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People’s Pharmacy: Cancer link to HRT gives women pause

Tue., Nov. 2, 2010

Women worry about breast cancer and for good reason. Almost everyone knows a friend or relative who has been diagnosed with this disease.

That is why the link between hormone replacement therapy and breast cancer has captured headlines.

Premarin has been a best-selling drug for decades. The company once advertised that more than 30 billion doses had been dispensed. If you add other brands of estrogen along with Prempro, which combines estrogen and progestin in its formulation, the numbers are even higher.

At the peak of its popularity, doctors prescribed HRT not just to alleviate hot flashes and night sweats, but also to prevent osteoporosis, dementia, heart disease and numerous other problems.

At one time, almost any woman with hot flashes would be given a prescription for HRT. Women who voiced concerns about the safety of hormones were told that they were essential for good health.

While estrogen can strengthen bones, the Women’s Health Initiative was stopped early in 2002 because the data showed that women taking Prempro were more likely to suffer heart attacks, strokes and cancer.

Shortly after the Women’s Health Initiative report came out, we received this message from a reader whose doctor dumped her because she chose to stop her hormones:

“I have been on hormone replacement therapy for 10 years, and my doctor has always been a strong proponent of HRT. I have asked about its safety in the past. He said that the news media highlight the negative results of studies and ignore the positives, and he has always convinced me to continue taking HRT.

“I called my doctor’s office to discuss the recent warnings and learned that he has not changed his position. I informed the nurse that I was uncomfortable taking the hormones and was going to discontinue them. I was then shocked to receive a letter from my doctor saying he will no longer treat me.”

This was not an isolated situation. Many physicians encouraged women to keep taking hormones regardless of what they read:

“I am a 61-year-old woman who just had surgery for breast cancer. I started on Premarin because of hot flashes and have taken it or Prempro for more than eight years. At every annual checkup, I asked about stopping the treatment and was always told: ‘The benefits outweigh the threat of breast cancer, and even if you do develop it, it is curable if caught early.’ ”

At first physicians believed that women who took estrogen plus progesterone developed less aggressive, easier-to-treat forms of breast cancer. But a new analysis published in the Journal of the American Medical Association (Oct. 20) contradicts that belief. Researchers followed women for 11 years. Those who took Prempro had more aggressive tumors and were more likely to die from breast cancer than those taking placebo.

It is hardly any wonder that millions of women feel betrayed and at a loss for how to deal with hot flashes. To help them, we offer our Guide to Menopause with a variety of nonhormonal options. Anyone who would like a copy, please send $3 in check or money order with a long (no. 10), stamped (61 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. W-50, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website:

Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. E-mail them via their Web site:

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