatments, work in similar ways to estrogen and therefore may carry the same risks.
In an editorial accompanying the study, the UCLA oncologist and reproductive biologist called for more studies to clarify the role of estrogen and progestin in promoting breast cancer.
"For breast cancer survivors, current evidence supports non-hormone-based interventions for [menopausal] symptom control in most circumstances," he writes. "The possibility that use of estrogen alone in symptomatic breast cancer survivors with a hysterectomy may represent an option with a favorable risk/benefit balance warrants further clinical attention."