Breast Cancer Chemotherapy and the Endocrine System
by Michael Russell
Cancer chemotherapy affects the function of the ovaries in pre-menopause, specifically its ability to produce estrogen and progesterone. The ovaries secrete these hormones in a cyclic manner in response to trigger hormones produced by the pituitary gland. During the later part of a woman's reproductive life, during her late 40s or early 50s, the ovaries no longer produce these hormones and she is thus entering menopause. This process, where the ovaries shut down their sex hormone production, takes several months to a year or so to happen. The gradual decrease in estrogen and progesterone is usually accompanied by menopausal symptoms such as cessation of menstrual periods, hot flashes and vaginal dryness. Undergoing chemotherapy may accelerate menopause. This basically means that at the very same time a woman is handling a breast cancer diagnosis, she must deal with the changes and possible undesirable effects of the menopause. The same is true for woman on hormone replacement therapy who must abruptly stop her hormone treatment due to the diagnosis of breast cancer.
The association between breast cancer and endocrine status is complex and varies with every woman. The standard therapy for a recently diagnosed breast cancer patient is to stop hormone replacement therapy. This is because it has been found from numerous researches that estrogen increases the risk or breast cancer. In the past, women with breast cancer were advised not to resume hormone replacement therapy or begin it. Fortunately, this practice has changed and nowadays, treatment is based on each woman's individual situation. Nevertheless, you must consider the risks and benefits of hormone replacement therapy in relation to your disease.
Chemotherapy in younger women often produces symptoms of menopause that can be distressing and debilitating. Fortunately, women suffering from these symptoms can turn to Eastern medicine for relief. Certain herbal medicines used for many years by Eastern medical practitioners contain estrogen-like substances called phytoestrogens. Some of these herbs relieve symptoms without having any cancer promoting effects of estrogen. A few of these herbs are gotu kola and oil of evening primrose.
A lot of women have also found that through dietary modifications, they experience fewer hot flashes. Soy and soy products contain genistein, an estrogen-like substance. It is much less potent than the estrogen produced by the ovaries, but it does have the ability to improve hot flashes to varying degrees in most women.
After chemotherapy, many women will experience vaginal dryness as a result of estrogen deficiency. There are a number of effective vaginal moisturizers that can alleviate this symptom. Estrogen vaginal cream provides an excellent remedy, but in such cases, estrogen is absorbed systematically, which is usually contraindicated in the setting of breast cancer. The thinner the vaginal membranes, the more quickly estrogen is absorbed, thereby allowing large amounts to enter the body. New products are available on the market today in the form of a slow-releasing formulation estrogen vaginal inserts which may provide minimal amounts of estrogen to the body. These agents help ease the discomfort of dryness but do not provide so much estrogen as to stimulate growth in the cancer cells and interfere with treatment. You may want to discuss with your oncologist regarding treatment options when you are experiencing these adverse effects of chemotherapy on your endocrine function.
Michael Russell
Your Independent guide to Breast Cancer
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