HRT for HER2+, ER-, PR-

[JohnL]

My wife Monica (47) finished her Chemo and 12 months Herceptin about 6 months ago.

We've been talking to her Surgeon and Onc about Hormone Replacement Therapy - which they are quite keen to do to prevent bone density loss etc and feel that the risks are probably 'low' compared to the long-term benefits.

Theoretically, being ER/PR- she should be free of any increased risk of recurrence - but there is only a smattering or research on this and I don't think either of them have significant direct experience amongst their own patients.

So I wondered if anyone out there with a similar profile is on HRT or how it is handled elsewhere?

Regards

John L (UK)

[Becky]

Dear John


Although I am not on HRT (as I am mildly ER positive as well), on the ASCO site in the last few months, there has been a tremendous amount of data in regard to breast cancer risk while on HRT or birth control pills, especially in women who are lean.

There was also a paper (quite a bit back) that eluded to the fact that Her2+ disease that is ER/PR negative MIGHT begin by the body being in a hyper estrogen state (perhaps during the perimenopausal period with HRT or during pregnancy). Mind you, the article was not a clinical trial or anything.

I am sure there are others who are more knowledgeble than me (especially those on HRT).

Kindest regards

Becky

[al from Canada]

John,
There is very limited research on this subject but if we put together the bit of literature:

1. Herceptin prevents re-occurrance in about 56% of patients. This leads me to believe that there are cancer cells out there waiting to be destroyed

2. We know that cancer cells can morph into both HER2+ and ER+ from their negative counter parts.

3. We know that one's own immune system will also kills cancer cells.

Conclusion (my opinion): There may be a remote possibility that there are a few ER+ cancer cells circulating in your wifes system, waiting to be activated. That said, I don't know if I would chance it however, if you investigate DIM and I3C, which are supplements which modify estrogen metabolism, i certainly wouldn't take one without the other. ie, HRT without DIM or I3C.

I think you are treading on thin ice.

Good luck,
Al

[Lauriemn]

Hi John, I am 38 and just finishing up my year of Herceptin. My endocronologist wanted me to start Hrt, but my onc and gyno both said no. They said I should wait at least 2 or 3 more years before even considering it. Right now, I am using an estrogen cream for vaginal dryness,which was ok'd by all of my drs.. I also take fosomax for bone loss and I did start taking a low dose of testosterone.

I will probably never go on estrogen. I think I will continue to treat whatever problems that crop up because of being in menopause.

Laurie

[RobinP]

See Dr. Susan Love's website,she answers some questions like yours concerning HRT on the frequently asked question section.

[JohnL]

Thanks for the response. That has given us a lot more to think about. I didn't know about the HER2 cells morphing into somthing else, or the estrogen surge theory.

More research required. And a cautious approach.

If I find anything interesting I'll post it here.

John L

[mamacze]

John, I just logged on and saw your thread; I want to add my voice to the be cautious chorus. I am stage 4, Her2 +++ and ER/PR negative. 3 oncologists, my gynocologist and 2 surgeons all advised, with no hesitation, no hormone replacement whatsoever. I have been hormone free now for 2 years and once I got past the hot flashes it is not so bad. Hang in there, I know it is not easy sorting all of this out.
Kim from CT

[Monique M]

John:

I am also HER+++ and ER/PR negative. My onc said absolutely no to any HRT.

Monique