Friday, December 15, 2006

Not forever, not for everybody

Hormones again in headline news, this time newsworthy by the the benefits of their absence.

Recent analysis of cancer incidence statistics for 2003 show a significant 7% drop in breast cancer cases for this particular year, the first full year of data following the abrupt termination of the Women's Health Initiative. Millions of women went off HRT as a result of the WHI data, and within a year, breast health improved.

While doctors acknowledge that cancers take years to form, they theorize that cancer cases may have decreased as itty bitty cancers that were forming in response to estrogenic stimulation shrank or disappeared. Indeed, the biggest decline was in tumors whose growth is fueled by estrogen--no estrogen, no support of tumor growth.

This news emphasizes the importance of individual decision-making in medical care. Any big decision--and to take hormones or not is a huge one--requires weighing many factors including personal and family health history, current symptoms, individual beliefs and worst fears, and future health goals.

Estrogen stimulates cell growth and repair. That is a good thing for neurons, muscle cells, osteocytes (bone), connective tissue, and healthy blood vessels. That is a bad thing for breast and uterine cells.

If a lack of estrogen makes a woman fuzzy-headed, sad, anxious, stiff, sleepless, or hot beyond belief, she may choose to use hormones for some indefinite period of time. If she has a family history of Alzheimer's disease, she may elect ongoing use. If she has a personal or family history of breast cancer, or if that is her worst fear, she may pass up HRT no matter how uncomfortable she is.

This is certainly dramatic news, and I will add this information into my discussions with menopausal women as they consider their plans for future care. I'm certainly taking it into consideration in my personal health care; for now, the pros continue to outweigh the cons in favor of ongoing HRT use. The patch stays attached into 2007!

I appreciate all of you who sent me e-mails regarding these statistics, and I look forward to talking to you about it as we adjust your therapies in the months to come.