Introduction: Estrogen Reconsidered: Exploring the Evidence for Estrogen's Benefits and Risks
Cancer J. 2022 May-Jun 01;28(3):157-162. doi: 10.1097/PPO.0000000000000602.NO ABSTRACTPMID:35594461 | DOI:10.1097/PPO.0000000000000602 (Source: Cancer Journal)
Source: Cancer Journal - May 20, 2022 Category: Cancer & Oncology Authors: Avrum Zvi Bluming Source Type: research

Estrogen for the Treatment and Prevention of Breast Cancer: A Tale of 2 Karnofsky Lectures
Cancer J. 2022 May-Jun 01;28(3):163-168. doi: 10.1097/PPO.0000000000000600.ABSTRACTIn 1971, Sir Alexander Haddow et al. delivered the inaugural David A. Karnofsky lecture at the American Society for Clinical Oncology. This award was designated American Society for Clinical Oncology's highest, as he had used translational research to identify the first clinical therapy, that is, synthetic estrogens to treat breast cancer. His lecture was entitled "Thoughts on Chemical Therapy." For 40 years, high-dose synthetic estrogens were used as palliative therapy, for some advanced breast cancer patients 5 years following menopause. M...
Source: Cancer Journal - May 20, 2022 Category: Cancer & Oncology Authors: Balkees Abderrahman V Craig Jordan Source Type: research

Menopausal Hormone Therapy and Breast Cancer
Cancer J. 2022 May-Jun 01;28(3):169-175. doi: 10.1097/PPO.0000000000000601.ABSTRACTAssociations of estrogen-alone and estrogen plus progestin with breast cancer incidence and related mortality are reviewed from observational studies (The Collaborative Group on Hormonal Factors in Breast Cancer and The Million Women Study, 2019) and the Women's Health Initiative's (2020) two randomized trials evaluating conjugated equine estrogen alone, for women with prior hysterectomy or with medroxyprogesterone acetate. Findings are generally concordant for estrogen plus progestin use with both observational and randomized studies report...
Source: Cancer Journal - May 20, 2022 Category: Cancer & Oncology Authors: Rowan T Chlebowski JoAnn E Manson Source Type: research

Update on Pregnancy Following Breast Cancer Diagnosis and Treatment
This article reports an updated overview on the current state of the art on pregnancy in women with prior breast cancer diagnosis and treatment, with a main focus on the issues faced by patients with history of hormone receptor-positive disease and BRCA carriers.PMID:35594464 | DOI:10.1097/PPO.0000000000000599 (Source: Cancer Journal)
Source: Cancer Journal - May 20, 2022 Category: Cancer & Oncology Authors: Marta Perachino Francesca Poggio Luca Arecco Eva Blondeaux Stefano Spinaci Camilla Marrocco Alessia Levaggi Matteo Lambertini Source Type: research

Hormone Replacement Therapy After Breast Cancer: It Is Time
This article reviews the decades of evidence supporting the reproducible benefits of HRT for menopausal symptom control, improved cardiac health, prevention of hip fracture, reduction in the risk and pace of cognitive decline, and enhanced longevity. It quantifies the increased risk of thromboembolism associated with oral, though not transdermal, HRT. It evaluates the repeated claims that HRT is associated with an increased risk of breast cancer development, and, when administered to breast cancer survivors, an increased risk of breast cancer recurrence. Twenty-five studies of HRT after a breast cancer diagnosis, published...
Source: Cancer Journal - May 20, 2022 Category: Cancer & Oncology Authors: Avrum Zvi Bluming Source Type: research

The Menopause Management Vacuum
Cancer J. 2022 May-Jun 01;28(3):191-195. doi: 10.1097/PPO.0000000000000594.ABSTRACTThe burden of untreated menopause symptoms in midlife women is substantial and can result in reduced quality of life as well as lost work productivity, lost opportunities for advancement at work, and increased health care costs. Unfortunately, the health care system is largely unprepared to help women manage these symptoms, which have a mean duration of 7 to 9 years. Hormone therapy usage rates have plummeted following publication of the results of the Women's Health Initiative trials due to safety concerns. In addition, postgraduate medical...
Source: Cancer Journal - May 20, 2022 Category: Cancer & Oncology Authors: Stephanie S Faubion Chrisandra Shufelt Source Type: research

Individual Benefits and Risks of Intravaginal Estrogen and Systemic Testosterone in the Management of Women in the Menopause, With a Discussion of Any Associated Risks for Cancer Development
Cancer J. 2022 May-Jun 01;28(3):196-203. doi: 10.1097/PPO.0000000000000598.ABSTRACTSeveral formulations of intravaginal oestrogen are available for the treatment of genitourinary syndrome of menopause (GSM). These are safe and effective treatments for the symptoms of GSM. Licensed doses of intravaginal oestrogen do not elevate systemic estradiol levels above the normal postmenopausal range with long term use and there is no evidence of an increased risk of coronary heart disease, stroke, thromboembolism, colorectal cancer, endometrial cancer, breast cancer or breast cancer recurrence with their use. This should reassure bo...
Source: Cancer Journal - May 20, 2022 Category: Cancer & Oncology Authors: Abbie J Laing Louise Newson James A Simon Source Type: research

Menopause Hormone Therapy in the Management of Postmenopausal Osteoporosis
Cancer J. 2022 May-Jun 01;28(3):204-207. doi: 10.1097/PPO.0000000000000592.ABSTRACTThis narrative review analyzes the customization of menopause hormone therapy (MHT) for osteoporosis prevention and treatment in the context of the patients' age and menopausal age. In short, MHT is indicated in most women suffering from menopause before the age of 45 years except for breast cancer survivors. These women should be treated with MHT until the age of 50 years. For women who have entered menopause at around the age of 50 years, risks associated with MHT are low, and MHT is a safe option, provided there is an indication for it. W...
Source: Cancer Journal - May 20, 2022 Category: Cancer & Oncology Authors: Serge Rozenberg Jean Vandromme Perrine Revercez Mathilde Valcarenghi Aur élie Joris Source Type: research

Menopausal Hormone Replacement Therapy and Reduction of All-Cause Mortality and Cardiovascular Disease: It Is About Time and Timing
Cancer J. 2022 May-Jun 01;28(3):208-223. doi: 10.1097/PPO.0000000000000591.ABSTRACTThe totality of evidence indicates menopausal hormone replacement therapy (HRT) effects are determined by timing of initiation according to age and/or time since menopause, underlying health of target tissue, and duration of therapy. Initiated in women at younger than 60 years and/or at or near menopause, HRT significantly reduces all-cause mortality and cardiovascular disease (CVD), whereas other primary CVD prevention therapies such as lipid-lowering fail to do so. The magnitude and type of HRT-associated risks, including breast cancer, st...
Source: Cancer Journal - May 20, 2022 Category: Cancer & Oncology Authors: Howard N Hodis Wendy J Mack Source Type: research

Mechanistic Effects of Estrogens on Breast Cancer
This article reviews studies that address estrogen-mediated breast cancer development, the prevalence of occult tumors at autopsy, and the natural history of breast cancer as predicted by a newly developed tumor kinetic model.METHODS: This article reviews previously published studies from the authors and articles pertinent to the data presented.RESULTS: We discuss the concepts of adaptive hypersensitivity that develops in response to long-term deprivation of estrogen and results in both increased cell proliferation and apoptosis. The effects of menopausal hormonal therapy on breast cancer in postmenopausal women are interp...
Source: Cancer Journal - May 20, 2022 Category: Cancer & Oncology Authors: Richard J Santen Cynthia A Stuenkel Wei Yue Source Type: research

Concerns About Compounded Bioidentical Menopausal Hormone Therapy
Cancer J. 2022 May-Jun 01;28(3):241-245. doi: 10.1097/PPO.0000000000000597.ABSTRACTFollowing the release of the Women's Health Initiative data, women began to use compounded bioidentical hormone therapy (cBHT) in the misguided belief of greater safety and efficacy than traditional hormone therapy. New guidelines recommend government-approved hormone therapy for symptomatic healthy menopausal women younger than 60 years or within 10 years of menopause at the time of initiation. For women requesting bioidentical hormones, those similar to the hormones present before menopause, there are many government-approved hormone thera...
Source: Cancer Journal - May 20, 2022 Category: Cancer & Oncology Authors: JoAnn V Pinkerton Source Type: research

Effective Image Communication of Hormone Replacement Therapy Risks and Benefits
This article focuses on the value of a unique graphic/image designed to communicate health risks and benefits related to the administration of hormone replacement therapy. It will demonstrate why equations, technical terms, and confusing rhetoric need not be used for communication to patients and others. The use of a "familiar" theater graphic (given the name Benefit/Risk Characterization Theater) will allow physicians and patients to share decision-making by visualizing tradeoffs through the use of a clearer format: example Benefit/Risk Characterization Theaters: breast cancer risks associated with hormone replacement the...
Source: Cancer Journal - May 20, 2022 Category: Cancer & Oncology Authors: Erik Rifkin Source Type: research

Introduction: Estrogen Reconsidered: Exploring the Evidence for Estrogen's Benefits and Risks
Cancer J. 2022 May-Jun 01;28(3):157-162. doi: 10.1097/PPO.0000000000000602.NO ABSTRACTPMID:35594461 | DOI:10.1097/PPO.0000000000000602 (Source: Cancer Journal)
Source: Cancer Journal - May 20, 2022 Category: Cancer & Oncology Authors: Avrum Zvi Bluming Source Type: research

Estrogen for the Treatment and Prevention of Breast Cancer: A Tale of 2 Karnofsky Lectures
Cancer J. 2022 May-Jun 01;28(3):163-168. doi: 10.1097/PPO.0000000000000600.ABSTRACTIn 1971, Sir Alexander Haddow et al. delivered the inaugural David A. Karnofsky lecture at the American Society for Clinical Oncology. This award was designated American Society for Clinical Oncology's highest, as he had used translational research to identify the first clinical therapy, that is, synthetic estrogens to treat breast cancer. His lecture was entitled "Thoughts on Chemical Therapy." For 40 years, high-dose synthetic estrogens were used as palliative therapy, for some advanced breast cancer patients 5 years following menopause. M...
Source: Cancer Journal - May 20, 2022 Category: Cancer & Oncology Authors: Balkees Abderrahman V Craig Jordan Source Type: research

Menopausal Hormone Therapy and Breast Cancer
Cancer J. 2022 May-Jun 01;28(3):169-175. doi: 10.1097/PPO.0000000000000601.ABSTRACTAssociations of estrogen-alone and estrogen plus progestin with breast cancer incidence and related mortality are reviewed from observational studies (The Collaborative Group on Hormonal Factors in Breast Cancer and The Million Women Study, 2019) and the Women's Health Initiative's (2020) two randomized trials evaluating conjugated equine estrogen alone, for women with prior hysterectomy or with medroxyprogesterone acetate. Findings are generally concordant for estrogen plus progestin use with both observational and randomized studies report...
Source: Cancer Journal - May 20, 2022 Category: Cancer & Oncology Authors: Rowan T Chlebowski JoAnn E Manson Source Type: research