Role of Hormone Replacement Therapy (HRT) in Gynecological Cancers: Endocrinologist’s Perspective

Abstract

The safety of HRT use in Gynecological cancer patients is a debatable issue and not entirely clear. The aim of this article was to review whether HRT is safe in Gynecological cancer patients or not. Squamous cell carcinoma, ovarian, vulva, vagina, endometrial serous carcinomas and uterine sarcomas are not considered estrogen dependent, and HRT can be given safely in these tumors. In early-stage endometrial cancer, HRT use has no harmful effect which may be due to no left behind residual cells. In advanced-stage tumors, HRT could have a harmful effect due to the hormone-responsive residual cells. Some studies have opposed the use of HRT in cancer patients, while some studies have supported the role of HRT in these patients; however, the evidences are based on case series without the proof of randomized trials. The variable responses in Gynecological cancer patients may be due to inclusion of heterogeneous patient with estrogen and progesterone receptor-positive or receptor-negative tumors. The responses may also vary depending on the tumor type, disease grade, stage and the type of drug used. Therefore, it is not possible to make definitive recommendations on the role of HRT. The objective of this article was to provide an overview about the current literature related to the role of HRT after Gynecological cancers treatment.