Why is ERT after endometrial cancer controversial?
It has been commonly assumed that ERT is not safe for women with a history of endometrial cancer. Many physicians fear that ERT will increase a woman’s chances of having the cancer reappear. (Even though the uterus has been removed, the cancer can recur in nearby tissues or spread to other parts of the body.) There are several reasons for this assumption. One is that estrogen makes endometrial cancer cells grow in the laboratory. In addition, there is a good deal of evidence that estrogen, taken without progestins (another female hormone), can contribute to the first development of endometrial cancer. However, two studies of patients with a history of endometrial cancer have suggested that ERT does not increase the risk of recurrence in selected patients. These findings have led to the current debate. 6. What is the evidence linking ERT with the first development of endometrial cancer? Several large studies have found that women who take estrogen without progestins have a higher risk o
