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Evorel/Estradiol patch 25mg with a diagnosis of endometrial carcinoma?  Advice anyone Evorel/Estradiol patch 25mg with a diagnosis of endometrial carcinoma? Advice anyone

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  #1  
Unread 03-07-2003, 09:45 AM
Evorel/Estradiol patch 25mg with a diagnosis of endometrial carcinoma? Advice anyone

Hiya

I was diagnosed with endo carcinoma and had a total hysto with lymph nodes removed. All came back, very luckily, negative. Cancer classed as grade1A so no radiation. Im now 7 weeks post op and along with my night sweats i am getting really bad headaches which do not go away with the normal medication. These headaches tend to last 24 hours and are exhausting. They always start at night where they tend to wake me up with the feeling that i am burning up. My gyne wants me to try a evorel/estradiol patch 25mg the lowest dose to see if it helps headaches which she feels are hormonal. She mentioned to me that 10 years ago this would not be prescribed to me but that feelings have now changed. Anyone else heard of this? Im not very keen on taking it as it seems to me that HRT is more hassle than its worth e.g higher rate of breast cancer, DVT. Any advice would be SOOOOOOOOOO helpful. Thanks
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  #2  
Unread 03-08-2003, 02:42 AM
Evorel/Estradiol patch 25mg with a diagnosis of endometrial carcinoma? Advice anyone

Hi Sheila! I think what your DR meant about feelings changing is that at one point, any or all HRT was considered to increase your risk of developing breast cancer, but more recently research is starting to indicate that it is certain modified hormones that can increase your risk, not necessarily all hormones.

In particular, the bio-identical hormones (like the estradiol in your patch) are starting to be viewed as much safer than, for example, Premarin, which is a mixture of conjugated estrogens. The logic is that merely replacing the exact same molecule that your ovaries made prior to your hyst, assuming you don't use too much, should not increase your risk.

You mention increased risk of DVT... have you had problems with clots in the past? Is this something that your DR feels is a particularly great risk for you? If so, that might affect your decision about the patches.

It's true that often, headaches such as you describe can be due to low estrogen levels or changes in estrogen level. Dr. Elizabeth Lee Vliet, in her book "Screaming to be Heard", has a great chapter on Migraines and Hormonal Headaches which might be worth a read.

You might want to wander over to the Hormone Jungle forum and also the No-Hormone Desert Oasis forum here, to see how sisters on HRT and not on HRT are coping with their headaches. Perhaps you will find something that will strike a chord with you, or information that you can discuss with your DR.

BTW, congratulations on all the nodes being negative, Yay!

s,
-Linda
  #3  
Unread 03-08-2003, 04:22 AM
HRT

Hi Sheila! I'm in a situation similar to yours. I had a TAH/BSO for an ovarian tumor in December then another surgery for staging of ovarian cancer Feb. 7. Fortunately, my nodes were also negative so my cancer was a stage 1A. I'm also wondering about HRT. When I told my gyn onc I was having trouble sleeping (I'm typing this at 2:45am), he wrote me a script for estradiol, but I'm a bit afraid to take it. Apparently, there just isn't a lot of research on whether HRT might cause a recurrence of ovarian cancer. I also have a strong family history of strokes. I, too, am having headaches. I had them before my hyst also, and they didn't seem to be related to my cycles so I didn't think they were hormonal. They've been much more frequent since my hyst, but I don't know why. I've been getting acupuncture for them. It seems to have helped a little, but I still have them once or twice a week. My acupuncturist is against HRT and says he can help my menopausal symptoms. I've only had 2 treatments for them, and it hasn't helped yet. I'll certainly let you know if it does! I'm interested in seeing what else we can find out here on this site. In addition to the insomnia and headaches, I'm also having hot flashes and wicked depression and irritability. Arrrgh! I should be really happy right now because my cancer was only stage 1A, but I have to admit, I'm feeling a bit out of sorts. I just wanted to commiserate with you! Maybe we can figure this hormone thing out together!

Amy
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  #4  
Unread 03-10-2003, 06:02 AM
Evorel/Estradiol patch 25mg with a diagnosis of endometrial carcinoma? Advice anyone

Hiya Surfinbabe

Thanks so much for replying. No i have not had any blood clots in the past but i did read that HRT can increase the likelihood of this happening. I shall try and buy that book over the internet as i couldnt find it in a couple of bookshops that i went into at the weekend.

I really feel that if you can do without HRT so much the better, but i have to admit that if it gives me my energy back and stops my hair from looking so dull and lank! and, not forgetting, my sex drive that is non existent may be i should take it! ;sunny:
  #5  
Unread 03-10-2003, 06:09 AM
Evorel/Estradiol patch 25mg with a diagnosis of endometrial carcinoma? Advice anyone

Hiya Amy

Thanks for your post. I would love to hear how your acupuncture goes. When i got my estradio patch and read the accompanying leaflet i just didnt know what to do. For a start if you are 50 and take HRT for five years it states that statistics show that you are 16% more likely to get breast cancer than if you hadnt taken it. Who needs all that to deal with?? Im still at a loss as to what to do... ohhhhhhhhh well. Perhaps we will have to put up with our headaches. Im now taking soya tablets and drink soy milk and eat soy cheese and yoghurt! will let you know what happens. How do you find out people's emails on here? I would love to keep in touch via email.
  #6  
Unread 03-10-2003, 06:43 AM
Evorel/Estradiol patch 25mg with a diagnosis of endometrial carcinoma? Advice anyone

Sheila
My gyn/onc highly recommended that I take estrogen after my hyst for endometrial (uterine)cancer, stage 1a , but my gyn that I have gone to for 20 years said no. She said that most endometrial cancers are estrogen receptive and if any cells had escaped, however unlikely the estrogen would feed them, without estrogen they would die. She said at the two year mark I can take it if needed. I asked the onc/gyn about it and he said that current research has shown that estrogen is safe with a stage 1a cancer dx. I am still trying to figure out 7 months post op what is the best course of action. I guess what spooks me is that research seems to change and I don't want to take it and then have a new "research" study show that the old research was correct. I opting for caution and trying to manage with the natural stuff. Chris
  #7  
Unread 03-10-2003, 12:39 PM
Headaches, acupuncture, and HRT after cancer

Hi, Sheila. The acupuncture hasn't helped my headaches yet or my menopause symptoms. I'm going to talk to the acupuncturist when I go in tomorrow. If it doesn't help soon, I may have to try the HRT. I'm hesitant for the same reasons you are, but I can't stand the depression and irritability much longer. Then there's the libido issue! I have to go back to work soon and can't work very well with the depression. I don't know what to do about the headaches because I'm not convinced they're hormone related. I'll send you an e-mail or private message. Basically, the way it's done is by clicking on "Members" at the top of the page. Search for the name of the member you want to get in touch with. Their e-mail address will be in their profile if they entered it. If not, you can send them a private message through this website.

Chris, I feel the same way about the research as you do. I want to err on the side of caution. My gyn onc said there was only 1 study on the whether HRT might cause a recurrence of ovarian cancer (which is what I had). That study showed no difference in survival between the women who took HRT and those who didn't. However it was just done by one doctor on his patients so I can't imagine he had a very large sample size. Both my gyn onc and my regular gyn have said HRT would be ok on a temporary basis. I don't know how long "temporary" is! I still don't know what to do.

Amy
  #8  
Unread 03-11-2003, 07:39 AM
Evorel/Estradiol patch 25mg with a diagnosis of endometrial carcinoma? Advice anyone

Hi All!

My hyst was for early stage ovarian cancer last year. I did take estrogen for a while after my hyst. Very reasonable docs can disagree on the use of hrt after gynecological cancers, and may vary their advice from patient to patient.

My gyn onc said for women with very early stage disease there was little risk in short term use of low dose bio-identicals. His definition of "short term" was less than a year, and early stage was no post-op chemo. He sometimes prescribes more liberally than this when symptoms are severe.

After the 6mo-1year mark things seem to get murkier. He recomends that young women (under 35) seriously consider staying on estrogen (unless they have one of the relatively rare hereditary cancer syndromes in their family) and that women over 40 consider stopping. The idea here is that one needs to look at the "total" health picture - heart disease, fractures, quality of life before making a decision. None of this applies to women with cancer in their lymph nodes.

I used estrogen for 6-8 months after my surgery to ease the transition to menopause and tapered off over a couple months. My decision to stop was based, after consulting with my gyn onc and internist on 2 factors

--the evidence from the WHI trial which suggested that while not harmful, HRT may have little benefit for heart disease

--another breast cancer popping up in my family tree (mom has both breast and ovarian) which made me more suspicious that I might have a genetic cancer syndrome.

I still, by the way use vaginal estrogen cream. For me this has the best risk-to-benefit ratio

I hope this info helps.

Dorrie
  #9  
Unread 03-11-2003, 10:00 PM
HRT

Hi, Dorrie. Thanks for the interesting post. Will the menopause symptoms be less severe in 6 months or a year, or would taking HRT for a while only be postponing what I'm going through now until a later date? If it's just putting off the inevitable, I guess I'd rather just get it over with now. I saw my acupuncturist today and told him what an awful time I'm having with the depression, irritability , and headaches. He treated some different points so maybe that will help. I'm going to give it a bit more time before I go for HRT. I probably will at least get some vaginal estrogen cream at some point. Can you get that over the counter or is it prescription only? I need to spend some more time researching this stuff.

Amy
  #10  
Unread 03-12-2003, 10:37 AM
Evorel/Estradiol patch 25mg with a diagnosis of endometrial carcinoma? Advice anyone

I has worse symptoms in the first few post-op weeks with estrogen than I did once I stopped. I did however, taper my dose down over several months.

During the taper period and the first month or two of no estrogen, I did have not flashes - not often but inconveniently in the middle of the night, and milder ones several times during the day. I did not get depressed. While on estrogen, I did concentrate quite a bit on my health - eating right, exercising, etc and I think that made a difference in how I reacted to being estrogen free.

Estrogen cream is available by prescription only. For those of us with cancer - I would be cautious about ANY over the counter product. A tube may seem expensive (40-60 dollars if you have no insurance) but it lasts 3-4 months once you are using it only 2x a week.

And one does need to remember that a number of docs consider any estrogen to be inadvisable for any cancer survivor.

Dorrie
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