I also had adenocarcinoma (diagnosed in May 2017) and was told right away that I wasn’t a good candidate for HRT because of the type of cancer I had. Once treatment started, the symptoms started - I had my first mild hot flash about a week after my first chemo. My symptoms were hot flashes, trouble sleeping at night, fatigue, and an unyielding need for ice cream and potato chips.
About a month or two into my treatment the hot flashes were almost unbearable - at its worst I was probably catching fire about 15 to 20 times per day and they would wake me up throughout the night. When I spoke again with my oncologist about it at my 3-month checkup, he said that if I felt I couldn’t handle them, we could look into some alternatives to HRT that might help with some symptoms, and if that didn’t help then we could weigh the risk vs benefits of HRT. I said I’d give it another 3 months and let him know, and at my 6-month check up I had to admit that the symptoms were quite a bit less.
At almost 9 months post treatment, I still feel warm at night, but I sleep with only a sheet or a very light blanket and have a fan by the bed, and staying cool helps me to sleep through the night. I don’t really catch fire regularly anymore - I may have only had one hot flash in the last month. Fatigue is still a bit of an issue, but I had an aggressive treatment and really can’t say if it’s the menopause or the treatment recovery that is causing that. I can say that it is getting better, though, slowly but surely.
At this point, all I’m taking is a calcium supplement. Easy peasy.
I would suggest to her to just see how her symptoms play out and if they are just too disruptive in her life, then she can decide to either research some alternatives or pursue the HRT. Every woman is different, and maybe she will be lucky and it just won’t have to be a decision she has to make. For me, I’m very happy not to have to take the HRT.
Full disclosure: I was just finishing an ice cream cone when I read your post...