cancer/estrogen therapy

On July 3, 2002 I had tah/bso/cervix removed also. I have used HRT since 1/2000 so I elected to continue estrogen during the recovery period. My surgery confirmed the diagnosis of Type 1b endo/adeno cancer. Not sure of the stage but it was less than one third into uterine wall. Lymph nodes/perineal fluid were clear. I am currently using Triest 1.25 divided dose and feel fine. My surgeon said using estrogen was up to me because the WHI tests so far were ambiguous. Is anyone else still using estrogen with a diagnosis of cancer? I am scared to stop and afraid to continue.......any advise?

I did use estrogen after my diagnosis of very early stage ovarian cancer, with the support of my gyn onc and my medical oncologist. As the results of the studies came out over the summer I lowered my dose and a recently stopped after re-evaluating the risks and benefits with both of my doctors.

There is no one right answer here. I haven't heard anything about estrogen and endometrial cancer after the uterus is removed (it can cause endometrial cancer in women with a uterus if no progesterone is given).

You can always get another opinion if you have any concerns.

Dorrie

Hi Bev,
I was diagnosed with Stage II Ovarian cancer 2 years ago, and have been on (Estrogel) a brand of Estrogen gel since May of 2001.

After the study results I did get a little nervous, however my Dr. feels for me the benefits out-weight the risks as I have osteopenia and am trying to build up my bone mass.

It does concern me, but I have faith that my Gyn and Oncologists know enough about this and wouldn't keep me on it if there was a serious risk of recurrance due to the estrogen.

I am also on Actonel a bone building drug and high dose calcium daily to help with the bones as well, and if after my next bone density test there is a great improvment I plan to go off the estrogen.

Its hard to know what to do when it comes to HRT after a cancer diagnosis, and it really is a very individual decision I think.

Best of luck to you,
Hugs
Maria

Hi Bev!

I second and third what the other gals have said, it a very personal decision and depends greatly on not only what kind of cancer you had as in area, but also what type of cancer "cells" were involved also.

I don't know as much about Uterine, I know in Ovarian for instance, they can normally tell you if your cell "type" was estrogen receptive or not. That's my understanding anyway. I was told that my type was a receptive type so was told no estrogen, natural or otherwise for at least two years after completing treatments. I'm coming up on that two year mark in February and honestly I don't know if I'll go on it or not.

I can't say its been all that difficult nor has it been all that easy. Most of the time, the only time I really vary in body temp is at night...covers on, covers off, over and over. I do notice that if I get aggravated or stressed about something it'll kick off the hot flashes. The majority of my co-workers now make sure they have a sweater handy since I'll freeze them out the majority of the time, not due to hot flashes, just a higher body temp now I think.

I'd do as much research on this in combination with your cancer type and then discuss it again with your physicians. Hopefully you'll be able to make a decision that you'll be comfortable with.

{{hugs}}

Vicki

Oh - one clarification

When I was talking about cancer - I've had ov ca, but I also have a family history of ov ca and breast cancer. I do have to say that even with all of that neither my gyn onc or my medical oncologist thought estrogen was an absolute "no." They did recommend lowering my dose. For those of us with a history or strong family history of cancer, the HRT decision really needs to be individualized.

I went off on a trial basis after gradually lowering my dose and since my menopausal symptoms have not been that bothersome to me, I stopped. If I had severe symptoms or was unwilling to do weight-exercises for my bones, I might have made the choice to stay on a while longer.

Dorrie

I had a hyst for endometrial c, stage 1. My onc surgeon is all for me taking estrogen and was not happy when I opted to do without it. My reg. gyn is more cautious about it and says to not take it for at least two years after surgery. The onc/gyn says that recent studies have shown no increase in recurrence for women with a stage 1 endo c taking estrogen, but I am opting to take the extra precaution. I am leery of these studies, because it seems they come out with a study and everyone goes with it and then in a few years another study comes out and disputes totally the previous results....Who do you believe? It is all so confusing. I want to do what is best for my overall health, but I am so scared of a recurrence that i have opted to risk the things estrogen is suppose to help.

my endo aden was estrogen driven. my onc. says no estrogen (except the type for vaginal dryness - which i'm not on yet) for 2 yrs., however, he has said i can take black cohosh. when they thought my cancer was more serious than it turned out, i was told i couldn't even take that.

i definitely don't have the answers and am trying to figure out what's best as far as supplements for me. to take RX estrogen or not is one decision that was made for me - at least for the next 2 yrs., but i feel the same as the previous person - i'm too scared of the cancer recurring (it can even if no more uterus), so i doubt i'll take it after the 2 yrs. is up.

ginny

GinGin
Two years must be the magic number. My gyn says after two years I can take the estrogen if needed, without worry of it causing a recurrence. My c was also named an uterine adenocarcinom, but it was staged at stage 1a.....my onc/gyn said it was so superficial he could actually scrape it off the uterine wall.....thankifully it hadnt invaded anything....
What has your docs said about vaginal estrogen? My gyn has not mentioned it....only the possibility of test gel.....I tried prog. cream but I think it was giving me achy joints.

my onc. says that when i need it (and he says i will DEFINITELY need it - but i sure hope not) i can take the vaginal estrogen (i don't know the name) as that type of estrogen doesn't go beyond the vagina, or, at least, that's what they believe.

he says that without that, my vagina can atrophy! what a horrible thought!

anyway, so far i don't need it, but when i do, he says to contact him asap because it's better controlled if you start right away.

what have you heard about vaginal dryness? is that a basic symptom of menopause and does everyone get it or are us hysters more apt to have this problem?

ginny

I was Stage IIIc endo CA, diagnosed 5/00. My original oncologist/surgeon actually told me he thought estrogen was fine - that studies had shown it was no problem- but when I researched it,the studies were, I think, only up through Stage I. And then when I moved and got another onco., he said no estrogen. Now that it's been over two years, he says estrogen CREME is OK, but I'm still sceptical. My internist doesn't think I should take estrogen creme. I'm using Replens, and so far vaginal dryness isn't intolerable.... Also, from discussions I've had over on the "hormone jungle" board, I've learne that apparently testosterone (which I'm considering for libido) can also help with vaginal atrophy... I guess either testosterone OR progesterone can convert to a little estrogen - but still, I would think, this is a little less estrogen than actually taking estrogen "straight", so I'm more inclined to try it.

Anyway.... for you Stage I endo CA people, there WAS at least one big study that said it was fine. Personally, I'd wait at least two years - but that's just me.

Now, it's my understanding that ovarian CA is a whole different thing - I think that they DO prescribe estrogen more readily for that, and your posts seem to support this.

Lily