Estrogen replacement therapy and ovarian cancer.
Estrogen replacement therapy (ERT) has been shown to be of benefit for menopausal women, especially in prevention of coronary heart disease and osteoporotic fractures. Cancer fear is an important obstacle to use of ERT. From our literature review, there is a weak or no association between ERT and ovarian cancer risk. Individual risk of cancer should be considered before ERT use. The second issue in this review is ERT in patients with ovarian cancer. The majority of patients with ovarian cancer are postmenopausal or become menopausal after surgery. ERT is considered by many physicians to be contraindicated in patients with cancer. However, there is evidence that ERT in selected cancer patients may be of benefit for survival and quality of life. After weighing the evidence from studies on ERT in patients with ovarian, breast or endometrial cancer, we propose the use of ERT in selected ovarian cancer patients who are suffering from or are at a high risk of debilitating menopausal symptoms, osteoporosis, and coronary heart disease. The benefit of ERT to selected patient's health and quality of life appears to outweigh the risk of cancer recurrence.
Sittisomwong
T
T
Department of Internal Medicine Specialties, The University of Texas M.D. Anderson Cancer Center, Houston 77030-4095, USA.
Suneja
A
A
Kudelka
A P
AP
Verschraegen
C F
CF
Kavanagh
J J
JJ
D001315:Australia / Q000453:epidemiology; D015914:Estrogen Replacement Therapy; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000209:etiology* / Q000401:mortality*; D011788:Quality of Life; D012307:Risk Factors; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology