Question 35 -HRT With History Of Cancer - "Grin And Bear It?" (Posted April 8, 2000)

Dr N,

I have read your page with interest, but have a question. I have recently visited my doctor to discuss HRT as I am experiencing severe nightsweats (waking 3-5 times each night drenched in sweat). I also have many hot flashes but can tolerate this as I never go red (just sweat on the brow which is visible) He does not recommend HRT for me as my mother died of breast cancer (she was 48), and have two cousins with breast cancer on my mothers side and I have had a breast lump removed, which was benign. Although he was very nice he was dismissive of my symptoms and said they would only last a few months. Is there anything I can do to help or should I "just grin and bear it?"

Hi,

This is a personal choice, there is not a wrong or right decision. There is little doubt that hormone deprivation negatively impacts your appearance, health, longevity and quality of life.

Even with this knowledge it is difficult for many women to take postmenopausal HRT if it is their perception that it will increase their risk of breast cancer, which I do not think it does.

Some physicians suggest this approach more from a concern that they need to protect themselves from a future malpractice claim if you are to develop breast cancer than a concern for what is best for you.

In view of your mother's and cousins' cancers, you might consider seeing an oncologist with expertise in genetics to ascertain whether you have a gene which indicates that you have an inherited gene mutation that puts you at increased risk of breast cancer. My understanding is that if the gene mutation is not present, that you may not be at an increased risk.

Read the section of the web site, Breast Cancer and HRT, as it will provide additional insight.

As far as your physicians attitude. it is much easier to tell someone to "grin and bear it", than "grin and bear it" yourself. And, by the way, I have treated patients in their 80's who were still having hot flashes. 20% of women have flashes, 5 years or longer.

Whatever you decide to do, stay in charge and make the decisions yourself.

Let me know what and how you do.


Dr N