Hello! You've probably heard of the hormone estrogen. We often hear this name in connection with women's health. But you may not know that estrogen can also affect the development of certain types of cancer. That's what we're going to talk about today, very simply, in a way that you can understand.
What is estrogen? Let's understand it first!
Simply put, estrogen is a natural chemical that our bodies produce. We also call it a hormone. This estrogen hormone travels through our blood to cells and tissues throughout our bodies.
Many people think that estrogen is something that is limited to women. In fact, the ovaries, which are part of the female reproductive system, produce the most estrogen hormone. But surprisingly, everyone, regardless of gender, produces some amount of estrogen in their bodies, including breast tissue and fat cells.
In women, puberty is caused by a combination of estrogen and another sex hormone, progesterone. This means things like breast development and pubic hair growth. It is also the hormone estrogen that controls the monthly menstrual cycle.
However, the hormone estrogen plays a very important role in men as well. It affects brain development, healthy sexual function, and libido.
So, what are estrogen-dependent cancers?
Now let's look at what these estrogen-dependent cancers are. Sometimes you may hear them called estrogen receptor-positive , hormone-dependent , hormone-positive , hormone receptor-positive , or hormone-sensitive . Either way, they mean the same thing.
Simply put, this means that the hormone estrogen helps cancer cells grow, that is, grow and spread. Just like a plant needs water, the hormone estrogen is essential for these types of cancer.
There are several types of cancer that are primarily estrogen-dependent. The main ones are:
- Breast cancer
- Ovarian cancer
- Uterine cancer – This is also called endometrial cancer.
Does estrogen really cause cancer? This is a bit confusing, isn't it?
This is actually a bit of a complicated story. The hormone estrogen is sometimes called a carcinogen. That means it has some ability to cause cancer. But we need to understand how that happens.
Almost every cell in our body has a special type of protein called hormone receptors. The estrogen in our blood comes and binds to these receptors. This is normally essential for many functions in our body. In healthy cells, estrogen helps the cells function normally and grow healthily.
However, for some reasons, when certain factors come together, healthy cells can turn into cancer cells. In such a case, estrogen starts acting like a spark. That is, estrogen helps cancer cells that have already formed to divide rapidly, multiply, and spread from one place to another in the body.
Therefore, rather than saying that estrogen alone causes cancer, it is more accurate to say that estrogen, in combination with other factors that contribute to the development of cancer, helps an existing cancer grow .
What factors increase the risk of developing estrogen-dependent cancers like this?
There are several factors that increase the risk of developing estrogen-dependent cancers to some extent. Let's take a look at what they are:
- Having higher than normal levels of estrogen in the body: Some people have naturally high levels of estrogen.
- Taking Hormone Replacement Therapy (HRT): This is a treatment that is often given to treat physical discomforts (e.g. hot flashes, night sweats) that occur after menopause. Imagine that your mother or aunt was prescribed hormone medication by a doctor for her post-menopausal symptoms. That's what HRT is.
- Obesity: As body fat increases, estrogen production can also increase.
- Having a condition called Polycystic Ovary Syndrome (PCOS): This is also associated with a hormonal imbalance.
- Diethylstilbestrol (DES) use: This is a synthetic estrogen that was given to pregnant women to prevent miscarriages from 1938 to 1971. If the mother used DES during this time, or if the mother was exposed to DES during pregnancy and gave birth to a child, the child is at risk of developing this type of cancer later in life.
What is the relationship between estrogen and breast cancer?
When it comes to breast cancer, about eight out of ten breast cancers are hormone receptor-positive . Simply put, these cancers require estrogen, progesterone, or both of these hormones to grow.
The risk of breast cancer increases with prolonged exposure to estrogen in high concentrations. The main reasons for this are:
- Hormone replacement therapy (HRT) for menopause.
- Naturally high estrogen levels in the body.
- Klinefelter syndrome is a genetic condition that affects men (men with this condition have relatively high estrogen levels).
In the past, some men were given the hormone estrogen as a treatment for prostate cancer. But now doctors rarely recommend that treatment because it also increases the risk of breast cancer in men.
What is the relationship between estrogen and ovarian cancer?
Exposure to estrogen over a lifetime can increase the risk of developing ovarian cancer. Risk factors include:
- Starting menstruation before the age of 12 (meaning early puberty).
- Never getting pregnant.
- Experiencing menopause (meaning having periods for a longer period) after the age of 55.
- Taking combination hormone therapy (hormone therapy) after menopause, which contains both estrogen and progesterone.
What is the relationship between estrogen and uterine cancer?
Uterine cancer, or as we mentioned earlier, endometrial cancer, develops in the lining of your uterus . Women are more likely to develop this cancer after menopause.
The risk of estrogen exposure may be increased by factors such as:
- Estrogen replacement therapy: Estrogen helps to reduce the discomforts of menopause, such as hot flashes, night sweats, and vaginal dryness. However, taking estrogen-only therapy increases the risk of developing uterine cancer. This is because estrogen stimulates the growth of the lining of the uterus. That is why estrogen is often given with a hormone called progesterone (combination hormone therapy). This reduces the risk of uterine cancer. However, if you have had a hysterectomy, you will not develop this cancer because you do not have a uterus.
- Tamoxifen Uses: Tamoxifen is a very important drug used to treat breast cancer and prevent the cancer from coming back. It works as a Selective Estrogen Receptor Modulator (SERM) and blocks the effects of estrogen on breast tissue. However, in postmenopausal women, tamoxifen acts like estrogen in the uterus. This stimulates the growth of the lining of the uterus, which increases the risk of endometrial cancer to some extent. But don't worry, the risk of developing endometrial cancer due to tamoxifen is usually less than 1% per year. There is also a very small risk of developing uterine sarcoma, a rare type of cancer that develops in the muscles or other tissues of the uterus.
How are estrogen-dependent cancers diagnosed? How do doctors detect this?
If you suspect you have cancer, the first thing your doctor will do is take a small piece of tissue from the tumor (we call this a tumor biopsy) and send it to a lab. There, they will use special tests to check if those cells have hormone receptors.
If the test result comes back as hormone receptor positive (HR+) , it means that estrogen, progesterone, or both of these hormones are helping your cancer grow, that is, feeding it.
How are estrogen-dependent cancers like this treated?
It is important for doctors to know the hormone receptor status of a cancer, as some treatments are only effective for hormone-positive cancers. Some of the main treatments for these types of cancers are:
- Aromatase inhibitors: These medications work by preventing the body from converting androgens, a hormone, into estrogen. This treatment is only effective in women who have gone through menopause (i.e., their ovaries have stopped producing estrogen).
- Other hormone therapies: These reduce or stop the body's production of estrogen.
- Tamoxifen and other SERM drugs: As we've discussed before, these work by blocking the hormone receptors from binding to estrogen.
- Oophorectomy: In some cases, the ovaries, the main estrogen-producing organs, are surgically removed. This can significantly reduce estrogen levels in the body.
Can birth control pills really reduce the risk of this cancer?
The answer to this can be both 'yes' and 'no'. How is that?
Some studies have shown that women who use hormonal birth control methods, such as the pill, may have a very small (about 7%) increased risk of developing breast cancer .
However, on the other hand, taking birth control pills may also reduce the risk of developing the following types of cancer:
- Cervical cancer
- Colorectal cancer
- Ovarian cancer
- Uterine cancer
So, as you can see, this is a bit complicated. Therefore, it is always best to talk to your doctor and decide which birth control method is best for you, and which is the safest.
What can we do to prevent the development of estrogen-dependent cancer?
Most cancers develop for no apparent reason. This means that sometimes cancer can develop no matter how careful we are. However, there are some simple things we can do to reduce the risk of cancer to some extent.
- If possible, breastfeed your children. Breastfeeding has been found to reduce the risk of breast cancer.
- Reduce alcohol consumption as much as possible and avoid smoking completely. These are things that contribute to many cancers.
- Try to eat a healthy diet. Eat more vegetables and fruits. Also, exercise daily and be physically active.
- If you are overweight, that is, obese, try to lose weight.
- Talk to your doctor about the safest birth control method for you.
- If you want to manage the discomforts of menopause, seek medical advice about combination hormone therapy or nonhormonal treatments.
What are the most important questions I should ask my doctor?
If you have any concerns about this condition, or about estrogen-related cancer risk, never hesitate to ask your doctor. It's important to clear your doubts. Here are some questions you can ask:
- Is my cancer estrogen-dependent or hormone-receptor-positive?
- What are the best treatments currently available for this type of cancer?
- What are the risks and side effects of these treatments?
- What changes can I make to my lifestyle to protect my health and reduce my risk of cancer?
- Should I change the birth control method I'm currently using? What method is best for me?
- Is it appropriate for me to take hormone therapy? Are there any risks for me?
Finally, what to remember (Take-Home Message)
Most of the time, the hormone estrogen plays a beneficial role in our bodies, helping them function healthily. However, estrogen-dependent cancers are an exception. In these specific cancers, estrogen actually helps the cancer grow, that is, it feeds the cancer.
If you are diagnosed with a cancer and your doctor suspects that it may be hormone-sensitive, they will definitely do the necessary tests to find out if it is related to estrogen. Based on that information, your doctor will be able to choose the most effective and most suitable treatment for you.
Therefore, without fear or holding anything back, openly discuss all your questions and doubts with your doctor. It is very important for your health and your mental well-being.
` Estrogen, cancer, hormones, breast cancer, ovarian cancer, uterine cancer, women's health
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න