In a study of 498 women with lung cancer, those who had used postmenopausal hormones for at least 6 weeks before their lung cancer diagnosis were younger at the time of lung cancer diagnosis and had worse survival. These results were published in the Journal of Clinical Oncology.

As women reach menopause and beyond, more than 80% will experience symptoms such as hot flashes, night sweats, sleep disturbance, and vaginal dryness. Estrogen, with or without progestin, is the most effective treatment for many of these symptoms, but recent research has raised the question of whether the risks of hormone replacement therapy (HRT) outweigh the benefits.

Lung cancer is the leading cause of cancer mortality in both men and women. Estrogen receptors have been found in normal and cancerous lung tissue, prompting interest in whether use of HRT by postmenopausal women will influence either the likelihood of developing lung cancer or the length of survival with lung cancer. Studies of the relationship between HRT and the diagnosis of lung cancer have produced inconsistent results; some studies suggest an increased risk and others suggest a decreased risk. Less attention has been paid to the relationship between HRT and survival once lung cancer has developed.

To assess the relationship between hormone replacement therapy (HRT) and lung cancer survival, researchers evaluated 498 women who were diagnosed with lung cancer between 1994 and 1999. Eighty-six percent of the women were smokers and 17% had used HRT. Information was collected by reviewing the patients’ medical records. The study was not able to collect information about type of HRT or total duration of use.

Results suggest that HRT users were diagnosed with lung cancer at an earlier age and had shorter survival.

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  • The median age at lung cancer diagnosis was 63 in HRT users and 68 in non-HRT users.
  • Median survival was 39 months among HRT users and 79 months in non-HRT users.
  • The adverse effect of HRT on lung cancer outcomes was particularly pronounced for smokers.

The researchers conclude that HRT may worsen lung cancer outcomes. They note that “Further studies examining the role of HRT use on outcomes from lung cancer, especially in women with a history of smoking, are urgently needed to clarify this important problem.”

An accompanying editorial notes that although these data are not definitive, they “strongly suggest that HRT use should be discontinued after a lung cancer diagnosis.”

Reference: Ganti AK, Sahmoun AE, Panwaldar AW et al. Hormone Replacement Therapy is Associated with Decreased Survival in Women with Lung Cancer. Journal of Clinical Oncology. Early online publication November 28, 2005.

Accompanying Editorial: Siegfried JM. Hormone Replacement Therapy and Decreased Lung Cancer Survival. Journal of Clinical Oncology 2005. Early online publication November 28, 2005.

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