You may have heard conflicting information regarding whether hormone replacement therapy (HRT) is something women should consider when they approach menopause.
Women who take HRT usually do so to reduce or eliminate severe menopausal symptoms, such as hot flashes that disrupt a woman’s normal functioning. But there have been news reports that HRT causes cancer, and others that concluded it doesn't. Some research says HRT causes heart disease, some say it doesn't.
And with studies showing that, for certain groups of women, taking an estrogen-progesterone combination after menopause may decrease the risk of developing colon cancer, you’re probably wondering what you should do.
As with other medical treatments, the answer to the question "should you take HRT?" isn't a clear "yes" or "no," but a murky "it depends."
Colon Cancer: The Numbers
The National Cancer Institute estimated that approximately 106,000 new cases of colon cancer will be diagnosed in the United States in 2009, and colon cancer and rectal cancer would likely claim almost 50,000 deaths for the same year. For men and women combined, colon cancer is the second-leading cause of cancer-related deaths. However, that death rate has been falling for more than two decades, due to more screenings and better treatments.
Colon Cancer Prevention and HRT: A Complicated Relationship
There has been quite a bit of research regarding how HRT can increase the risk of developing some types of cancers. One piece of information that did emerge from various studies is that while HRT may increase the risk of some cancers, such as breast cancer, taking HRT doesn't increase the risk of developing colon cancer.
Other research found that it decreases the risk. A large, long-term study called the Women's Health Initiative investigated several aspects of women's health issues. Among other things, researchers looked at whether estrogen and progesterone HRT helped reduce colon cancer risk, which it did, by about 40 percent.
However, the researchers also found that while fewer women who took HRT developed colon cancer, those women who did develop the cancer were diagnosed with more advanced cases — that is, cancer that had spread to the lymph nodes — than were those who had colon cancer and didn't take HRT.
Researchers are puzzled as to why this would happen. Although nothing definite has been found, one theory is that something related to HRT delays discovery of cancers in general. The mystery means it's important for women taking HRT to go for regular colon cancer screening. Colon cancer, when caught early, has a 90 percent five-year survival rate.
Colon Cancer Prevention and HRT: Proceed With Caution
With these confusing findings, taking HRT to prevent colon cancer is not usually recommended. Thomas Imperiale, MD, professor at the Indiana University School of Medicine and research scientist at the Regenstrief Institute in Indianapolis, says, "The magnitude of benefit from HRT is offset by its numerous risks."
Whether you decide to take HRT, particularly the estrogen and progesterone combination, depends on what you and your doctor decide. And, while it may be reassuring to know that the rate of colon cancer may drop with HRT, it's important to remember that if you do get the disease, the colon cancer may be worse. Going for regular colon cancer screenings is the best way to reduce your risk.