Hormonal replacement therapy after gynaecological cancer.
Thousands of women are treated each year for gynaecological cancers; many of these are already in menopause, while other younger patients will go into early menopause due to surgery, chemotherapy and/or radiotherapy to the pelvic region. The aim of this paper is to review the biological and clinical evidence in favour and against hormone replacement therapy (HRT) use after gynaecological cancers. With the exception of breast and endometrial cancer, there is no biological evidence that HRT may increase the recurrence risk. In women with previous endometrial cancer, HRT use is not supported by univocal and conclusive data to formulate specific recommendations, whereas most authors suggest that oestrogens may be used after adequate information about risks and benefits. The use of HRT in breast cancer patients is, at present, considered contra-indicated, even if results of clinical trials are not concordant. Therapeutic non-hormonal alternatives may be proposed to these patients.
Biglia
Nicoletta
N
Institute for Cancer Research and Treatment (IRCC), Academic Department of Gynaecological Oncology, University of Turin, Candiolo, Italy. nbiglia@mauriziano.it
Mariani
Luca
L
Marenco
Davide
D
Robba
Claudio
C
Peano
Elisa
E
Kubatzki
Franziska
F
Sismondi
Piero
P
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms; D016022:Case-Control Studies; D000075202:Contraindications; D016889:Endometrial Neoplasms; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005185:Fallopian Tube Neoplasms; D005260:Female; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female; D006801:Humans; D008207:Lymphatic Metastasis; D008593:Menopause / Q000187:drug effects*; D008594:Menopause, Premature; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010051:Ovarian Neoplasms; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012306:Risk; D018570:Risk Assessment; D017741:Survivors; D013997:Time Factors; D002583:Uterine Cervical Neoplasms; D014625:Vaginal Neoplasms; D014846:Vulvar Neoplasms