TY - JOUR
T1 - Hormone replacement therapy in gynecologic cancer survivors
T2 - Why not?
AU - Ibeanu, Okechukwu
AU - Modesitt, Susan C.
AU - Ducie, Jennifer
AU - Von Gruenigen, Vivian
AU - Agueh, Modupe
AU - Fader, Amanda Nickles
PY - 2011/8
Y1 - 2011/8
N2 - Purpose: As a result of treatment, many women with gynecologic malignancies will go through menopause and display climacteric symptoms at an earlier age than occurs naturally. Iatrogenic menopause may adversely affect quality of life and health outcomes in young female cancer survivors. Hormone replacement therapy (HRT) has often been withheld from women with gynecologic cancer because of concern that it might increase the risk of relapse or the development of new primary cancers. The purpose of this review was to examine the published literature on menopause management in gynecologic cancer survivors and highlight the risks and benefits of conventional and alternative HRT in this population. Methods: A comprehensive literature search of English language studies on menopause management in gynecologic cancer survivors and women with a hereditary predisposition to a gynecologic malignancy was performed in MEDLINE databases through December 2010. Results: Both our review and a 2008 Cochrane review of randomized trials on the effects of long-term HRT demonstrate that for menopausal women in their 40s or 50s with and without gynecologic cancer, the absolute risks of estrogen-only HRT are low. Several prospective observational studies and randomized trials on HRT use in women with a genetic predisposition for or development of a gynecologic malignancy suggest benefits in quality of life with no proven adverse oncologic effects as a result of short-term HRT use. Conclusion: In select women, it is reasonable to discuss and offer conventional HRT for the amelioration of menopausal symptoms and to improve quality of life. HRT does not appear to increase the risk of gynecologic cancer recurrences; however, this conclusion was largely based on observational data and smaller prospective studies.
AB - Purpose: As a result of treatment, many women with gynecologic malignancies will go through menopause and display climacteric symptoms at an earlier age than occurs naturally. Iatrogenic menopause may adversely affect quality of life and health outcomes in young female cancer survivors. Hormone replacement therapy (HRT) has often been withheld from women with gynecologic cancer because of concern that it might increase the risk of relapse or the development of new primary cancers. The purpose of this review was to examine the published literature on menopause management in gynecologic cancer survivors and highlight the risks and benefits of conventional and alternative HRT in this population. Methods: A comprehensive literature search of English language studies on menopause management in gynecologic cancer survivors and women with a hereditary predisposition to a gynecologic malignancy was performed in MEDLINE databases through December 2010. Results: Both our review and a 2008 Cochrane review of randomized trials on the effects of long-term HRT demonstrate that for menopausal women in their 40s or 50s with and without gynecologic cancer, the absolute risks of estrogen-only HRT are low. Several prospective observational studies and randomized trials on HRT use in women with a genetic predisposition for or development of a gynecologic malignancy suggest benefits in quality of life with no proven adverse oncologic effects as a result of short-term HRT use. Conclusion: In select women, it is reasonable to discuss and offer conventional HRT for the amelioration of menopausal symptoms and to improve quality of life. HRT does not appear to increase the risk of gynecologic cancer recurrences; however, this conclusion was largely based on observational data and smaller prospective studies.
KW - Gynecologic cancer survivor
KW - Hormone replacement therapy
KW - Menopause
KW - Quality of life
UR - http://www.scopus.com/inward/record.url?scp=79960451602&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79960451602&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2011.03.012
DO - 10.1016/j.ygyno.2011.03.012
M3 - Review article
C2 - 21474167
AN - SCOPUS:79960451602
SN - 0090-8258
VL - 122
SP - 447
EP - 454
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 2
ER -