Menopausal hormone therapy for BRCA-mutation carriers: attitudes of Israeli healthcare providers before and after a brief educational intervention

Objective: BRCA-mutation carriers are offered risk-reducing bilateral salpingo-oophorectomy (RRBSO) at age 35 to 40 years, leading to major life-quality and health-related issues associated with early menopause. Hormone therapy (HT) may significantly alleviate menopausal symptoms without increasing breast or ovarian cancer risk in BRCA carriers. We investigated attitudes of Israeli healthcare providers to HT post-RRBSO in BRCA carriers, before and after a brief educational intervention. Methods: In this pre-post survey of gynecologic departments in Israel, healthcare providers were given questionnaires (based on scores of 1-4) assessing attitudes to prescribing HT in different clinical scenarios, before and after an educational intervention on current knowledge about HT in BRCA-mutation carriers. Higher scores indicated higher tendency to prescribe HT. Mean and median scores were calculated for each scenario, and the association between scores and various healthcare providers’ characteristics were assessed. The change in attitude pre versus postintervention was evaluated, and the Cohen's d effect size was calculated. Results: Of the 200 healthcare providers who were offered participation, 162 responded. Of them, 25.3% were obstetricians, 13.6% gynecologists, 5.55% gynecologic-oncologists, 8% medical oncologists, 38.9% obstetrics-gynecology residents, and 8.6% were nurses. Median age was 44 (interquartile range 36-58); 42.6% were males. Higher score correlated we...
Source: Menopause - Category: OBGYN Tags: Original Studies Source Type: research

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AbstractPurposeDisentangling the effects of endogenous estrogens and inflammation on obesity-related diseases requires a clearer understanding of how the two biological mechanisms relate to each other.MethodsWe studied 155 healthy postmenopausal women not taking menopausal hormone therapy enrolled in the Prostate Lung Colorectal and Ovarian (PLCO) screening cancer trial. From a baseline blood draw, we measured endogenous estradiol and 69 inflammation biomarkers: cytokines, chemokines, adipokines, angiogenic factors, growth factors, acute phase proteins, and soluble receptors. We evaluated the estradiol –inflammation ...
Source: Cancer Causes and Control - Category: Cancer & Oncology Source Type: research
Conclusions: Although based on a small number of women, these findings suggest that oophorectomy does not increase psychological distress among women at an elevated risk of ovarian cancer.
Source: Menopause - Category: OBGYN Tags: Original Studies Source Type: research
Conclusions: The risks of hormone therapy should be assessed on an individual basis, with consideration of age, type of hormone therapy, dose, duration of use, regimen, route, and prior exposure. Systemic hormone therapy is not recommended in breast cancer survivors, whereas vaginal low-dose estrogen appears safe. Hormone therapy may be used by endometrial, cervical, and ovarian cancer survivors with low-risk, non-estrogen-receptor–positive subtypes. Video Summary:http://links.lww.com/MENO/A516.
Source: Menopause - Category: OBGYN Tags: Review Article Source Type: research
CONCLUSIONS: Hormone replacement therapy may slightly improve overall survival in women who have undergone surgical treatment for EOC, but the certainty of the evidence is low. HRT may make little or no difference to quality of life, incidence of breast cancer, TIA, CVA and MI as the certainty of the evidence has been assessed as very low. There may be little or no effect of HRT use on progression-free survival. The evidence in this review is limited by imprecision and incompleteness of reported relevant outcomes and therefore the results should be interpreted with caution. Future well-designed RCTs are required as this is...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
We report a unique case of a 60-year-old woman developing endometrial cancer in a uterine deposit 18 years after she had undergone laparoscopic subtotal hysterectomy with morcellation for benign pathology. She had used unopposed estrogen as menopausal hormone therapy. She presented with a pelvic mass that was causing pressure symptoms. On imaging, the mass had an enhancing vascular nodular component and appeared to abut normal ovaries and the residual cervix. She proceeded to laparotomy, where a 12 cm pelvic mass was found morbidly adherent to the bladder anteriorly and to the cervical stump. The pelvic mass was excise...
Source: Case Reports in Womens Health - Category: OBGYN Source Type: research
Waseem Abbas, Ranga Raju RaoIndian Journal of Cancer 2019 56(4):293-296Adjuvant ovarian suppression, on addition to chemotherapy, reduces the risk of breast cancer in pre-menopausal women after surgery and adjuvant hormonal therapy. Suppression of Ovarian Function Trial (SOFT) and Tamoxifen and Exemestane Trial (TEXT) showed greater benefit with exemestane in high risk females in comparison to Tamoxifen. Ovarian Function Suppression (OFS) and exemestane became the standard of care, with 30% patients experiencing grade 3 and more side effects. Much higher benefit was seen in high risk group. But there are concerns about inc...
Source: Indian Journal of Cancer - Category: Cancer & Oncology Authors: Source Type: research
Introduction: Recent evidence demonstrates that women with myotonic dystrophy type 1 are at increased risk of reproductive organ tumors. However, studies of reproductive cancer risk factors in those patients are lacking.Methods: Using questionnaires, we collected and analyzed personal history information related to cancer risk factors from women enrolled in a UK and US registry for myotonic dystrophy (dystrophia myotonica; DM) patients.Results: The survey was completed by 242 DM type 1 (DM1) and 44 DM type 2 (DM2) women enrolled in the UK Registry (N = 124) and the US National Registry (N = 162). The mean age at DM1 diagno...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
How can you have a moonshot trying to cure cancer and not mention people dying of cancer?I believed the narrative that is pushed on women, that if you check your breasts and if you catch it early, you’re fine.ide class="right-rail__container right-rail__container--ad"> Lianne Kraemer had been living with metastatic breast cancer for more than a year when I met her in December 2017 at the Henry B. González Convention Center in San Antonio. Throughout the week, more than 7,000 doctors, scientists and pharmaceutical-company representatives would descend on the city for the country’s most impor...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized Breast Cancer health Source Type: news
ConclusionPerineal use of talc powder is a possible cause of human ovarian cancer.
Source: Reproductive Toxicology - Category: Toxicology Source Type: research
In this report, we examined if hormone secretion from cHT constructs is impacted by incorporation of bone marrow-derived mesenchymal stem cells (BMSC) since these cells contain regulatory factors such as aromatase necessary for estrogen production. Incorporation of BMSCs led to enhanced estrogen secretion in vitro. Moreover, cHT constructs with BMSCs achieved estrogen secretion levels significantly greater than constructs without BMSCs in ovariectomized rats from 70 to 90 days after implantation, while also regulating pituitary hormones. cHT constructs with BMSC ameliorated estrogen deficiency-induced uterine atrophy ...
Source: Annals of Biomedical Engineering - Category: Biomedical Engineering Authors: Tags: Ann Biomed Eng Source Type: research
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