Dear OncoLink "Ask The Experts,"
I am 44 years old, and a 2-year survivor of Stage 1, grade 3 epithelial ovarian cancer (sporadic, as opposed to hereditary).
You wrote that hormone replacement therapy does not increase the risk for ovarian cancer, therefore, why does my oncologist NOT want me on any hormones?
Stephen C. Rubin, MD, Professor and Chief of the Division of Gynecologic Oncology, University of Pennsylvania Health System, responds:
There is no evidence that estrogen replacement therapy increases the risk of recurrence in patients treated for ovarian cancer, and most gynecologic oncologists do not hesitate to prescribe them, particularly in younger patients who are symptomatic.
That being said, there is fear in the primary care community with regards to breast cancer risk for patients on hormone replacement (as well as other health risks associated with it). The largest study looking at this is the Women's Health Initiative, but this study only found the risk to be associated with the estrogen and progesterone combination therapy. They did not find an increased risk using estrogen alone (used in women without a uterus). It comes down to an individual decision based on symptoms and length of use. Discuss your concerns with your oncologist and see if your case fits.