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  • Q&A with Australian Health Practitioners

    What menopause treatments are available for post breast cancer patients?

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    Breast Cancer Cancer Menopause
    I am 52 years of age, had breast cancer in 2006 and went into menopause early.

    I have menopausal symptoms that are adversely affecting my quality of life, I have tried all the alternative treatments with no lasting improvements.

    What options do I have?
    • 2 answers
    • Dr Barry Wren
    • Dr Carolyn Ee
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    Dr Barry Wren

    Endocrinologist, Gynaecologist

    Dr Barry Wren was one of the original founders of the International Menopause Society in 1976 and subsequently founded the Australian Menopause Society, becoming its … View Profile

    Breast cancer develops when a normal breast cell undergoes a series of mutations producing an alteration in the shape, structure and response of the cell. However most breast cancers still have the capacity to respond to most hormonal messengers, including oestrogen. For that reason most breast cancers will grow faster in the presence of oestrogen and for that same reason, most oncologists treating breast cancer avoid prescribing oestrogen.
    Women who develop breast cancer are usually advised to stop HRT or to use a chemical (tamoxifen) that will block the action of oestrogen, but some women who are deprived of oestrogen find that the symptoms are so bad that they are prepared to use oestrogen in spite of a potential increased risk of spread of their cancer. In several large studies including one of my own, involving 1400 women with breast cancer, it has been found that women using oestrogen following treatment of their breast ancer do not have a worse outcome than women who avoid oestrogen. Similar results have been reported in all other studies where oestrogen has been prescribed for women after treatment of breast cancer. I advise that those women who have appropriate treatment (surgery followed by radiotherapy) for either cancer in-situ, stage 1 or even stage 2 cancers will have a high chance of cure and if their cancer is cured, the risk of recurrence when using oestrogen will be low. However, it is important to appreciate that this advice is not standard and only about 10% of women elect to use oestrogen to relieve symptoms after breast cancer. The point to appreciate is that oestrogen does not cause breast cancer - it makes it grow more vigorously. If your breast cancer has been cured, then you may use an oestrogen based HRT with no increased risk of recurrence but the decision is yours alone. For further details of this problem I would suggest you obtain a book I have written with my co-author Margaret Stephenson Meere in which we discuss this dilemma in greater detail.
    MENOPAUSE : CHANGE, CHOICE AND HRT Published by Rockpool Publishing  

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    Dr Carolyn Ee

    Acupuncturist, GP (General Practitioner)

    I'm a Sydney GP with a special interest in women's health especially menopause and TTC ( trying to conceive). I specialise in acupuncture, and am … View Profile

    It would depend on what your symptoms are - if you are suffering from hot flushes, you may benefit from some of the non-hormonal treatments available such as SSRI and SNRI antidepressants (eg Venlafaxine/Efexor), or other medications that affect the nervous system such as Gabapentin or Clonidine. If you are wanting to avoid hormones altogether I would advise you to avoid any “natural” or herbal supplements as the evidence for their effect on menopausal symptoms and hot flushes is weak at best, and their effect on your cancer recurrence risk is unknown.

    Several small controlled studies have demonstrated the effectiveness of acupuncture in treating hot flushes in breast cancer patients, so this may be an option for you.

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