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Cancer and BioIdentical Hormones Cancer and BioIdentical Hormones

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Unread 06-17-2004, 12:13 PM
Cancer and BioIdentical Hormones

Hi Everyone -
I am currently dealing with Endometrial Cancer. I have already had my hysterectomy (TAH & BSO) and about to undergo the Radiation treatment for it.
I am 42 and am (was) pre-menopausal so now I am doing lots of research regarding whether to use/not use hormone replacement. Being a natural woman, I am only considering to bio-identical options, but I am getting lots and lots of different opinions from doctors and others.
Can I ask a few questions to those of you out there who have had hysterectomies due to cancer?
What are your reasons for choosing/not choosing bio-identical hormones?
Which combination of the bio-identical hormones have worked for you?
How about estrogen? Are you avoiding bio-identical estrogen due to the cancer risks involved? (I"m getting many mixed messages on this one.)
I understand that NHRT is supposed to be cycled - mimicing our natural cycle and allowing our uterus to shed it's lining. What about in our case? Do you still mimic the cycle or have any of you learned how to adjust it to account for your hysterectomy?
Any light any one can shed would be greatly appreciated here?
Thanks very much
Peace & Love
Red Raven
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Unread 06-17-2004, 10:32 PM
Cancer and BioIdentical Hormones

Hi (((Red Raven))) I didn't have my hysterectomy for cancer, but have had a cancer diagnosis (breast) since then. I am on bio-identical HRT's and have been since my hysterectomy. I tried cutting my estrogen dosage in half and going on Tamoxifen after the breast cancer diagnosis, but the symptoms were so severe that I could not tolerate that and went back to what I was on before, just adding diindolymethane (DIM) in place of the Tamoxifen. DIM is a natural substance isolated from broccoli that is available OTC... I posted a thread about it here:

I chose to go on transdermal bio-identical HRT's because I believe it's less risky to replace what my body was making in the ovaries that were prematurely removed than it would be to ingest foreign compounds that pass through my digestive system and break down into various smaller products that my body doesn't need and can't use, leaving only a tiny amount of the substance my body is missing. My DRs were totally in agreement with that decision so that made it easy.

The HRT's I am on are: Vivelle dot .075 patch (estradiol); compounded estriol vaginal cream (to prevent vaginal dryness); and 1% compounded natural testosterone cream (for libido and energy). I also occasionally use a tiny (I do mean tiny) dab of natural progesterone cream if I have soreness in my breasts... I tried using larger amounts of progesterone cream as well as taking compounded oral progesterone capsules and did not feel well on either. I also take tons of vitamins and supplements, and eat a much healthier diet than I did previously.

I'm not avoiding estrogen, but I'm not using as much as I started off with. My GYN, internist and oncologist are all on board with my decision to stay on estrogen, particularly since I'm taking DIM, which alters estrogen metabolism away from the forms most likely to cause proliferation of cancer cells. I'm also getting regular (every 6 months now) mammograms. You're right, there are mixed messages out there about cancer and estrogen. There are some great links in our Resource Links directory to information about HRT and cancer risk; check particularly the breast cancer and hormone jungle sections (to get to Resource Links, just click on Resources at the top of the page).

Most of us who are post hysterectomy/oophorectomy and on HRT's choose not to cycle our hormones. The reason is that hormonal fluctuations can trigger all kinds of symptoms for some of us, including hot flashes and migraine headaches. Plus we don't have that uterine lining to worry about shedding .

I hope this helps.... good luck with your decision!

Unread 06-18-2004, 10:04 AM
Cancer and BioIdentical Hormones

Hi there RedRaven

I am 2 weeks post op from a TAH/BSO and also wonder about HRT. I read some recently that if you have endometrial cancer (as I did also) that estrogen isn't a good idea. Has anyone else read that anywhere. I haven't talked to my GYN about options yet, I guess I will talk to him at my next appointment.

Any enlightenment would certainly be appreciated by me also.

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Unread 06-18-2004, 02:10 PM
Cancer and BioIdentical Hormones

Since the reason that women with a uterus take progestin is that estrogen alone increases the risk of endometrial cancer, I would think that estrogen would not be a good choice if you already have endometrial cancer.

I do take a bit of estrace (reacted badly to a patch)-- .5 mg a day. This is bio-identical in a pill. I started because I thought it was healthier given my high risk of heart disease (family, weight)--at the time it was thought to help. but I found that it made a huge difference in joint pain, urinary incontinence, mood, memory--given the benefit to risk ratio in my case, I decided to stick with it and none of my doctors are hollering yet (I'm 52 as of yesterday and been on it since 2000).

Oh, my cancer is rare form of ovarian and not clearly related to hormone levels so the increase in risk was unclear.
Unread 06-19-2004, 04:20 AM
Hi Redraven,

I had TAH/BSO in January 2004 due to ovarian cancer (I'm 41). My onc just prescribed me Estrace (2mg) -natural bioidentical estrogen. I've been suffering from severe night sweats (to the point where I need sleeping pills), hot flushes, migraines, etc. My onc told me I couldn't take any progesterone since I don't have a uterus? He told me we'll start with the estrogen and see if that helps. I asked him about my concern regarding cancer/estrogen and he felt it was safe as long as it is not for a prolonged period of time and I get followed up every three months. My sex drive is gone and sex (for me) is now painful. I 'm trying Replens for lubrication, but my onc feels I shouldn't take testosterone yet. I'm really confused with all these hormones! But I'm trying to find what will work for me. I also take vitamin E, a multivitamin, calcium and evening primrose. If this doesn't do it, I'll ask my onc for another variety of hormones. I asked for a blood workup to see which hormones I was low on or missing and he didn't feel that would help. He said our hormones change constantly and blood tests would never be accurate. It's been three days I'm on Estrace and so far, the night sweats and hot flushes are a little better -I'm getting some sleep which makes me a nicer person to live with!! As for the sex I haven't tried yet! That's the part of my life that has changed drastically-my husband and I have always enjoyed one another and now -it's totally gone. My husband is very understanding but I'm wondering how long that will last -he is human (and male!). I hope things improve soon. I went for my first ovarian cancer support group Thursday and mentioned this problem -many women agreed with me but no one seemed to have a solution. The chairperson of the group will get a guest speaker to come in soon who is a sex specialist for women with hyst -maybe she can shed some light on this! Good Luck to you!
Unread 06-19-2004, 04:55 AM
Cancer and BioIdentical Hormones

My primary goal after completing treatment for endometrial cancer in 1999 was to do everything possible to avoid a recurrence. My very experienced and highly regarded gynecologic oncologist said he was not comfortable with me taking any type of hormone replacement for at least five years. I was already at an elevated risk for recurrence because, among other reasons, my tumor was very deeply invasive and arose in the lower uterine segment.

Although there are almost as many opinions as doctors on this topic, I decided to rely on my gyn-onc's judgment. While I had a difficult first year and suffered from insomnia, anxiety, and the inability to concentrate, things improved dramatically over time. I did take anti-anxiety medication for my sleep problems, but gradually weaned off of the medication as my body adjusted to both the cancer diagnosis and the effects of being thrown into surgical menopause.

I now am five years post-treatment, and I have virtually no symptoms that would motivate me to explore the option of any sort of hormone replacement.

Best of luck to you in your recovery.

Unread 06-19-2004, 06:03 AM
Cancer and BioIdentical Hormones

Red Raven: I was diagnosed with endometrial cancer last October. My oncologist has told me to avoid HRT. But I had serious vaginal problems after surgery and intercourse was very painful. He suggested the use of Premarin cream to keep the vaginal tissues moist and supple. I apply a dab 2-3 times a week. I am still on my first tube of the cream and it's about half gone now. The amount of estrogen in that tube is approximately that in 2 cycles (6 weeks) of the normal HRT. I think it will last well over a year. The other good thing about the cream is that it works locally and very little is absorbed.

If you are worried about the systemic problems of menopause, talk to your oncologist about the options.

Unread 06-19-2004, 12:02 PM
Cancer and Bioidentical Hormones

Thanks for replying everyone.

I guess one thing is clear - there is no one size fits all answer when it comes to which hormones work safely after cancer - or whether or not hormone supplementation is the answer at all.

Linda (Surferbabe) - Thanks for the tip on DIM - I'll look into it. (It may be similar to IP6 and IC3 which I am currently taking.) And thanks for directing me to Resources - I hadn't noticed that yet.

Maxime - I'm glad Estrace is working for you, and I'm curious about what your doctor said about Projesterone - not needing it since we don't have a uterus. This contradicts a lot of what I've read that claims that projesterone is responsible for a lot of functions in our body - not just for the shedding of our uterus lining.... Hmmm. So much to understand - and so much contradictory information... By the way - I would love to find out what your sex specialist tells you in your group about women with hysterectomies. I have lost my libido entirely since surgery, but I am optimistic (and determined) to get it back.

Moekay - Good for you for going it alone without any NHRT. I am considering this option myself amidst the flurry of all of this confusing information. However, I am concerned about some long term issues. Now that you've made it through the worst of the symptoms, are you experiencing any of the rumoured degenerative conditions that are reported to happen without the support of NHRT? (like bone loss, for example?)

I'm on bio-identical projesterone cream now, because both my oncologist and gynocologist said that estrogen was too dangerous for me for 2 years or 5 years - depending on who I listen to. The cream seems to be taking the edge off some of my symptoms - I'm also on an organic vegan diet and tons and tons of supplements too - so who knows what's really helping. So - I have no clue at the moment about whether the projesterone cream is a wise choice or a foolish one. One doctor said it would have an anti-estrogenic effect and therefore help prevent a reoccurence. Another said, this may or may not be true, but it probably woudn't hurt. Then, I read things that make me question both of them. Who knows.
Like you, Moekay, my first priority is to avoid a reoccurence - so I will do what it takes and suffer through whatever is necessary to make that happen - as much as it is in my power to make that happen. I just don't want to suffer needlessly. Been there, done that a little too much already.
So - thanks for all of your input so far, and if anyone has anything else to share on the subject, I'd be very happy to hear about it.
Peace & Love,
Red Raven.
Unread 06-20-2004, 08:58 AM
Cancer and BioIdentical Hormones

Hi, RedRaven,

My first bone density test done about two months after completing radiation was normal. The next one done a year and a half later showed mild osteopenia. In reserching the issue, I determined that bone loss is often most significant for the first couple of years after hysterectomy which results in surgical menopause as well as after pelvic radiation. I wanted to avoid taking medication for bone density, if possible, so I increased my weight-bearing exercise, increased my calcium and magnesium intake, and decreased my intake of caffeinated beverages, which deplete the body of calcium.

Since then, I have had two additional bone density tests which have both shown no further loss. In fact, the most recent test showed very mild, though not significant, improvement in my bone density. So for the time being, my doctor is satisfied with my bone status and has said that I do not need to take Foxamax or Actonel as long as my test results remain stable.

Unread 06-20-2004, 04:42 PM
Cancer and BioIdentical Hormones

Red Raven,

I had endometrial cancer 1b and had TVH on 7-17-03. My onc will not give me any hormones for the first 2 years after surgery. My mother was diagnosed with breast cancer at age 80, so this in another concern of his and mine. Like someone else said we are working toward not getting a reoccurence of cancer. But as you said there are probably as many answers to this question as


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