New Study Firmly Ties Hormone Use to Breast Cancer

[DeepModem Mom]

Source: NYT/AP

Taking menopause hormones for five years doubles the risk for breast cancer, according to a new analysis of a big federal study that reveals the most dramatic evidence yet of the dangers of these still-popular pills.

Even women who took estrogen and progestin pills for as little as a couple of years had a greater chance of getting cancer. And when they stopped taking them, their odds quickly improved, returning to a normal risk level roughly two years after quitting.

Collectively, these new findings are likely to end any doubt that the risks outweigh the benefits for most women.

It is clear that breast cancer rates plunged in recent years mainly because millions of women quit hormone therapy and fewer newly menopausal women started on it, said the study's leader, Dr. Rowan Chlebowski of Harbor-UCLA Medical Center in Los Angeles....

Read more: http://www.nytimes.com/aponline/2008/12/13/health/AP-MED-Breast-Cancer-Hormones.html

[ayeshahaqqiqa]

1. What kind of hormone therapy?

The article mentions pills, but doesn't tell exactly what is in them. And the study didn't include use of hormonal creams and other forms of estrogen and progesterone pills. Although the article cites the study, it doesn't give a link to the actual findings, only a summary. I'd really like to know the Rx of the pills and check and see if other forms have also been studied before I agree with a blanket statement like this.

[DeepModem Mom]

2. If I run across other articles on the subject, I'll post them in this thread.

This is the only one I've seen so far.

[ayeshahaqqiqa]

3. Thanks

I am very leery of articles like this, because they tend to overgeneralize without giving the relevant details.

[CountAllVotes]

4. I agree!

This type of generalized statement does not address the issue of how other forms of hormone treatment may affect women such as creams, etc.

I find this worrisome nonetheless. :scared:

How reliable is this information?

:shrug:

:dem:

[Warpy]

6. I think you can pretty much rely on the study

concentrating on accepted pharmacological interventions, not the health food store creams and phytoestrogen preparations.

More information can be found at the Women's Health Initiative website: http://www.nhlbi.nih.gov/whi/

[diane in sf]

21. I notice they said progestin--the synthetic, altered form of progesterone,

in other words molecularly altered enough to be a patentable drug, not the natural hormone in a biologic dose.

[earcandle]

5. When I used hormones I just used Wild Yam drops.

You can buy them at whole foods.  They calm the sweats,
restore hair, and muscle strength while avoiding the toxic
chemicals of pharmaceuticals.  I don't use anything anymore,
and am doing fine, methinks.  My husband still thinks I am
sexy, and he stays healthy enough to avoid prostate problems. 


I would avoid pharmaceuticals as much as possible these days. 

[DeepModem Mom]

8. Thanks for posting your thoughts, earcandle -- and welcome to DU!!!

[Ian David]

38. Anecdotal evidence. And you also believe in ear candling, making you not a credible source.

Thanks for playing, though!

Good luck peddling your yam-stuff.

[BuddhaGirl]

45. lots of women have used wild yam

with good results. So if 10 of your friends told you the same thing - that they all got good results from a particular supplement/medicine/whatever - you wouldn't try it?? Oh well...

Thanks for playing! :hi:

[Ian David]

46. I know one woman who tried it, and look what happened to her...

[BuddhaGirl]

49. LOL !

eom

[emilyg]

7. After my breast cancer - I refused hormones for night sweats. Glad I did.

[Bobbieo]

9. I was told that by a Dr. in Maryland some 30 years ago -- SOOO

I never took hormones but Boy am I wrinkled, today!!!

[emilyg]

28. I call them my experience lines and boy

am I experienced!

[Tangerine LaBamba]

37. A friend of mine smoked and did serious HRT

She took so much of that crap that her periods started up again! I told her she was insane, that Mother Nature has a reason for menopause, that screwing with Mother Nature can't lead to anything good.

Her sister, who didn't smoke and who didn't take hormones, was diagnosed with breast cancer.

My friend kept smoking, had a face lift, and stayed on the HRT.

She was diagnosed with breast cancer in November 2006.

I'm glad you refused them, too. I remember a doctor trying to give my 74-year-old mother HRT, and, when I said I thought that was maybe a bit inappropriate, he bellowed, "EVERY WOMAN SHOULD TAKE ESTROGEN!"

He was a big fat man, head of the OB-GYN department at a major metropolitan hospital (DC area), and he died a couple of years later. My mother, at my urging, never took hormones and lived happily to the age of 87.

[emilyg]

52. Which shows us we must take charge of

our health. Hormones never sounded good to me. Good for your Mom.

[jwirr]

10. Estrogen alone or with progestin? They have always told us that the

latter is dangerous. Are they now telling us that estrogen alone is also dangerous?

[newfie11]

11. I am a x-ray technologist with a certification in mammography

I have been a full time mammo tech for 25 of the 40 years I have been a registered radiographer. I will tell you that the knowledge of HRT causing breast cancer was known in Europe at least 5 years before it was ever mentioned here in the states.

15 years ago I attended a seminar by Lazlo Tabar MD, one of three I attended over the years. This man is one of the Gurus of mammography and from Sweden.

He was asked at the first seminar about HRT (estrogen with progesterone or progestin, a synthetic hormone) causing breast cancer by a physician. Dr. Tabar's reply was it might but it does protect the heart and bones so just make sure all the women get their mammogram.

3 years later I again attend another of his seminars. Again one of the physicians asked the question about HRT causing breast cancer. Dr. Tabar's reply was yes it can and we are not sure it helps with the cardiovascular system.

10 years ago I went to the last Tabar Seminar. Once more he was asked the question by a physician about HRT causing breast cancer. His reply at that time was yes it does, it also does not help the cardiovascular system or prevent bone loss. I do not recommend it for any woman unless her quality of life is so that she cannot do without it.

This was several years before the "word" about the rise in breast cancer may correlate to the large use of HRT.

Here is a link to NIH and some research they have on HRT.

http://www.cancer.gov/ClinicalTrials/digest-postmenopausal-hormone-use

Now a personal note.

I had a GYN who insisted I take HRT. I had no hot flashes or any problems associated with menopause. He routinely put all his patients on it whether they needed it or not.
He was furious I refused it and I finally took his prescription just to leave his office. I of course threw it away.

My point is, over the years when breast cancer was skyrocketing from 1 in 10 to 1 in 9 to 1 in 8, the use of HRT was also going up tremendously.

[Hekate]

12. My former GYN prescribed Prometrium and Cenestin, two vegetable-based HRTs. However...

I took myself off them after all the bad publicity and after it turned out HRT doesn't help with either bone loss or heart health. I'm now 61 and my menopausal symptoms have never been intolerable, so it hasn't been that bad. I use a hormone suppository for dryness.

However -- and this is the really aggravating part -- all the bad publicity has referred to animal-based HRT. I couldn't find a thing about whether the studies included vegetable-based prescription HRTs. I only quit taking them as a precaution.

Hekate

[YvonneCa]

23. About 8 years ago...

...I went with a friend to a patient education class at Kaiser-Permanente about HRT (friend was menopausal and doctor was recommending HRT). This information class pushed the idea that HRT was necessary because of the heart benefits...it seemed that was standard Kaiser protocol at the time. I know so many women who took HRT because this is what they were being told. I also know a lot who had breast cancer, sadly.

[Caria]

44. Did we go to the same class?

The doc who was running it seemed to me to be using over-the-top scare tactics: Take HRT or you will go insane from the hormone loss, alienate you family and friends, become a humpback, break your hips, wrinkle like a prune, and live a generally miserable life until your early death from a heart attack.

I raised my hand and asked what breast cancer survivors like myself should do. He said I should talk to my doctor privately. As soon as his presentation ended, someone else (who had no knowledge of me, my medical history or my tumor makers) gave me information and a hard sell on how lower dose HRT in patch form was supposedly safe for me. Glad I didn't go that route.

[yardwork]

30. It's possible that your GYN was being paid to prescribe the drug.

[Sgent]

40. That's a pretty startling accusation

I've seen a lot of obscene things that drug companies do to induce prescriptions, but never even heard of a direct you prescribe this drug and we will pay you relationship.

[defendandprotect]

31. Because our doctors are on the Drug Co dole ...

and we're getting dangerous medicines that do great harm with FDA cooperation --

Politics doesn't make good medicine --

and we need more emphasis on prevention and less on cure --

[Ms. Toad]

33. My mother was diagnosed with breast cancer in 1999,

and I recall her remarking at the time that, based on what they know "now" (~1999), the length of time she had been on HRT probably contributed to her breast cancer. So you are correct - this is not news (in the sense that it was previously unknown).

[Whoa_Nelly]

13. So is the risk the same for women who take HRT after a hysterectomy?

Was 38 when I had my hysterectomy, so taking HRT seemed like the right thing to do at the time due to my age.

I quite taking Estrodiol (Estrace) about 4 years ago. At that time my dosage had been 0.5 mg/day (had to cut the 1 mg. tab in half)

But, after I completely stopped, I began getting hives...huge hives all over my body.

I don't know if there's an association with that, and am on Allegra 180 mg./day to keep the hives at bay.
It works most of the time, and am considered to have idiopathic hives (unknown cause)

Two years after stopping HRT, my mammo, which had previously been showing a non-changing small cyst in one breast, had disappeared.

[Th1onein]

15. The ONLY HRT you should take is PROGESTERONE

NOT progestin. Not black yams (this is a rip-off). Certainly not estrogen, or any form of it.

[Whoa_Nelly]

16. was told that with no ovaries, the only HRT for me to take was estrogen

:shrug:

[Th1onein]

24. Whoever told you that didn't know what they were talking about.

eom

[liberalhistorian]

26. I'm sorry, but that's wrong. I'm 43 and had a complete

hysterectomy six years ago at the age of 37. At that age, I still needed estrogen but wasn't producing any naturally, obviously, since I no longer had any ovaries. My taking estrogen is not HRT after menopause, it's simply replacing what I'd still be producing if I hadn't had to have the hysterectomy. You really do still need estrogen up to a certain age, especially if you've had a hysterectomy at a younger age. I simply will not go without estrogen, as I am not functional without it. Now the time may come in a couple of years, when I hit my mid to late forties, when that will change. But not right now. I've done my own research and have been under the care of three GYN's who've all said the same thing. I think they, and the others, know what they're talking about.

My new GYN has me on both 0.9 estrogen pill daily and 0.5 gram of estrogen/progesterone vaginal cream nightly. The cream has helped a lot as well. Not sure if I should be on both, however.

[Th1onein]

34. I'm sorry, but you are incorrect. Ovaries aren't the only source for estrogen.

Fat is a source, as well. When you lose your ovaries, though, you lose ALL progesterone production, and it should be replaced. Hormone health is not a matter of more is better; it is a matter of balance between the hormones.

HRT is one of the biggest mistakes ever to have been made in modern medicine. It is dangerous, no matter how old or how young you are.

[Ms. Toad]

35. The better advice for women having a hysterectomy,

is to do a partial hysterectomy and leave the ovaries in place (unless the ovaries are part of the problem). That way you don't have to debate whether the risks of associated with ERT are greater than the benefits.

Granted, there are some cases in which taking the ovaries is mandatory - but many surgeons just do a complete hysterectomy because if the uterus is gone, who needs the ovaries. My philosophy is that there is no point in taking out functional organs just because some (generally male) physician no longer thinks they are useful - particularly when you need drugs to replace the natural chemicals associated with the organ.

For background: My mother fought for (and won) a partial hysterectomy when she was 37. For years she could tell when she was ovulating, and she could certainly tell when she went into natural menopause some 25 years later (when she took HRT for 5 years contributing to her eventual diagnosis of breast cancer...which is a different story). When I was 42, my doctor tried to convince me to have a full hysterectomy since I didn't plan on having any more babies - after all, it's now just a useless organ; might as well get rid of it. I found a physician with a different perspective, and had outpatient surgery with a recovery time of about 24 hours (aside from the anesthesia grog, which prevented me from driving for 48 hours). That completely corrected the problem. I'm still enjoying my naturally produced estrogen 10+ years later.

[Acadia Blue]

54. There is an online international support group for urticaria, or hives

and it is at [e-mail]
There are many causes for hives and flauctuations in hormones can be one. Many women get them after childbirth.

I hope you go to the group because they can help.

[goclark]

14. Took them in the 90's and decided to stop

10 years ago.

My doctor told me that it was a bad idea to quit.

Sometimes you have to "be your own doctor."

My mother was taking 11 pills everyday when I came home to take care of her.

That was eight years ago.

She is now taking a pill for her blood pressure, that's it and she is 90 years old.

Why was she taking all those other pills?

Every time I took her to the doctor's, I asked questions and when it wes determined that maybe she didn't need a pill, we slowly took her off of them with the doctor's permission.

She was taking Aricept and got so depressed she was closing the door and hiding in her bedroom all day.

Took her to a Neurologist and he took her off of it right away.

She has problems remembering things but for 90 years old, she is doing extremely well.

I remember that a friend told me if he didn't like a doctor, he "FIRED HIM."

That's what I do too.

[zazen]

17. high breast density poses as great a risk as age, and is correlated with HRT

HRT is linked to higher breast density in post-menopausal women. Women going off HRT had reduced density. Which caused what? Density in _ absence_ of HRT is associated with something like 5 times the risk.

I find it frustrating that with all of the recent studies linking increased density to increased risk (and noting that the density itself is a covariant of these other risks), neither MSM nor most docs are informing patients about this. I just had a mammogram after 18 months of avoiding one (and have had early stage breast cancer) and neither the radiologist nor the tech (at a pretty "state of the art" facility in Raleigh, NC) seemed to know anything more about it than that it has some ill defined masking effect, despite dozens of scholarly articles on the subject, which I had bothered to read but they apparently had not.

It's not just that marked density (75-100% dense) masks cancers on mammograms. The nature of the tissue itself apparently leads to more cancers, and it's not just a factor in premenopausal women, since if you start out with really dense tissue, you'll tend to stay that way until your 70s.



see http://www.halls.md/breast/density.htm

Also, excerpted from http://www.msnbc.msn.com/id/16673818/

Dense breast tissue hikes risk of cancer
Strong predictor ‘ignored to an absolutely unbelievable degree’

Cancer turns up five times more often in women with extremely dense breasts than in those with the most fatty tissue, a study shows, signaling the importance of a risk factor rarely discussed with patients.

On mammograms, fat looks dark, but dense tissue is light, like tumors, so it can hide the cancers. But this study confirms that cancers are also more frequent — not just hidden — in women with dense breasts.

That means that density is a true risk factor, along with other strong predictors like age and the genes BRCA1 and 2. Yet specialists say that breast density is rarely considered with other risk factors in discussions between doctors and patients. . .

[DeepModem Mom]

19. Thanks for this post, zazen. nt

[newfie11]

36. HRT does increase density in breast tissue due to the estrogen

However at the last Tabar seminar I went to there was a mammographic image of what he called angry tissue. At that time Dr. Tabar felt giving a women with this type of tissue would result in a high probability of developing breast cancer. This is not a pattern I saw often but it was not rare by any means. This is not just the average dense looking breast tissue.

Most women at menopause, if not on HRT do not have dense breasts. There are always exceptions but many many women on HRT developed dense breasts after starting HRT. The proof was in their previous mammograms. Again this was not the angry tissue pattern Dr. Tabar spoke of. That tissue was there before ever starting on HRT.

One of the many questions the mammo tech should asked is what meds are you on. Some can cause breasts to become more dense.

Digital mammography does help to see through the very dense breasts. However even with the CAD (computer-aided detection) and a very experienced radiologist it is still possible for a lesion to not show. Even with a fatty breast.

Some cancers will not show even on a fatty breast until they are very large. I remember a patient that showed up with a lump about the size of a marble. I marked it with a BB, did add views, etc. She had totally fatty breasts and nothing showed. On ultrasound it did show. A week later she had a mastectomy and lived for one more year. It was a very fast growing, aggressive breast cancer. She was premenopausal.

HRT aside there are more and more young, premenopausal women developing breast cancer. That is a puzzle.

[Skittles]

42. I am 95% dense

almost solid white

[leftyladyfrommo]

47. I don't mean to be sarcastic - but so far just about everything causes an

increase in breast cancer. Everyday I read about something new. Genetics, environment, exercise, diet, radiation, HRT, radiation from Mammograms - the list just goes on and on.

I finally just quit worrying about it after years and years of worrying about it. Of course it helps that I can't afford any medical stuff now - my insurance payment is so high every month, and the deductible is so high there is no way I can afford to have tests for anything.

I am so completely sick of this mess. I finally just decided to quit worrying about my health and try living for a change.

[Ecumenist]

18. What about bioidentical hormone pellets that are titered for each individual?

[Runcible Spoon]

20. not to mention the cruel practices used to get some of these hormones..

ie, Premarin farms :grr:

[Locrian]

22. better article here...

Female Hormone Restoration
http://www.lef.org/protocols/female_reproductive/female_hormone_restoration_01.htm


Online References Updated: 01/20/2006

Few topics have attracted as much attention in recent years as hormone replacement therapy (HRT) among postmenopausal women. For decades, physicians have been prescribing HRT to combat the symptoms of menopause as well as protect patients against osteoporosis and heart disease. The rationale behind heart disease prevention was simple: during their reproductive years, women enjoy lower rates of heart disease than men do, primarily because of the protective effect of estrogen hormones. It seemed only logical that by replacing the estrogens lost at menopause, women would retain some of their protection against heart disease. To offset the increased risk of certain cancers caused by unopposed estrogen therapy, doctors frequently added progestins to the therapy (Andrade et al 2002; Formby 1998). Progestins are synthetic chemicals designed in a lab to mimic natural progesterone.

Unfortunately, the logic of conventional HRT turned out to be faulty. In 2002, the results of the Women’s Health Initiative were released early. This landmark study followed more than 16,000 women and assessed the effects of conventional HRT, including estrogen-only therapy and therapy that combined estrogen and synthetic progestin. The findings were shocking: the estrogen/progestin arm of the study was discontinued early because the hormone therapy not only failed to protect against heart disease but was shown to increase the risk of heart attack and breast cancer (La Vecchia et al 2001). Long-term conventional HRT also increases risk for uterine cancer (Hulley et al 2002; Van et al 2002). Side effects include weight gain, premenstrual symptoms such as depression and bloating, and breast tenderness (Walsh et al 2001).

[goclark]

25. Thanks for this article as well~

I happen to be allergic to just about every medicine I've ever been on.

It is a scary situation.

I kept telling my doctor that my arm was hurting while on cholesterol meds for the first time.

He kept telling me that it probably wasn't the meds but he took me off of that kind and put be on the other.

One day I got a cramp in my foot that was beyond intense.

I went to another doctor who took me off of that type.

Huuum, no more pains but now I have to control it on my own.

It's getting better but I know the Meds would help me if I could only take them. :shrug:

[BlueIris]

27. Estrogen is a carcinogen. People need to wake up. nt

[yardwork]

29. The development and marketing of these hormones has been an absolute scandal.

A real f*** up from start to finish.

[defendandprotect]

32. Also ... giving up animal eating can ease or eliminate hot flashes, sweats ...

[Mari333]

39. Anyone who has hot flashes, sweats, etc, please read

I went through menopause at 50 or so, did NOT experience anything more then cessation of menses. I read somewhere that around 50% of woman dont have symptoms, like me, and the other half do.
Nonetheless, I started having sweating and hot flashes around 55. It wasnt menopause, it was THYROID. hypothyroidism.
so, if you have hot flashes and sweating, it could be your thyroid gland.
get it checked before assuming its menopause symptoms.
force your physician to be thorough. they dismiss women's concerns too handily.

[YvonneCa]

41. Great point. I had terrible hot flashes in my forties. I kept...

...asking the doctor if it could be 'early menopause' because it felt like I had a broken thermostat. :) Turns out I had thyroid cancer. Once I was treated (successfully) for that...all my hormones returned to balance and all was well.

But I, too, had a doctor that just dismissed my concerns as stress for a LONG time.

[Le Taz Hot]

43. I did HRT for about 5 months

and kept reading about the subject the whole time. The more I read, the more nervous I got and finally I just quit taking them. Yes I have unbearable hot flashes and insomnia but I'm told the hot flashes diminish with time. The HRT just isn't worth the risk. The sad thing is that doctors are still recommending this shit.

[mainer]

48. What about the insomnia? That's what made me give in.

I suffered for a year with both the hot flashes and horrible insomnia. I tried all the usual natural remedies -- black cohosh, soy, etc., etc. I could live with the hot flashes, even though I was getting a dozen a day. But the insomnia just about drove me insane. My work requires a great deal of mental concentration, and I couldn't focus because I was so exhausted. I was sleepwalking through the day, and actually felt I was growing stupider as the months went by because of sleep deprivation.

Finally I surrendered and called my OB-gyn in desperation. He gave me HRT, and within three weeks I was sleeping again. And I could almost feel my IQ return to normal.

I've been on HRT about 5 months now. I really want to get off the hormones, but I worry about once again losing my brainpower.

I recently read some research by a sleep scientist who is convinced that one of the major reasons for dementia in older people has to do with interrupted sleep patterns as we get older. So now I feel as if I have to make a choice -- dementia vs. breast cancer!

[Le Taz Hot]

50. Luckily, I live in a medical marijuana state

so I will smoke a pipe load and drink something with milk in it; i.e., Carnation Instant Breakfast, hot chocolate, whatever is handy. The combination seems to allow me to go back to sleep most nights. I usually don't have a problem going to sleep, it's the staying asleep part that is the problem.

[mainer]

51. Sounds good to me -- too bad it's not legalized here!

I agree, it's the staying asleep part that's the problem for me. Also, I've heard that marijuana is protective against dementia, so it would be doubly good.

I fear going senile far more than I fear cancer!

[Locrian]

53. so what about birth control pills???

I mean - isnt there a ton of synthetic hormones in there as well? Oh, yeah. Right - the pharmaceutical industry makes MONEY off them so they must be safe...

"The Combined Oral Contraceptive Pill (COCP), often referred to as the birth-control pill, or simply "the Pill", is a combination of an estrogen (oestrogen) and a progestin (progestogen), taken by mouth to inhibit normal female fertility."

[zelta gaisma]

55. what did our great grandmothers do about the uncomfortableness of menopause?