title: The use of hormone therapy and its alternatives in women with a history of hormone dependent cancer.
abstract: OBJECTIVE
  Treating the effects of menopause in women with history of oestrogen-dependent cancers presents a clinical dilemma. Endocrine adjuvant agents like tamoxifen and other cancer treatments, often induce premature menopause. Vasomotor, psychological and somatic symptoms may be more severe in these women. The risk of hormone therapy (HT) and its efficacy must be balanced. Currently, there are no consensus guidelines for the management of these patients.
  
  
  METHODS
  This is a retrospective study carried out between 10/01/2011 and 27/01/2012 in a tertiary referral menopausal clinic.
  
  
  METHODS
  Data was collected about cancer type and treatment, symptoms, prior use of T, bone density analyses and menopause treatments.
  
  
  RESULTS
  590 patient records were scanned and 146 patients (24.7%) had a history of cancer. Of these, 45.9% were younger than 50 years old. 67.1% comprised breast cancer patients, of which 69.4% were on adjuvant endocrine agents. 24.7% consisted of gynaecological cancer patients who were predominantly treated with surgery in conjunction with adjuvant therapies. 90.4% of the women had at least one menopause-related symptom, vasomotor symptoms being most prevalent, followed by psychological and vaginal symptoms. Women used a variety of HT and non-HRT therapies for their symptoms. Of the 77 women who had a personal history of oestrogen receptor positive cancers, 19.5% chose to take HT in spite of it being contraindicated.
  
  
  CONCLUSIONS
  Prescribing HT to women with a history of hormone dependent cancer remains controversial. Patient 'Quality of Life' must be considered. More research is required in this area.
authors: GKT School of Medicine, King's College, London, UK.
authors: Hashviniya
authors: H
authors: Sekar
authors: Division of Women's Health, St Thomas' Hospital, London, UK.
authors: Tasneem
authors: T
authors: Singhal
authors: Guy's and St Thomas' Hospital, London, UK.
authors: Debra
authors: D
authors: Holloway
authors: School of Medicine, Kings College, London, UK Janice.rymer@kcl.ac.uk.
authors: Janice
authors: J
authors: Rymer
keywords: CAMs; HT; QoL; cancer; hormone dependent