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Some hormone treatments increase cancer risks
Patricia Reaney
2005-04-29

Two types of hormone replacement therapies (HRT) increase a woman's risk of developing womb cancer, scientists said on Friday.


HRT, which replaces hormones diminished by menopause, is given as oestrogen-only, combined oestrogen and progesterone or in some countries as a synthetic steroid treatment known as tibolone. In a study of more than a million women taking HRT, scientists found that patients using oestrogen-only and tibolone had a higher risk of the cancer of the womb than those not taking HRT. The dilemma is that oestrogen-only HRT causes a greater increase in cancer of the endometrium (the lining of the womb) but combined causes a greater increase in breast cancer, Professor Valerie Beral, of the charity Cancer Research UK which conducted the research, said. When you add them together, combined causes a substantially greater increase in cancer than does oestrogen-only, she added.

Women are prescribed HRT to relieve menopause symptoms such as hot flushes, night sweats and mood swings. Tibolone, which is available in Europe but not in the United States, is sold by Akzo Nobel unit Organon as Liviala. Scientists have known about the raised risk of endometrial cancer for some time, but the Million Women Study is the first to compare the risk of both diseases in the same women. Since breast cancer is much more common than endometrial cancer, combined HRT poses the greatest overall cancer risk, Beral said, adding that not taking HRT is the best option to reduce the odds of developing cancer.

The study, which is reported in The Lancet medical journal, showed that around three out of every 100 women on combined HRT will develop either breast or endometrial cancer over a five-year period, compared to 2,5 per 100 taking oestrogen-only HRT or tibolone and 1,5 per 100 not on any of the drugs. Since the study began in the late 1990s, about 1 300 of the women aged 50-64 years old have developed endometrial cancer and more than 10 000 have suffered from breast cancer.

Overweight or obese women in the study had a greater risk of endometrial cancer. Experts believe oestrogen stimulates the growth of cells in the womb which can lead to cancer and obese women usually have higher level of oestrogen in the blood. Most women who have not had a hysterectomy are prescribed combined HRT or tibolone. In a commentary on the research, Louise Brinton and researchers at the National Cancer Institute in the United States said the main question is how to prescribe hormones so women receive the biggest benefit and the least risk.

To minimize cancer and other risks, clinicians should prescribe the lowest possible dose of oestrogen for short periods of times, said Brinton.

(Source: IOL, April 29, 2005)

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