It is well known that estrogen as a carcinogen can promote the growth of breast cancer. A new review published this year in Maturitas- The European Menopause Journal suggests that high doses of estrogen can actually be used to treat selected patients with breast cancer.
In their report, Herjan J.T. Coelingh Bennink and colleagues say that high dose estrogen are effective in treating advanced breast cancer both as a first-line treatment and as a treatment for developed endocrine resistance to tamoxifen and exemestane.
However, high-dose estrogen may only be used to effectively treat breast cancer patients who have been subject to estrogen deprivation for some period. This means that the high-dose estrogen may be used only after breast cancer patients have been treated with medications intended to deprive estrogen.
The review finds that apoptosis induced by estrogen is regulated through the estrogen receptor and growth factor signaling pathways.
Although it is commonly known that high doses of estrogen can cause adverse effects like increased risk for cardiovascular disease and breast cancer in women without these diseases, the review does not see anything of major concerns.
The authors conclude that with the desired efficacy and a good safety profile, high doses of estrogen should be considered a valuable alternative to chemotherapy in selected breast cancer patients.
Comment: When the studies say no side effects are associated with use of high-dose estrogen, it could mean that the survival period for those patients may not be long enough. Breast cancer with advanced breast cancer and those who have received certain treatments indeed are not expected to live long in most cases. That could be why high-dose estrogen in those patients did not cause any major side effects or adverse effects. In any case, high dose-estrogen treatments are not for every breast cancer patients. (David Liu)
Herjan J.T. Coelingh Bennink, Carole Verhoeven, Alice E. Dutman, Jos Thijssen, The use of high-dose estrogens for the treatment of breast cancer, Maturitas- The European Menopause Journal, January 2017Volume 95, Pages 11–23
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