Estrogen use for early stage endometrial cancer patients
Dear OncoLink "Ask The Experts,"
A recent study showed that ERT does not increase endomentrial cancer recurrence. Based on this info, my gynecological oncologist recommends estrogen, to relieve my menopausal symptoms and yet my local oncologist and primary care provider recommend an aromatase inhibitor. I am 40 years old and recently had tumor tissue from a recurrence tested and it was estrogen receptive. What are your recommendations and where can I get more information?
Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:
For patients with early stage endometrial cancer, the use of estrogen for treatment of menopausal symptoms appears to be safe, though only a small number of patients have been evaluated. Survival does not appear to be decreased in patients taking estrogen. The American College of Obstetricians and Gynecologists Committee Opinion concluded that women with a history of endometrial cancer could use estrogen for the same reasons as any other postmenopausal women if the prognosis for her disease is good, given that the patient understands the potential risks. The Gynecologic Oncology Group is currently conducting a large-scale study to determine the safety of estrogen replacement in patients with early stage endometrial cancer.
For your case, it is difficult to make recommendations without knowing the details of your cancer and the extent of your symptoms.