Hrt, yes or no?

Good Morning ladies,

Hope you’re all keeping well.

I am 13 month post cancer treatment. Was diagnosed with stage 2b Adenocarcinoma last year and did 25 Radiotherapies, 5 Chemo’s and 4 Brachytherapies.

Had my check up last week with Oncologist and thankfully so far all is good :pray:

I mentioned to my Oncologist that I have started to suffer with stiff and painful joints, hot flushes, mood swings and complete lack of libido. He said he thinks hrt would be worth a try as the advantages would far outweigh the tiny risks.

Just had a telephone appointment with my gp who in all honesty sounded completely taken aback that my Oncologist would even suggest me taking hrt!! She said it will increase my risk of womb cancer, breast cancer etc etc. She said I could take a non hormonal tablet (anti depressant) which would hopefully help with the hot flushes and mood swings.

Not really sure how I feel about taking AD’s as they’re not gonna do anything for the joint stiffness and pain which is my main problem at the minute.

Any advice any of you lovely ladies could give me would be greatly appreciated, thanks.

:blush:

Hi @Lala123,

Firstly, it’s great news that you’re NED 13 months post-treatment :tada: Secondly, well done for lasting this long without HRT! :sweat_smile:

I finished treatment for adenocarcinoma about 6 months ago, and my oncologist suggested I go on HRT almost immediately! I think this might have something to do with my age (36), as oestrogen has a protective effect on the bones and heart.

I started getting hot flushes and achey joints very quickly after treatment ended, and I was referred by my oncologist to a menopause specialist who works with many cancer patients. I was quite wary of HRT because of the supposed cancer link, but she reassured me that the benefits far outweigh the tiny risks.

From my experience, quite a lot of GPs are a bit behind the times on menopause stuff, and if they haven’t had recent training, they can be cautious about prescribing it.

I wonder if your oncologist could refer you to a specialist to discuss it? I think it helps to talk to someone with an indepth knowledge of these things. I’ve also done quite a lot of research online – maybe not the best thing to recommend, but it’s helped put my mind at rest about it all!

Hope you get it sorted x

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Hi chick,

Thank you for the reply :smiling_face_with_three_hearts:

My Oncologist said he didn’t see any reason for me not to have the HRT so I was quite shocked at how hesitant my gp was.

I was 42 when diagnosed last year so would imagine I wouldn’t have gone through the menopause for another few years.

My Mother has severe joint problems, she’s had both hips replaced and is awaiting her knees being replaced too. This is what worries me as I don’t wanna be in pain like she is if the HRT can help prevent this.

My GP is writing to the gynaecologist I originally saw at my local hospital pre diagnosis to see what he recommends so fingers crossed :crossed_fingers:

How are you finding the HRT if you don’t mind me asking? I will definitely ask about a menopause specialist if I don’t have any joy.

Hope everything else is going well for you post treatment.

It’s a tough old journey! Xx

I can’t lie, my HRT experience has been…bumpy. I started on Evorel Conti patches, which gave me bad acne (joy), so I moved to oestrogel and oral progesterone, but a recent blood test showed I haven’t been absorbing the gel very well, so I’m moving on to a different patch now along with testosterone! :roll_eyes:

It’s very much trial and error, and I’m still pretty achy and tired, BUT it has completely stopped my hot flashes, and my moods have improved. There are so many different types of HRT around now, so it’s just about finding the one that works for you.

My mother also has joint problems and osteoporosis. She only took HRT for a year after having her ovaries removed because doctors were much more worried about the risks at that time. I’m totally with you on avoiding that kind of pain if possible!

It is a tough journey, but we’ll get there, even if we have to hobble! xx

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Hmm yes it sounds like you have a well meaning but very out of date GP. There was a study done in the 70s on post menopausal 60+ yo women taking an old style pill that detected a slight increase risk of BC. This has since been invalidated as it was not representative of the population of women taking HRT. Basically trans dermal HRT eg patch or gel has no increased risk of cancer and is as close to real estrogen as it gets and way better than it was in the 70’s.
Estrogen is required for so many other things in the body so I would definitely say go for it to ease your symptoms. If your mood doesn’t improve after HRT I would be surprised. But if it doesn’t then go for the antidepressants - they won’t replace the estrogen though!
Sorry I feel like a sales person but I do get annoyed that GPS are not more educated.
I would watch Davina McCalls documentary on menopause or research some Louise Newson - a menopause specialist GP.

Good luck :smiley:

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Oh bless you, it sounds like you’ve had a bit of a nightmare. Hopefully your new patch and the testosterone will be the right one for you :crossed_fingers:

I must admit up until last year I knew absolutely nothing about HRT. I suppose I thought I wouldn’t even need to think about it for a few years yet, but obviously my body had other ideas :see_no_evil::roll_eyes:

I’ve just made an appointment to have my bloods tested for Vit D levels and FSH. Hopefully this will set the ball rolling if nothing else.

Xx

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Yup I totally agree. I did think, if my Oncologist is happy for me to take it then why would my GP be so against it!? If my Oncologist thought there was any major risk of recurrence or secondary cancer, surely he would be the one trying to dissuade me!

I watched the Davina documentary at the time which actually completely changed my outdated view of HRT if I’m honest!

I will do some research on Louise Neeson. Thank you so much for the advice and info!

Xx

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I read that the cancer risk associated with taking HRT is considered at the same level as someone that drinks alcohol, so to me the risk isn’t very high. I think a lot of GPs are very out of date with their views on it to be honest :see_no_evil: I had terrible hot flushes and they totally stopped… I’m on HRT since I finished treatment and honestly could not be without it. I got referred to the menopause clinic as I was having awful insomnia, they said they would like me to remain on it for the heart and bones benefits so I’ve just kept with it.

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Your GP needs a little updating! There is an excellent systematic review of the evidence here. If you can’t access it from this link please message me with your email address and I can send it to you.

https://doi.org/10.1080/13697137.2020.1826426

Here is the abstract.

Gynecological tumor treatment, including cervical cancer (CC) treatment, often leads to iatrogenic premature menopause. This highlights the critical importance of investigating indications for hormone replacement therapy (HRT), as most patients, thanks to the improvement in diagnosis and treatment, have to deal with the sequelae of their cancer treatments for many years. This systematic review aims to provide an overview of the current knowledge regarding the risks of HRT and CC. In particular, we aim to investigate whether the use of HRT can increase CC incidence, and evaluate its risk in CC survivors. A systematic review, in agreement with PRISMA guidelines, of the English literature present in PubMed and SCOPUS has been performed. A total of 2805 articles have been screened, of which 10 were considered eligible. Several studies reported a significantly reduced risk of developing cervical squamous cell carcinoma in postmenopausal women treated with HRT, while a weak increase in the incidence of adenocarcinoma has been shown. No evidence reports a harmful effect of HRT on CC oncological outcome, while several benefits, in terms of reduced metabolic risk and increased quality of life, have been described, thus concluding that HRT should be offered to young CC survivors for the management of early menopause.

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Thank you so much for your reply.

I have definitely read something similar regarding the risks being similar to that of drinking alcohol. If I’m perfectly honest, it didn’t make me put my bottle of Cabernet Sauvignon down!!

I’m gonna wait and see what the Gynaecologist thinks about it but I do think my GP was rather clueless.

I’m so pleased the HRT is working so well for you. Reading all these positive stories is really encouraging.

Xx

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Thank you so much!

I’ve managed to open the link, thank you very much.

Will have a good read of that as I’m currently stuck in bed with Covid so welcome any interesting reading material!!

Thanks again Xx

Brilliant! (Not about the covid obviously!!)

Get well soon and i hope it helps you and your GP!

Karen x

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It wouldn’t make me put the cab sav down either!!! Haha hope your gynae appointment goes well and you recover from covid quickly :kissing_heart: xxx

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Thanks Karen, much appreciated xx

Thanks chick xx

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Hi,

I was diagnosed with 2b adenocarcinoma and I was referred to a menopause specialist to discuss my options. The consultant wasn’t in favour for HRT as she explained to me that adenocarcinoma is hormonal sensitive compared to squamous cell thus she suggested the antidepressant pills. Honestly as the menopause side effects are not so severe for me I choose not to take them. I hope it helps.

Xxx

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