|
Can Postmenopausal Hormone Therapy Reduce the Risk of Lung Cancer? |
|
|
|
|
Written by Gary Presant, MD
|
|
Sunday, 15 February 2009 |
Lung cancer is the leading cause of cancer deaths in both men and women in the United States. Although the rate of lung cancer deaths in men has been decreasing for many years (as a result of reduced smoking), the mortality rate in women has not yet begun to fall substantially. Smoking cessation is the single most important component of preventing lung cancer.
However, since so many women have taken postmenopausal hormone replacement (estrogen, or estrogen plus progesterone), it is important to ask if this increases or decreases lung cancer risk. Dr. C. Rodriguez of the American Cancer Society and her colleagues in a recent report (Cancer Epidemiology Biomarkers and Prevention Volume 17 Page 655, 2008) have shown that postmenopausal hormone therapy can prevent lung cancer.
The authors looked at the frequency of lung cancer according to smoking status in the Cancer Prevention Study to Nutrition Cohort, a study of over 72,000 women in the United States between 1992 and 2003. They found that use of any postmenopausal hormone replacement therapy (HRT) reduced the risk of lung cancer by 24 percent. This occurred regardless of smoking history. However, the decreased risk of lung cancer was more dramatic in women who had never smoked (a 44 percent reduction), compared to women who previously had smoked (a 24 percent reduction), or women who were active smokers (a 24 percent reduction). Continuing hormone replacement therapy was important, since women who stopped taking hormone replacement therapy no longer had a reduced lung cancer risk. These results supplement the results from the Women’s Health Initiative trial which showed that there was an increased risk for breast cancer and a reduction in the risk of colon cancer by hormone replacement therapy.
This study is important, since many women have been smokers in the past, or are current smokers at the present time. Because their risk of lung cancer is much higher than women who have never smoked, steps should be taken by those individuals and by their physicians to reduce the risks of smoking related lung cancer.
The most important factor in reducing ling cancer risk is to stop smoking. Your doctor can help you stop with several medications that can replace nicotine in cigarettes (Nicotrol, for example), reduce your dependence (Wellbutrin, for example), or reduce your desire (Chantix, for example). Selenium may also help.
It may also be important to start a screening program to detect any small cancers as early as possible when they are still highly curable. This can be done by annual CAT scanning. Be sure to discuss this as well as any lung symptoms (cough, shortness of breath, wheezing, coughing up blood, or chest discomfort) with your doctor.
And now, in addition, you should also get your doctor’s advice on hormone replacement therapy. In women current smokers and former smokers, consideration of possible postmenopausal hormone replacement therapy may be useful in conjunction with the other smoking cessation aids to further reduce the risk of lung cancer. But this should only be considered while recognizing possible risks of breast cancer. Since the leading cause of cancer death in the United States is lung cancer, this study is of great importance.
If you are a woman, be certain to discuss postmenopausal hormone therapy risks and benefits with your physician once you have reached menopause.
|
