Hormone therapy after endometrial cancer.

Abstract

Endometrial carcinoma is one of the absolute contraindications of hormone therapy (HT). After all the existing opinions so far, HT after Stage I or II is still thought of as a possibility and up to now, the continuously combined estrogen (CAS 53-16-7) / progestogen (CAS 57-83-0) replacement therapy (CCEPT) has been recommended. However, only observational studies have been conducted as yet. Although no study established an increased rate of recurrence or mortality, alternatives such as phyto-preparations, tibolone, or particular psychotherapeutic drugs such as venlafaxine should be considered for the relief of climacteric complaints. In particular considered is progestogen-only therapy. However, the currently discussed possible progestogen effects regarding the risk of breast cancer have to be taken into account. Generally after hysterectomy, at least for patients with cardiovascular risk factors, the preference today is to use low-dose estrogen therapy (patches, gels) instead of CCEPT, and this also is now recommended for patients after endometrial cancer. This is important because of the risk factors for endometrial carcinoma, such as hypertension, obesity, polycystic ovary syndrome, diabetes mellitus etc. However, each form of HT should only be exceptionally recommended, and the patients must be informed about the risks that exist and the use of alternatives.