HRT takers live longer than non HRT takers

Is this refering to women taking hormone replacement therapy prior to diagnosis? After treatment?  Or is this referring to Tamox and AI's?  I'm confused.

Here's what I don't understand about the article posted above by Layne157 (and thanks, Layne -- and this is directed at the authors of the paper, not you!!!!).

They say BC diagnoses dropped sharply in 2003.

The report of the Women's Health Initiative (WHI) trial came out in August 2002 -- saying that HRT increased the risk of BC, so that suddenly the number of prescriptions for HRT dropped sharply.

The authors speculate that the drop in BC cases is related to fewer HRT prescriptions.

But we are continually told that "by the time your BC is detectable, it has probably been growing for 7 to 10 years" -- we are even told this is especially true for ER+ cancers (because triple-negative, and ER-neg/HER+ are more aggressive and may have been faster growing) -- So-o-o-o-o-o

Is the "7 to 10 years" figure wrong?  Because if it's correct, then the drop in dx over all 12 months of 2003 couldn't possibly be caused by reduction of HRT prescriptions in the last 5 months of 2002.  IMHO.

So maybe the "7 to 10 years" IS wrong?

Any thoughts?

EDITED TO ADD: One hypothesis I have for the sharp reduction in 2003 is that the use of tamoxifen in women with DCIS began to be studied in about 1993, and positive results of clinical trials were published in 1998-99 -- so the sharp drop in invasive in 2003 reflected 5 to 10 years of the use of tamoxifen as a preventive treatment in high-risk women and women with IDC?????

AnnNYC, I've had the same concerns about the proclamation that the drop in BC was due to a decrease in HRT usage since the WHI report came out. It just doesn't seem plausible that there could be such a rapid effect, considering the lag time in diagnosing BC and the fact that the risk of new BC continues for several years after HRT is discontinued.  (Considering the tone of this thread, I wish I had a citation for that 2nd statement.)

Anyway, as for the post that began all this, I am upset that the article implies a "survival benefit" for women who develop BC and continue to take HRT.  What we are seeing as a citation ("Doctor's Guide") is just an e-newsletter that published a synopsis of the original report. The original report appears to be a paper presented at a conference--not a written report subjected to peer review and published in a scientific journal.  The group that did the work (Oregon Health & Science University, Portland, Oregon) has been reporting similar findings for several years. One published report from that group came out in 2002 and its conclusion was much like this latest one:  there are benefits to taking HRT because the tumors those women get are "less aggressive." IIRC, what they meant was that the tumors women get on HRT tend to be ER+.  Duh.  Well, I have one of those, even though I've never taken HRT; and my Oncotype score of 26 wasn't exactly in the "non-aggressive" range.  So can we assume that if I'd been on HRT, the Oncotype score for my ER+ HER2- tumor would have been lower?  There is no evidence to support that theory, even from the Oregon group.

Having a curious nature and way too much time on my hands (and this being a day when I should be feeling sluggish from my latest chemo tx), I am going to do some searching to see if I can find out more about the alleged "benefits" of taking HRT while you have BC. I want to know who is funding the research being done by the group at Oregon, and I want to know more of the details.

otter 

I think the orignal article's premise is accurate. It didn't say that HRT (or OCPs, for that matter) didn't cause bc. It said that women on HRT had easier to detect cancers, and were most likely detected earlier, because any provider worth his/her salt always required a mammo before prescribing the following years' HRT.

And, the ER/PR+ tumors found in women on hormones were more easily treatable, being low grade and lower stage.

All I can say is that was certainly MY case. I had been on OCPs for years and years, as adjunct to other medical problems. My cancer cells were about as normal as possible and still be cancer. The oncologist at UCLA suggested it was due to the hormones I had been taking.

So, if they "caused" my cancer, they were at least nice enough to make it a more manageable one.

That's just my own experience.

Anne

Shirley,

I'll try to explain it the way it was explained to me by a breast surgeon:  He told me "it's 30 doublings."  One cell goes awry (so to speak) and in about 100 days, that one cell becomes two malignant cells; and those two nasty cells in one hundred more days become four, and so on and so on.  Thirty doublings is roughly ten years.

Obviously, it's less than ten years for an aggressive cancer, but for those of us with grade 1/2, it's about ten years before it shows on a mammogram.

Note to the doctor's here:  please correct if this info is wrong.  I did my best in reiterating.

Good post RaiderGirl.  Good points. I have taken BHRT for 12 years and just recently was diagnosed with lobular cancer (stage II). But..it was undetectable until I'd started dental treatments some years ago (which I find out in hindsight were very toxic) by mammograms...I found it myself this past year and it's growth in a short time had been dramatic. That and the immune suppression drugs I was given that year were contributors I'm sure.

I also have weak adrenals and insomnia (for 12 years) which would set me up for cancer from the resultant inflammation.

There are other contributing factors to cancer. And our genetics can set us up also. I tested positive on the MFTHR test... an indication I was already vulnerable. So many things have to be taken into account. A healthy lifestyle, diet, etc. are so important...moreso than people can imagine.

On Otters post of May 17: I have a new integrative doc who cites research (I don't have that...trying to find it) that indicates that bio identical progesterone and testosterone can actually protect against BC. He does not suggest estradiol ....at least not for until 5 years have passed (and then only with progesterone).

There are a lot of factors at work. Genetics, environmental toxins, etc. can make some of us more vulnerable than others. Those of us who have been on BHRT have not had all the information we needed to protect ourselves. If I had known better I would have added certain supplements at the same time as I was taking BHRT (DIM and iodine...and others) to protect myself against breast cancer. I'd also have had some genetic testing done. These substances help metabolize the estrogens into their less harmful forms (estriol). I was not told any of this at the time. It would be best if our health care providers would insist on adding these to our protocols if we are to consider BHRT at all.

HI Momine,

Thanks. The iodine and the DIM aid the body into metabolizing the estrogen into mostly estriol which is protective. This isn't the whole story on estrogen metabolism. I know that estrogen is metabolized from testosterone. My doc knows this also but tells me that testosterone is also protective as is the progesterone. It isn't a simple matter. I will not take the AIs. I'm past menopause and they have too many side effects (insomnia which I already have in spades and don't need more, osteoporosis which I already have and don't need more) and they are toxic which is not the idea...am going all natural and organic and trying to rid my body of toxins to avoid 'spin off' cancers (I don't want any cancer at all!) . My doc keeps up with the latest research and his knowledge of the hormone pathways is in depth. He specializes in this area and is careful to design protocols for his patients that are not harmful. He has beaten cancer himself. It was that experience with toxic therapies that got him into the integrative field in the first place. I'll try to find out more detail on this to post to the forum.

http://anna.blog.wellsprings-health.com/2013/01/25/bioidentical-natural-progesterone-or-tamoxifen-to-reduce-breast-cancer-risk/ 

Hi Momine,

Thanks. I don't advocate this for everyone. I am a special case in fact. My adrenals are weak so I don't heal well (progesterone is a precursor to cortisol which I don't have enough of) and I'm also past menopause. I take very small amounts of these hormones (bioidentical progesterone balanced with testosterone) and only with certain supplements to ensure their correct metabolism. My doc says I need these for bone density (along with certain forms of minerals and K2, etc.), healing, sleep and also for my immune system (hormones necessary for that too). I tested positive for the MTHFR gene also so I'm on a protocol for that (certain extra B vitamins). He has designed a specific protocol for my type of condition and I think before anyone at all (cancer or not) decides to take bioidentical hormones (wouldn't touch non bioidentical) they should have such a protocol designed for them after genetic testing. Too dangerous otherwise. Here's something about iodine also: http://www.medsci.org/v05p0189.htm. Incidentally, my gyno also recommends that I take DIM. Some studies (including the one you cite) have used 'suboptimal' doses of DIM (under 200 mg).  Many of these traditional organizations don't test these effectively. The effective dose of DIM is 400 mg. a day. (sorry cannot find the article that cites these studies... will post when I find it) Here is one that studied DIM with ovarian cancer: http://www.biomedcentral.com/1741-7015/10/9. Again, I know I'm taking the 'road less traveled' here. There is tremendous pressure to use only traditional methods to fight cancer but I have decided to go another way for various reasons. For older people, actually the more toxic therapies don't work as well (we're probably toxic enough by now and our cells don't regenerate like younger folks). LEF.org does recommend the serms or the AIs along with certain supplements:http://www.lef.org/protocols/cancer/breast_cancer_les.htm.  Since I"m past menopause and can't afford the side effects due to my condition and family medical history I skipped them (plus I really didn't like the side effects I read about).   In the end I think the theme song for cancer patients might be "I did it my way".

I used bee pollenfor while then because of this information that some of it converted to estrogen I quit.

Well, I just stumbled upon this thread - it was created 2008, and now, 7 years later, has the data changed?

Quote from above:

"Patients with greater than 9 years of HRT also had 100% survival regardless of mode of tumour detection,"

Really????? Never heard of such a thing.

I share Kayb's skepticism about the rationale for giving long-term (artificial) doses of the very substance that is said to feed bc naturally in the first place. Then again, I am also skeptical about the study done in Stockholm, Sweden, and wonder who funded that research. My best surmise is that it was funded by none other than Sweden-based Astra-Zeneca, whose patent on (and mega profits from) tamoxifen has run out! (Lose one cash cow, find another, says big pharma.) And, by the way, RaiderGirl mentions an HRT trial being carried on in the UK and Sweden--again, that was no surprise to me, since Astra-Zeneca also has a research facility in Loughborough, England, as well as in Sweden. Just call me doubting Thomasina! The sugars and fats that I can't totally avoid in my diet give my body sufficient raw material to create estrogen to replace my menopausal loss of it!

Just want to add my 2 cents. I was on HRT 6 years prior to bc dx. My doc told me most of his patients were not on HRT so he does not believe it caused my bc. He also told me that women who are on it at dx do better and the bc is less aggressive. That being said he did want me off of it now. I am not taking an anti hormone, my choice. However I am looking into the testosterone/anastrozole pellets. One thing for sure, breast cancer is not black and white!