[JohnL]

Dear All

Well now, here is an interesting divergence of medical views. Let me quote an extract from a letter we have just received from Monica's consultant.

'Monica is T1 G3 N0, ER negative, PgR negative HER2+++ and has completed surgery, chemo and Herceptin........ As she is ER negative and PgR negative, she has really no significant risk of being on a form of HRT such as Kliovance or a continuous combined preparation of your choice........ I am very supportive of her decision to go ahead with HRT...'

Now this consultant is a specialist in this area and in one of the world's leading breast cancer hospitals. Another professor of breast oncology has also confirmed the view that if ER/PR-ve, there's no problem with the low doses involved in HRT.

Obviously, we have discussed with them the earlier response of our GP (in fact two different members of the practice) both of whom said effectively, 'HRT and breast cancer - one precludes the other'.

The view of the breast oncologists was that most generalists are clinging to the received wisdom pre specific tumour typing that you just don't give HRT to people with a breast cancer relapse risk. That, or they are working on the basis that until someone stands up with a huge epidemiological study which says 'It's safe, here's a hard bit of research, nobody can sue you now', then they will stick to the safe option of just not doing it.

Our Onc isn't a natural risk taker, so we're assuming that for him and a colleague to be comfortable with this, they have to have been made comfortable by something.

So here's the thing. Could it possibly be that many HER2 patients brought into early menopause could now be happy and healthier on HRT?

Who is right here, because if Monica's team are correct then this could be an important treatment option that may have been unecessarily denied to many readers of this site.

If you are hormone -ve not on HRT and would like to be, maybe it's worth reasking the question and pushing for a clearer answer as to why 'no' and not 'yes'.

Is timing an issue. Is 2/3/4/5+ years post surgery long enough to be able to say, OK why not your background list has declined to background level?

If we get those answers back, I'll be feeding them to Monica's onc and I will certainly let you know what their response is.

Monica is seeing an endocronologist who works with cancer patients in the next few weeks, so get those responses in and I'll be giving him a printout of this string and taking a note of what he says.


John L