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Question: HRT during Chemo to enhance cell sensitivity to carboplatin?
| bceuro
- Fri Feb 02, 2007 7:23 am |
Patient is 58 who inadvisably had 10 years of HRT estrogen and progesterone
Right side 1.
9 cm tubulo lobular, Left side 1.
1 cm invasive ductal and 4 cm DCIS. ER 6+, PR 12+, HER2 3+, Grade 3 poorly differentiated with necrosis
No Lymph node involvement, no metastaies
Bilateral mastectomies with clear margins
About to start 2nd cycle of TCH Chemotherapy which includes carboplatin. The Chemo will total 6 cycles. Herceptin will continue to complete a full year.
HRT stopped immediately on Ultrasound discovery of tumors 8 weeks ago. Hot flushes at night experienced since that time
Does it make sense to take HRT pill again for 3 days starting on the day of the next TCH administration and to do this for the next 1 or 2 cycles ?
I just read the MD Anderson study of Chemo effectiveness on ER positive and negative Breast cancer patients
[url]=http://www.
meridianhealth.
com/rmc.
cfm/MediaRelations/News/BreastHealth/2006Jun.
cfm
To an engineer like me its not surprising that tumors which were stimulated by hormones do not react as as dramtically to Chemo agents when their hormone diet has been supressed by Chemo agents and these cancer cells are not dividing as rapidly as they were when fed by hormones
What would be the negatives and risks of taking HRT during the next 2 or 3 Chemo cycles ?
Thanks in advance for your comments
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| Dr. Safaa Mahmoud
- Fri Feb 02, 2007 6:38 pm |
 Hello,
It is contraindicated to give HRT in patients who have hormone responsive Breast cancer as they act as growth factors. Even if the tumor is excised and the patient is receiving Chemotherapy (since there is no available data supporting that issue, to the contrary all recommended not to give). It is also clear that the patient has bilateral high grade disease, it is advisable not to take the risk.
Regarding the menopausal symptoms, counseling, and non hormonal drug therapy can reduce menopausal symptoms in Breast cancer survivors.
Follow up with your Doctor is essential.
Best regards.
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| bceuro
- Fri Feb 02, 2007 7:57 pm |
Thank you for your prompt reply.
The menopausal symptoms are quite bearable for this patient.
After doing more reading about mechanisms which reduce cancer cell sensitivity to platinum Chemo agents, the mechanisms are quite complex and multifactorial. Rapid cell division could well increase the likelihood of cancer cells eveloving a mechanism to reduce the effectivenss of a platinum based Chemo agent.
The patient will definitely stay away from hormone supplements of any kind during and after Chemo treament
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