Journal List > J Korean Med Assoc > v.62(3) > 1118967

Ahn and Hwang: Menopausal hormone therapy in the cancer survivors

Abstract

Due to advances in the treatment and diagnosis of cancer, many women survive long after treatment, and therefore express concerns about the impact of estrogen deficiency on their quality of life. Cancer treatment can induce menopause through surgical removal of the ovaries, chemotherapy, or radiation. Women who undergo induced menopause usually experience more sudden and severe menopausal symptoms, including vasomotor symptoms, psychological symptoms, genitourinary symptoms, cardiovascular disease, and osteoporosis. Menopausal hormone therapy (MHT) is especially important in women younger than 40. In this review, we consider the role of MHT after the diagnosis of breast, gynecologic, colorectal, stomach, liver, lung, and hematologic cancers. MHT is advantageous in endometrial cancer type I, cervical squamous cell carcinoma, colorectal cancer, hepatocellular carcinoma, and hematologic malignancies. However, MHT is not recommended for use in breast cancer, endometrial stromal sarcoma, hormone receptor–positive gastric cancer, and lung cancer survivors because it is linked to an increased risk of cancer recurrence. Depending on the type of cancer, clinicians should recommend that cancer survivors receive appropriate MHT in order to reduce vasomotor symptoms and to benefit from its positive effects on the cardiovascular and skeletal systems.

References

1. Korean Statistical Information Service. Statistics by theme [Internet]. Daejeon: Statistics Korea;cited 2019 Mar 1. Available from: http://kosis.kr/eng/index/index.do.
2. Shifren JL, Gass ML. NAMS Recommendations for Clinical Care of Midlife Women Working Group. The North American Menopause Society recommendations for clinical care of midlife women. Menopause. 2014; 21:1038–1062.
crossref pmid
3. National Cancer Information Center. 2018 Cancer statistics [Internet]. Goyang: National Cancer Information Center;2019. cited 2019 Mar 1. Available from: https://www.cancer.go.kr/lay1/S1T639C640/contents.do.
4. Ganz PA. Breast cancer, menopause, and long-term survivorship: critical issues for the 21st century. Am J Med. 2005; 118:Suppl 12B. 136–141.
crossref pmid
5. Makki J. Diversity of breast carcinoma: histological subtypes and clinical relevance. Clin Med Insights Pathol. 2015; 8:23–31.
crossref pmid pmc
6. Manson JE, Chlebowski RT, Stefanick ML, Aragaki AK, Rossouw JE, Prentice RL, Anderson G, Howard BV, Thomson CA, LaCroix AZ, Wactawski-Wende J, Jackson RD, Limacher M, Margolis KL, Wassertheil-Smoller S, Beresford SA, Cauley JA, Eaton CB, Gass M, Hsia J, Johnson KC, Kooperberg C, Kuller LH, Lewis CE, Liu S, Martin LW, Ockene JK, O'Sullivan MJ, Powell LH, Simon MS, Van Horn L, Vitolins MZ, Wallace RB. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women’s Health Initiative randomized trials. JAMA. 2013; 310:1353–1368.
crossref pmid pmc
7. Holmberg L, Iversen OE, Rudenstam CM, Hammar M, Kumpulainen E, Jaskiewicz J, Jassem J, Dobaczewska D, Fjosne HE, Peralta O, Arriagada R, Holmqvist M, Maenpaa J. HABITS Study Group. Increased risk of recurrence after hormone replacement therapy in breast cancer survivors. J Natl Cancer Inst. 2008; 100:475–482.
crossref pmid
8. Lupo M, Dains JE, Madsen LT. Hormone replacement therapy: an increased risk of recurrence and mortality for breast cancer patients? J Adv Pract Oncol. 2015; 6:322–330.
crossref pmid pmc
9. Fahlen M, Fornander T, Johansson H, Johansson U, Rutqvist LE, Wilking N, von Schoultz E. Hormone replacement therapy after breast cancer: 10 year follow up of the Stockholm randomised trial. Eur J Cancer. 2013; 49:52–59.
crossref pmid
10. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016; 66:7–30.
crossref pmid
11. Singh P, Oehler MK. Hormone replacement after gynaecological cancer. Maturitas. 2010; 65:190–197.
crossref pmid
12. Beral V, Bull D, Reeves G. Million Women Study Collaborators. Endometrial cancer and hormone-replacement therapy in the Million Women Study. Lancet. 2005; 365:1543–1551.
crossref pmid
13. Chapman JA, DiSaia PJ, Osann K, Roth PD, Gillotte DL, Berman ML. Estrogen replacement in surgical stage I and II endometrial cancer survivors. Am J Obstet Gynecol. 1996; 175:1195–1200.
crossref pmid
14. Creasman WT, Henderson D, Hinshaw W, Clarke-Pearson DL. Estrogen replacement therapy in the patient treated for endometrial cancer. Obstet Gynecol. 1986; 67:326–330.
crossref pmid
15. Lee RB, Burke TW, Park RC. Estrogen replacement therapy following treatment for stage I endometrial carcinoma. Gynecol Oncol. 1990; 36:189–191.
crossref pmid
16. Suriano KA, McHale M, McLaren CE, Li KT, Re A, DiSaia PJ. Estrogen replacement therapy in endometrial cancer patients: a matched control study. Obstet Gynecol. 2001; 97:555–560.
crossref pmid
17. Barakat RR, Bundy BN, Spirtos NM, Bell J, Mannel RS. Gynecologic Oncology Group Study. Randomized double-blind trial of estrogen replacement therapy versus placebo in stage I or II endometrial cancer: a Gynecologic Oncology Group Study. J Clin Oncol. 2006; 24:587–592.
crossref pmid
18. Shim SH, Lee SJ, Kim SN. Effects of hormone replacement therapy on the rate of recurrence in endometrial cancer survivors: a meta-analysis. Eur J Cancer. 2014; 50:1628–1637.
crossref pmid
19. Tabata M, Ichinoe K, Sakuragi N, Shiina Y, Yamaguchi T, Mabuchi Y. Incidence of ovarian metastasis in patients with cancer of the uterine cervix. Gynecol Oncol. 1987; 28:255–261.
crossref
20. Bodner K, Laubichler P, Kimberger O, Czerwenka K, Zeillinger R, Bodner-Adler B. Oestrogen and progesterone receptor expression in patients with adenocarcinoma of the uterine cervix and correlation with various clinicopathological parameters. Anticancer Res. 2010; 30:1341–1345.
pmid
21. Lacey JV Jr, Brinton LA, Barnes WA, Gravitt PE, Greenberg MD, Hadjimichael OC, McGowan L, Mortel R, Schwartz PE, Kurman RJ, Hildesheim A. Use of hormone replacement therapy and adenocarcinomas and squamous cell carcinomas of the uterine cervix. Gynecol Oncol. 2000; 77:149–154.
crossref pmid
22. Ploch E. Hormonal replacement therapy in patients after cervical cancer treatment. Gynecol Oncol. 1987; 26:169–177.
crossref pmid
23. Jelovac D, Armstrong DK. Recent progress in the diagnosis and treatment of ovarian cancer. CA Cancer J Clin. 2011; 61:183–203.
crossref pmid pmc
24. Guidozzi F, Daponte A. Estrogen replacement therapy for ovarian carcinoma survivors: a randomized controlled trial. Cancer. 1999; 86:1013–1018.
crossref pmid
25. Mascarenhas C, Lambe M, Bellocco R, Bergfeldt K, Riman T, Persson I, Weiderpass E. Use of hormone replacement therapy before and after ovarian cancer diagnosis and ovarian cancer survival. Int J Cancer. 2006; 119:2907–2915.
crossref pmid
26. Pergialiotis V, Pitsouni E, Prodromidou A, Frountzas M, Perrea DN, Vlachos GD. Hormone therapy for ovarian cancer survivors: systematic review and meta-analysis. Menopause. 2016; 23:335–342.
pmid
27. Eeles RA, Morden JP, Gore M, Mansi J, Glees J, Wenczl M, Williams C, Kitchener H, Osborne R, Guthrie D, Harper P, Bliss JM. Adjuvant hormone therapy may improve survival in epithelial ovarian cancer: results of the AHT Randomized Trial. J Clin Oncol. 2015; 33:4138–4144.
crossref pmid
28. Besevic J, Gunter MJ, Fortner RT, Tsilidis KK, Weiderpass E, Onland-Moret NC, Dossus L, Tjonneland A, Hansen L, Overvad K, Mesrine S, Baglietto L, Clavel-Chapelon F, Kaaks R, Aleksandrova K, Boeing H, Trichopoulou A, Lagiou P, Bamia C, Masala G, Agnoli C, Tumino R, Ricceri F, Panico S, Bueno-de-Mesquita HB, Peeters PH, Jareid M, Quiros JR, Duell EJ, Sanchez MJ, Larranaga N, Chirlaque MD, Barricarte A, Dias JA, Sonestedt E, Idahl A, Lundin E, Wareham NJ, Khaw KT, Travis RC, Rinaldi S, Romieu I, Riboli E, Merritt MA. Reproductive factors and epithelial ovarian cancer survival in the EPIC cohort study. Br J Cancer. 2015; 113:1622–1631.
crossref pmid pmc
29. Murphy N, Strickler HD, Stanczyk FZ, Xue X, Wassertheil-Smoller S, Rohan TE, Ho GY, Anderson GL, Potter JD, Gunter MJ. A prospective evaluation of endogenous sex hormone levels and colorectal cancer risk in postmenopausal women. J Natl Cancer Inst. 2015; 08. 01. [Epub]. DOI: 10.1093/jnci/djv210.
crossref
30. Stevanato Filho PR, Aguiar Júnior S, Begnami MD, Ferreira FO, Nakagawa WT, Spencer RMSB, Bezerra TS, Boggiss PE, Lopes A. Estrogen receptor β as a prognostic mar-ker of tumor progression in colorectal cancer with familial adenomatous polyposis and sporadic polyps. Pathol Oncol Res. 2018; 24:533–540.
crossref pmid
31. Topi G, Ehrnstrom R, Jirstrom K, Palmquist I, Lydrup ML, Sjolander A. Association of the oestrogen receptor beta with hormone status and prognosis in a cohort of female patients with colorectal cancer. Eur J Cancer. 2017; 83:279–289.
crossref pmid
32. Kim HW, Kim JH, Lim BJ, Kim H, Kim H, Park JJ, Youn YH, Park H, Noh SH, Kim JW, Choi SH. Sex disparity in gastric cancer: female sex is a poor prognostic factor for advanced gastric cancer. Ann Surg Oncol. 2016; 23:4344–4351.
crossref pmid
33. Brusselaers N, Maret-Ouda J, Konings P, El-Serag HB, Lagergren J. Menopausal hormone therapy and the risk of esophageal and gastric cancer. Int J Cancer. 2017; 140:1693–1699.
crossref pmid
34. Deli T, Orosz M, Jakab A. Hormone replacement therapy in cancer survivors: review of the literature. Pathol Oncol Res. 2019; 01. 08. [Epub]. DOI: 10.1007/s12253-018-00569-x.
35. Adami HO, Persson I, Hoover R, Schairer C, Bergkvist L. Risk of cancer in women receiving hormone replacement therapy. Int J Cancer. 1989; 44:833–839.
crossref pmid
36. Shi L, Feng Y, Lin H, Ma R, Cai X. Role of estrogen in hepatocellular carcinoma: is inflammation the key? J Transl Med. 2014; 12:93.
crossref
37. Montella M, D’Arena G, Crispo A, Capunzo M, Nocerino F, Grimaldi M, Barbieri A, D’Ursi AM, Tecce MF, Amore A, Galdiero M, Ciliberto G, Giudice A. Role of sex hormones in the development and progression of hepatitis B virus-associated hepatocellular carcinoma. Int J Endocrinol. 2015; 2015:854530.
crossref
38. Hassan MM, Botrus G, Abdel-Wahab R, Wolff RA, Li D, Tweardy D, Phan AT, Hawk E, Javle M, Lee JS, Torres HA, Rashid A, Lenzi R, Hassabo HM, Abaza Y, Shalaby AS, Lacin S, Morris J, Patt YZ, Amos CI, Khaderi SA, Goss JA, Jalal PK, Kaseb AO. Estrogen replacement reduces risk and increases survival times of women with hepatocellular carcinoma. Clin Gastroenterol Hepatol. 2017; 15:1791–1799.
crossref pmid pmc
39. Yang X, Wang C, He X, Wei J, Wang Y, Li X, Xu LP. Hormone therapy for premature ovarian insufficiency patients with malignant hematologic diseases. Climacteric. 2017; 20:268–273.
crossref pmid
40. Tauchmanova L, Selleri C, De Rosa G, Sammartino A, Di Carlo C, Musella T, Martorelli C, Lombardi G, Rotoli B, Nappi C, Colao A. Estrogen-progestin therapy in women after stem cell transplant: our experience and literature review. Menopaus. 2007; 14:320–330.
41. Nakamura H, Ando K, Shinmyo T, Morita K, Mochizuki A, Kurimoto N, Tatsunami S. Female gender is an independent prognostic factor in non-small-cell lung cancer: a meta-analysis. Ann Thorac Cardiovasc Surg. 2011; 17:469–480.
crossref pmid
42. Lim VW, Lim WY, Zhang Z, Li J, Gong Y, Seow A, Yong EL. Serum estrogen receptor beta mediated bioactivity correlates with poor outcome in lung cancer patients. Lung Cancer. 2014; 85:293–298.
crossref pmid
43. Chlebowski RT, Schwartz AG, Wakelee H, Anderson GL, Stefanick ML, Manson JE, Rodabough RJ, Chien JW, Wactawski-Wende J, Gass M, Kotchen JM, Johnson KC, O’Sullivan MJ, Ockene JK, Chen C, Hubbell FA. Women’s Health Initiative Investigators. Oestrogen plus progestin and lung cancer in postmenopausal women (Women’s Health Initiative trial): a post-hoc analysis of a randomised controlled trial. Lancet. 2009; 374:1243–1251.
crossref
44. Clague J, Reynolds P, Henderson KD, Sullivan-Halley J, Ma H, Lacey JV Jr, Chang S, Delclos GL, Du XL, Forman MR, Bernstein L. Menopausal hormone therapy and lung cancer-specific mortality following diagnosis: the California Teachers Study. PLoS One. 2014; 9:e103735.
crossref
45. Ganti AK, Sahmoun AE, Panwalkar AW, Tendulkar KK, Potti A. Hormone replacement therapy is associated with decreased survival in women with lung cancer. J Clin Oncol. 2006; 24:59–63.
crossref pmid
46. Miki Y, Abe K, Suzuki S, Suzuki T, Sasano H. Suppression of estrogen actions in human lung cancer. Mol Cell Endocrinol. 2011; 340:168–174.
crossref pmid
47. Moleti M, Sturniolo G, Di Mauro M, Russo M, Vermiglio F. Female reproductive factors and differentiated thyroid cancer. Front Endocrinol (Lausanne). 2017; 8:111.
crossref pmid pmc
48. Rossing MA, Voigt LF, Wicklund KG, Daling JR. Reproductive factors and risk of papillary thyroid cancer in women. Am J Epidemiol. 2000; 151:765–772.
crossref pmid
49. Memon A, Darif M, Al-Saleh K, Suresh A. Epidemiology of reproductive and hormonal factors in thyroid cancer: evidence from a case-control study in the Middle East. Int J Cancer. 2002; 97:82–89.
crossref pmid
50. Truong T, Orsi L, Dubourdieu D, Rougier Y, Hemon D, Guenel P. Role of goiter and of menstrual and reproductive factors in thyroid cancer: a population-based case-control study in New Caledonia (South Pacific), a very high incidence area. Am J Epidemiol. 2005; 161:1056–1065.
crossref pmid pmc
51. Jastrzebska H, Gietka-Czernel M, Zgliczynski S. Hormonal replacement therapy in women after surgery for thyroid cancer treated with suppressive doses of L-thyroxine. Wiad Lek. 2001; 54:Suppl 1. 383–388.
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ORCID iDs

Hyo Jeong Ahn
https://orcid.org/0000-0002-8705-2203

Kyu Ri Hwang
https://orcid.org/0000-0001-6845-1260

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