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550018 tn?1264194565

hormone replacement therapy

Dr. Goodman,

I was diagnosed stage 1c ovca in 07/08, conservative surgery, 6 rounds of carbo, got pregnant and gave birth in 03/10 and just had a full hysterectomy/staging last Monday(08/10). Still waiting on the path report, but there was no evidence of disease and the washings were clear, so fingers crossed.  I am 29 years old and I am concerned about being on hormone replacement therapy for a long period of time.  However, I know that menopausal symptoms will be almost unbearable without the therapy. Is there a heightened risk of recurrence due to HRT in regards to ovarian cancer?  There is a lot of information about the general population and HRT, but I'm finding it difficult to understand how HRT affects ovca patients.  Any information would be great.  Thanks so much.  

1 Responses
242604 tn?1328124825
Hi Marie,

In general, it is thought that hormone replacement therapy at your age is very appropriate. You are right, there are no large studies looking specifically at young ovarian cancer survivors and the risks/benefits of estrogen.

I would frame it this way: this is what we know

-the use of oral contraceptive pills (estrogen /progesterone) in premenopausal women reduces the risk of ovarian cancer by 50%
-the use of prempro (estrogen/progesterone) in women in their 60s who have not had a hysterectomy causes a small increase in breast and ovarian cancer and a decrease in colon cancer
-the use of estrogen by itself in women in their 60s does not increase breast and ovarian cancer
-hysterectomy is associated with increased cardiac disease
-the consequences of estrogen deficiency include: osteoporosis, vaginal thinning with sexual dysfunction

putting that all together, I would say that you should consider and discuss with your doctor:
-the use of vaginal estrogen which works specifically to prevent vaginal thinning
-estrogen low dose pills or patches without progesterone
-a baseline mammogram

also if you have not undergone genetic testing for BRCA1/2 gene mutations, you should do so to help understand your baseline risk of breast cancer

best wishes
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