Hormone blockers

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Hello all and thank you Macmillan for having a place to exchange thoughts and anxieties. 

I was diagnosed with breast cancer in July, had since 2 ops and now waiting for radio therapy. All of this so far I have taken in my stride, But I have been told that my cancer is hormone sensitive and I will need blockers. Having done so well on HRT ( mainly mood and brain fog for me, never had hot flushes) I am very concerned how I will cope having it even more suppressed! 

I am currently taking nothing and feel I could do with the odd top up of HRT? Has anybody in a similar situation any advice? How about  plant based HRT? 
Thank you in advance 

  • Hello Hopeful Barb,

    No I haven’t watched the podcast but I will seek it out later this evening. Thank you for recommending it.

    I am so sorry to hear that you were affected by hurricane Helene. I hope the aftermath wasn’t too bad for you.

    I have lifted the following from the letter that my breast care nurse wrote to my GP:

    A history of breast cancer is always a consideration for future HRT use. The BMS have issued a consensus statement which I will briefly summarise:
     
    1. HRT with oestrogen alone is associated with no or little change in risk.
    2. HRT with oestrogen and progestogen ‘can be associated with an increase in the risk.’
    3. Risk of diagnosis is not elevated in past users of HRT.
    4. Any increase in risk ‘is related to treatment duration and reduces after stopping HRT.’
    5. No significant increase in breast cancer mortality was found. This has been confirmed subsequently with long-term follow-up of the WHI study (Women's Health Initiative) and a large meta-analysis, where use of unopposed or combined HRT was not associated with any adverse effect on all cause, total cancer or breast cancer mortality.
     
    NICE has taken a pragmatic approach, recommending lifestyle and non-hormonal alternatives for
    first-line management of vasomotor symptoms, recognising HRT could be considered if symptoms
    are refractory. Ultimately her biggest risk factors for developing further breast cancer are her age. BMI and alcohol are also other significant risk factors, which poise a higher than the use of HRT, so those could also be addressed if relevant.
     
    If she wished to try HRT then please consider the lowest dose possible and ideally oestrogen only preparation (with Mirena coil for example) but ultimately this decision lies between the patient and the prescriber.
     
    I appreciate that this is based on UK health recommendations and that other countries may differ.
    It is a very difficult decision but as an active 55 year old  
    I just want a better quality of life so am prepared to take the risk in the short term. 
  • Super email from your BCN. And it totally seems that is the advice we all get. 

    what I don’t get though is how can it both be true that there’s no link between BC and HRT and yet statement 4 also be true. If there’s no link then surely it makes no difference if you’ve taken it for 5 years or 5 minutes. Am I missing something?! 

    i do absolutely agree that it’s a quality of life call and there are so many factors involved…… truthfully mainly being a woman, age and luck! 

  • Hiya

    I have her2 positive breast cancer - driven by oestrogen and am due to meet my oncologist tomorrow to discuss what next after radiotherapy which I completed a month ago. I listened to a talk given recently by a BC oncologist and a  surgeon and they were absolutely adamant about no HRT being taken by someone like me. Not even a plant based version as it could bring about recurrence so I am not going to chance anything as I've worked so hard to get to where I am.  I know other people have their own thoughts but I am going to stick with lubricants, moisturisers etc and anything else that will sort symptoms though not sure what to do about the mood swings and brain fog!

  • Hello,  Menopause and Cancer podcasts are great.  Dani Binnington is a breast cancer survivor and moderator and terrific.  She carried BRCA gene.  I watch her often.  
    I agree with most of what was said but the risk of recurrence is always an issue.  Mortality is a big factor too for sure but for me mine round of breast cancer is enough.  
    I find it interesting that most breast surgeons don’t support any HRT after ER positive BC.  Even triple negative is an issue as more prone to reoccurrence and could come back as ER positive not triple negative.  
    I honestly understand how you feel as with low estrogen we don’t feel like ourselves.  As estrogen is in every part of our body it is no wonder we feel like crap sometimes.  

    The last 6 years I did hormone pellets with estradiol and testosterone.  Took progesterone capsules too.  I really believe the pellets are stronger than patches or creams as I felt absolutely fabulous on them.  Maybe too good.  My GYN who put in my pellets was also diagnosed with Bilateral DCIS a month or so after me.  She was also on pellets.  

    Whatever decision you make it is a personal decision and I wish you the best in searching for feeling better.  

    Barbara 

  • Thank you all for all your tips - much appreciated!

  • I also spotted this. It surely doesn’t ring true that the risk is not elevated yet any increase in risk is related to duration of treatment. Maybe something scientific that I don’t understand. I’m also struggling to understand why Oestrogen HRT is deemed to be ok but not Progesterone. Most BCs that are hormone dependent are 100% ER and any %PR. I get the BMI to a certain extent as after menopause Oestrogen is not produced by the ovaries but in fat cells. The fat cells respond to an enzyme called Aromatase naturally produced by the body. Aromatase then converts to Oestrogen. That’s why we are given aromatase inhibitors, Maybe it’s the affects of blocking Aromatase rather than Oestrogen itself that causes the side effects. I don’t know, it’s a real minefield.