Department of Obstetrics and Gynecology, Campus Biomedico University, Rome, Italy.
Department of Obstetrics and Gynecology, Campus Biomedico University, Rome, Italy.
Crit Rev Oncol Hematol. 2018 Apr;124:51-60. doi: 10.1016/j.critrevonc.2018.02.005. Epub 2018 Feb 8.
As growing of old women population, menopausal women will also increase: an accurate estimation of postmenopausal population is an essential information for health care providers considering that with aging, the incidence of all cancers is expected to increase. Hormone replacement therapy (HRT) has proven to be highly effective in alleviating menopausal symptoms such as hot flashes, night sweats, dyspareunia, sexual disorders, and insomnia and in preventing osteoporosis. According to preclinical data, estrogen and progesterone are supposed to be involved in the induction and progression of breast and endometrial cancers. Similarly, in epithelial ovarian cancer (EOC), the pathogenesis seems to be at least partly hormonally influenced. Is HRT in gynecological cancer survivors possible? The literature data are controversial. Many clinicians remain reluctant to prescribe HRT for these patients due to the fear of relapse and the risk to develop coronary heart disease or breast cancer. Before the decision to use HRT an accurate counselling should be mandatory in order to individualizing on the basis of potential risks and benefits, including a close follow-up. Nevertheless, we do believe that with strong informed consent doctors may individually consider to prescribe some course of HRT in order to minimize menopausal symptoms and disease related to hormonal reduction.
随着老年女性人口的增长，更年期女性也会增加：准确估计绝经后人群是医疗保健提供者的重要信息，因为随着年龄的增长，所有癌症的发病率预计都会增加。激素替代疗法（HRT）已被证明在缓解更年期症状（如热潮红、盗汗、性交困难、性功能障碍和失眠）和预防骨质疏松症方面非常有效。根据临床前数据，雌激素和孕激素被认为参与了乳腺癌和子宫内膜癌的诱导和进展。同样，在卵巢上皮癌（EOC）中，发病机制似乎至少部分受到激素的影响。HRT 是否适用于妇科癌症幸存者？文献数据存在争议。由于担心复发和患冠心病或乳腺癌的风险，许多临床医生仍然不愿意为这些患者开 HRT。在决定使用 HRT 之前，应该根据潜在的风险和收益进行个体化的准确咨询，并进行密切随访。然而，我们确实认为，在获得充分知情同意的情况下，医生可以根据个人情况考虑开一些 HRT 疗程，以最大程度地减轻更年期症状和与激素减少相关的疾病。
