Progesterone for stage 4
Does anyone know if there are any forms of MBC that can be treated with bio identical progesterone ? Anyone using it ? Just curious . I know most oncologists think it growscancer but just wondering !
Comments
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Yes progestin is one of the possible treatments for ER+ cancer. It's generally used after all the anti-hormonal treatments have failed.
The theory is that the aromatase inhibitors, the SERDs (Faslodex) and SERMs etc. starve the cells of estrogen and progesterone so the cancer cells grow thousands of receptors in order to capture any available hormone. Then you give either estrogen or progesterone. It floods the receptors and the cells essentially explode. They can't handle the onslaught.
There have been trials of giving estrogen in that setting. About 1/3 of women respond.
My onc and I discussed this. He was against straight out estradiol because he thought the blood clot risk was too high. He was OK with the idea of trying Megace. That's progestin. The major side-effect is it makes you hungry. It's normally used to treat cachexia (people who are wasting away because they can't eat). I decided I weighed too much already so didn't try it.
In a straight out PR+ setting (not as I described above) you are feeding the cancer cells. When you're PR+ it means the cancer cells have receptors for progesterone and use it as fuel.
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I am taking a synthetic form of progesterone, Megace. This drug has been studied and has been shown to be beneficial with HR+ breast cancer. It's an old drug, and not used alone much because there are so many more effective drugs out now. Best Bird has it on her list as a Stage IV drug sometimes used when everything else fails.
My oncologist prescribed it to increase my appetite, as I've lost too much weight this year. I am also taking Falodex and Verzenio, which seem to be working for me. The Megace will probably not make too much difference to my cancer in my case ( I am very low PR ( 1%) and high HR). I am enjoying my meals for the first time in months, so it is probably helping in that way.
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Pajim thanks for the info - but what if u are PR-?
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Because docs gloss over the PR+ part of the equation, us BC ladies often are left to assume that PR+ means the same thing as ER+ with just a different hormone feeding/fueling the cancer. In actuality, this is not the case. PR+ is actually a very good thing as it means there are PR receptors on the cancer cells. Why is that good? Because the progesterone interaction at the receptor actually works to break down cells with DNA errors in them which is what cancer cells are. Here's a great visual on how that works:
By increasing the amount of PR in the body it ups the amount of cancer cell interruption/breakdownthe body can do and slows its ability to grow/replicate. The biggest side effect of this is as a therapy is significant weight gain as increasing PR makes you VERY hungry ALL the time - 24/7 feeling like you're starving. And from what I've read, bio-identical PR is the way to go vs synthetic PR. If your BC is PR-, this process does not happen as there are no receptors to make it happen.Hope this helps!
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So here is my concern. I was using bio identical progesterone cream which makes me wonder if that was the cause. Since discontinuing it my symptoms have gotten worse so I'm inclined to use it again in spite of what the oncologists say. It's a very tricky issue. I don't think it's been proven that progesterone causes any growth. However, I have read of other women using bio identical progesterone who also got breast cancer during that time. I don't know the hormonal status yet but will be seeing my oncologist soon. Please let me know if anyone knows WHY oncologists generally say it isn't good to use it especially with lobular.
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Most commercially available progesterone/progestin creams are synthetic. Synthetic has shown increased risk of breast cancer. The question then becomes how much you’re using, how often you’re using it and how much is getting into the blood stream which can have an adverse effect. Bio-identical progesterone does not increase breast cancer risk and has the protective effect like the progesterone your body makes naturally. (It turns out Suzanne Somers was actually on to something with bio-identical hormones—at least when it comes to progesterone.) Check with your OB/GYN and see if they have been inserviced on intrarosa. (If not ask them to contact the local rep and get inserviced.) If they have been inserviced ask if intrarosa might be a good solution to your issues. Or see if you can find bioidentical progesterone cream to use. Here’s a helpful link on the difference in action bio-identical vs synthetic PR:
https://breastcancerconqueror.com/exciting-discovery-natural-progesterone-may-prevent-breast-cancer/
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Lula,
But yet, Lula, S. Sommers did get breast cancer.. Do you think there is a correlation? Also, to change the subject slightly (or to enlarge upon it, lol) I've read a lot about estrogens not produced by our bodies. Plastic wrap, or plastic grocery bags, Tupperware type storage containers, all of these produce an estrogen like substance which our bodies cannot tell the difference from. Read up on it It's very interesting. Sue
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snooky- yes she did. I was only commenting on the bio-identical progestin hormone though. In that case what we see is that bio-identicalprogrstin does not promote breast cancer while synthetic progestin does. there’s 0 evidence that her cancer was caused by the bioidentical hormones she took. Sometimes cancers happen that are ER+ that have absolutely nothing to do with hormone therapy one may or may not have taken.
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Interestingly, both progesterone alone (like Megace) or estrogen alone are old school breast cancer treatments that can in fact work.. The effects of various hormones and the balance among different hormones, along with other proteins, growth factors, enzymes, etc. are all very complex and different forms of progesterone and estrogen can have drastically different impacts on cancer, depending on the specific form taken and which other hormones are in the mix around the same time. Combining or cycling the two seems to turbo charge BC growth. My take is to tread lightly and keep in mind that just because a theory about how something works or should work in the body sounds logical doesn't mean it is true. There are too many complicated variables in our bodies that hormones cannot be boiled down to “this one fuels cancer" and “this one haults cancer". This is a field best left to the experts - the oncologists - and is truly a good place to say “don't try this at home".
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Lulu and JFL
Thank you for the food for thought! There's so much to know about this disease that it's mind-blowing. Please, keep sharing your info, it keeps me humble. And boosts my admiration for Onc and all others in the field. Many Blessings
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