It’s the second blow of a one-two punch.
Last week I told you about a major study of hormone replacement therapy (HRT) that was abruptly halted when researchers decided a continuation of the study would put their research subjects at risk of developing breast cancer.
This week the news is no better for the millions of women who take estrogen to manage the effects of menopause. Just yesterday, the National Cancer Institute (NCI) reported the results of a research study with conclusions thatI hope will prompt every woman taking estrogen to reassess her treatment.
No place to run
Their conclusion was troubling, to say the least. They found that post-menopausal women who take estrogen for 10 or more years may have a full 60% higher risk of developing ovarian cancer than women who never use HRT. In addition, they believe that the longer a woman uses estrogen, the more likely she is to develop ovarian cancer.
On what should have been something of a bright note, the researchers also concluded that women who use a combination of estrogen and progestin do not have a significantly elevated risk of developing ovarian cancer. But at best this could only be considered cold comfort in the wake of last week’s news that the Women’s Health Initiative study concluded that that same mix sharply increases the risk of breast cancer.
Suddenly, it seems that everywhere an estrogen user turns she’s hemmed in on all sides with disappointing news. This must be how General Custer felt in his final hour at Little Big Horn. But fortunately for these women there are choices – it doesn’t have to be a last stand.
My cousin Emily, for instance, uses estrogen to manage hot flashes and other menopausal conditions. Emily is an educated, health-conscious individual, so she does not chose estrogen therapy lightly. Faced with the choice of enduring a condition that creates considerable discomfort and anxiety each and every day, or of taking a medication that will control the condition while creating a long-range anxiety in the possibility of developing cancer, she has made a hard decision.
And as with so many like her, Emily hopes to discontinue HRT within a year or two, hoping also that she won’t have exposed herself to enough estrogen to develop cancer. She doesn’t like this situation, but she’s decided to take her chances, and, while I’m concerned about her health, I respect her right to make that decision for herself.
With the news from last week and now this week, hard decisions are in order for the millions of women who are experiencing the daunting difficulties of menopause. Some, like Emily, will decide to take a chance with one of the hormone replacement therapies. Others may be fortunate enough to be able to control their conditions with natural alternatives: using herbal remedies, for instance, such as dong quai, black cohosh, licorice, red clover and chasteberry. Nutritional supplements of vitamins A, C and B complex, plus minerals like boron may also be effective. In addition, some women may find relief in yoga, acupuncture or special exercise regimens.
The important thing for women to know is that there are a number of ways they can cope with menopause naturally. They don’t work for all women, but these alternatives should be given a second look now that we know the choice of estrogen may have even more dire consequences than we had previously suspected.
When the Women’s Health Initiative’s HRT study was discontinued last week, they announced that they would still continue another study, already in progress, to test the effects of estrogen on 11,000 post-menopausal women. Now that they know of the danger of ovarian cancer, will that study continue?
The estrogen that was used in the discontinued study was a synthetic estrogen. But that was a controlled test. The NCI study was a research of data. So was their result based on women who were taking synthetic estrogen? I suspect it probably was, but we’ll have to wait for further information to find out if natural estrogen played any part in their research.
And what about the math? We’re told that women who take estrogen for 10 years or longer have a substantial risk of developing ovarian cancer. I’ve heard at least one commentator (on National Public Radio’s “All Things Considered”) imply that women who use estrogen for less than 10 years should not consider themselves at serious risk. But I’m not comfortable with that conclusion at all. From everything I’ve come to understand about cancer, it would seem very likely that a woman who discontinues estrogen use at, let’s say, six years might have already set the cancer in motion – a cancer that may not be diagnosed for many years.
These are just three questions among the many that are sure to come up in the next few days. I’ll be reading anything and everything on this subject and I’ll keep you informed as further information arrives.
To Your Good Health,
Jenny Thompson
Health Sciences Institute
Sources:
“Menopausal Hormone Replacement Therapy and Risk of Ovarian Cancer” Journal of the American Medical Association, 2002;288:334-341
“Estrogen Hikes Ovarian Cancer Risk” msnbc.com
Copyright 1997-2002 by Institute of Health Sciences, L.L.C.
