A new study shows that women diagnosed with non-small cell lung cancer may have a higher risk for dying if they use estrogen plus progestin hormone replacement therapy (HRT). Also called combined hormone therapy, these hormones are used by some women to help control the symptoms of menopause. Non-small cell lung cancer is the most common form of lung cancer and smoking is the most common cause.
The study findings were presented at the 2009 American Society of Clinical Oncology meeting. Researchers had analyzed data from more than 16,600 women who participated in the landmark Women's Health Initiative (WHI). The WHI was designed to test the effects of postmenopausal hormone therapy, among other factors, on risk for several chronic diseases. About 15 percent of postmenopausal women in the U.S. use hormone therapy.
Despite the benefits, hormone therapy has many risks. Women enrolled in the WHI study took combined hormone therapy or a placebo for almost six years. They were then followed for another two years. Over eight years of study treatments and follow-up, 168 participants in the HRT and placebo groups developed lung cancer.
Risk for the cancer was highest in current smokers, less high in former smokers, and least high in women who never smoked. Rates of smoking were similar in the two study groups.
Risk for lung cancer mortality among smokers was higher in the hormone group. Almost 3.5 percent of smokers diagnosed with lung cancer in the hormone group died compared to 2.3 percent of smokers in the placebo group.
Choosing whether or not to use menopausal hormone therapy is one of the most important health decisions women will make. The U.S. Preventive Services Task Force does not recommend that healthy women take hormone therapy to prevent chronic conditions. A review of evidence found that combined therapy may reduce the risk for fractures and colorectal cancer, but it does not prevent heart disease. In addition, it may lead to increased risk for other diseases, including breast cancer, stroke, and dementia.
If you are currently taking hormone therapy for menopausal symptoms, or considering it, talk to your doctor about the balance of risks and benefits. Expert groups suggest that women who decide to take hormone therapy to relieve menopausal symptoms use the lowest effective dose for the shortest possible time.
Use the following questions to help guide your discussion:
For a free, easy-to-read brochure on the risks and benefits of menopausal hormone therapy, visit the National Institute on Aging - Hormones and Menopause link below.
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Hormone replacement therapy (HRT), which can relieve hot flashes and night sweats, also can boost the risk for breast cancer and other diseases. And the FDA hasn't approved the heavily marketed bioidentical HRT. Ask your doctor about alternatives such as soy isoflavones, black cohosh, and red clover. Lifestyle changes such as dressing in layers and maintaining a normal weight can be effective, too.
Always consult your physician for more information.