Hormone therapy is a treatment option for women at risk of breast cancer, but is dealt with caution as symptoms are severe and may possibly induce other forms of cancer. Doctors usually prescribe combination hormone therapy (estrogen and progestin) to relieve symptoms of menopause among menopausal women. Though combination therapy is an issue, the article that brought this to my attention raised another issue: prescription of estrogen to prevent heart disease and breast cancer. A trial was conducted by the Women’s Health Initiative on 10,739 postmenopausal women with prior hysterectomies.
The trial sought to evaluate the effect equine estrogen had on chronic diseases such as heart failure and cancer. Women involved in the trial were excluded if they had any prior incidence of cancer and if they did not have a hysterectomy. Women were randomly assigned to an estrogen only group and a placebo group. Presence of invasive cancer, stroke, pulmonary embolism, and death were observed for 7 years to measure rate cancer and heart failure.They found that women in the estrogen only group had a 23% lower risk of breast cancer compared with those in the placebo group, while the heart risks had age discrepancies. Women in their 50s within the estrogen group were likely to experience 12 fewer heart attacks, 13 fewer deaths, and 18 fewer adverse events for every 10,00 women compared to those in the placebo group. However, women in their 70s within the estrogen group were likely to experience 16 extra heart attacks, 19 extra deaths, and 48 serious adverse events for every 10,000 women. Based on these findings, it is apparent that the age must be considered when doctors are prescribing estrogen to reduce heart risks of a patient and that postmenopausal women with hysterectomies are likely to benefit from estrogen only treatment to prevent cancer. The molecular mechanism of why estrogen treatment alone helps lower the risk of cancer is not fully understood, but one theory of why this occurs is that increasing level of estrogen in postmenopausal women may induce cell death in possible tumors.
This study does not affect premenopausal women who are prescribed hormonal treatment for cancer prevention, but it did raise the significance of including one’s health history when deciding effective treatment options. This must be kept in mind when gathering information for our wikipage since my partner and I will analyze the cost/benefit of tamoxifen, as preventative measure, for postmenopausal and premenopausal women who face a variety of health issues in addition to being at risk of breast cancer.
