A retrospective analysis of data from the Women’s Health Initiative study, which was presented at ASCO, showed that women with non-small-cell lung cancer who used hormone replacement therapy were more than twice as likely to die from their cancer as those who did not take HRT. Richard Schilsky, president of ASCO, stated that the findings are “another piece of evidence to suggest that hormone replacement therapy should be used with great caution.”

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Researchers examined data from more than 16 600 women who were divided approximately equally into groups who took HRT or placebo. After more than five years taking HRT, data showed 96 cases of NSCLC and 67 deaths from the disease. In comparison, there were 72 cases of NSCLC and 39 related deaths among women in the study who took placebo. Researchers noted that the difference in the number of cases was not significant, but that the difference in the number of deaths was.

Further analysis indicated that among smokers in the study, 3.4 percent of women treated with HRT died of lung cancer, compared with 2.3 percent of those who received placebo. For non-smokers, 0.2 percent of women in the HRT group died from the disease, compared with 0.1 percent of those in the placebo arm. In response to the data, lead author Rowan Chlebowski warned that “women almost certainly shouldn’t be using combined hormone therapy and tobacco at the same time.”

Commenting on the findings, Wyeth, which markets Prempro (oestrogen and progestin), stated that the same risks observed in the analysis might no longer apply, given the current manner in which the drug is prescribed. The company’s head of medical affairs Joseph Camardo remarked that women in the WHI trial used high doses of HRT over a long period of time and started treatment at an average age of 63 years. “Practice has already changed significantly. Guidance and the label have changed…use has shifted toward much shorter duration and lower doses,” he explained.

In addition, Len Lichtenfeld of the American Cancer Society noted that the number of deaths so far in the study is too small for researchers to be able to make broad conclusions about risk in the general population.

Source: FirstWord

Popularity: 4% [?]

Men really do have an excuse for being wimpy about coughs and colds – their immune systems are not as strong as those of women.

Canadian research suggests the female sex hormone oestrogen gives women’s immune systems added bite at fighting off infection.

Oestrogen seems to counter an enzyme which blocks the inflammatory process.

The McGill University study appears in Proceedings of the National Academy of Sciences.

The researchers focused on an enzyme called Caspase-12, which is known to put a brake on the inflammatory process, the body’s first line of defence against harmful invaders such as bacteria and viruses.

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They worked on mice that lacked the Caspase-12 gene, and were thus extremely resistant to infection.

The human Caspase-12 gene was implanted into a group of male and female mice, but only the males became more prone to infection.

The researchers concluded that oestrogen produced by the female mice blocked the expression of the human Caspase-12 gene.

They were also able to locate the precise place where oestrogen binds to the gene in order to block its activity.

Since the experiments were conducted using a human gene, the researchers are confident their work is applicable to humans.

Lead researcher Dr Maya Saleh said: “These results demonstrate that women have a more powerful inflammatory response than men.”

The researchers believe women may have evolved a more robust immune system because of their key role in producing and nurturing young.

Their work raises the possibility of new ways to reinforce the immune system using genetic manipulation.

But writing in the journal, the researchers said: “A question remains: will men be amenable to the idea of being treated with an exclusively female hormone?”

Source: BBC NEWS

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Findings from an analysis published in the New England Journal of Medicine suggest that women who took long-term combined hormone replacement therapy with oestrogen and progestin experienced a marked decline in the risk of developing breast cancer soon after they stopped taking the treatment, and that the drop was unrelated to changes in frequency of mammography.

Researchers examined data from a group of more than 15 000 women who had been randomised to take either Wyeth’s Prempro (oestrogen and progestin) or placebo in the Women’s Health Initiative (WHI) trial. In addition, investigators analysed data from a separate WHI observational study that had begun in 1994 and involved over 41 000 women who had either chosen to take, or not to take, HRT.

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The randomised WHI clinical study was stopped in 2002 due to findings that women taking the therapy were at higher risk of breast cancer and other health problems. Regarding results from the observational study, the authors commented that “the incidence of breast cancer was initially about two times as high in the group receiving menopausal hormones as in the placebo group, but this difference in incidence decreased rapidly in about two years, coinciding with year-to-year reductions in combined hormone use.” They noted that the elevated risk of breast cancer decreased rapidly in both groups of women after they stopped taking HRT.

Responding to the findings, spokesperson Gwendolyn Fisher of Wyeth remarked that the study in the NEJM “does not support the theory that the decline in hormone therapy use, specifically oestrogen-plus-progestin use, caused the one-time abrupt nationwide decline in breast cancer incidence.” She suggested that the decline in breast cancer could be due to an increase in mammography during the 1990s, and the subsequent identification of a large number of cancers. Fisher also questioned why the authors “don’t offer an explanation of why breast cancer rates remain stable today when HRT rates continue to decline.”

Source: FirstWord

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The results of a study published in Neurology suggest that hormone replacement therapy may be linked to greater brain atrophy among older women. “These negative effects were really most evident in women who seemed to already be having some low cognitive function and possibly some memory problems,” stated Susan Resnick, study lead author.

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Researchers obtained MRI brain scans from 1403 patients aged 71 to 89. In the study, the results showed that women who had taken oestrogen, alone or in combination with medroxyprogesterone, had smaller brain volumes in areas associated with memory and thinking, versus patients taking a placebo.

“This suggests that oestrogen may adversely affect thinking skills among women whose brains may already be beginning a neurodegenerative disease process,” Resnick explained.

Source: FirstWord

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Research findings published in the January edition of the journal Cancer Epidemiology, Biomarkers and Prevention suggest that the risk of colorectal cancer was reduced among postmenopausal women taking hormone replacement therapy (HRT), compared with women who never took the hormones. The largest risk reduction was observed among women who completed use of combined oestrogen and progestin five or more years earlier.

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Investigators analysed data from 56 733 postmenopausal women participating in the Breast Cancer Detection Demonstration Project follow-up study who had completed interviews and questionnaires between 1979 and 1998. During an average follow-up period of 15 years, 960 new cases of colorectal cancer were diagnosed. The data indicated that, among women who had ever used the combination of oestrogen plus progestin, colorectal cancer risk was reduced by 22 percent. A 36-percent risk reduction was observed among sequential progestin users, while those who had stopped the oestrogen plus progestin combination at least five years ago, had a 45-percent lower risk of developing the disease.

Meanwhile, any use of oestrogen therapy was associated with a 17-percent reduced colorectal cancer risk. In particular, current HRT users had a 25-percent reduced risk of developing the disease, versus women who had never used the hormones, while those on the therapy for ten or more years had a 26-percent lower risk. Lead author Jill Johnson specified that the study was not designed to assess the biological mechanism for the protective effect of oestrogen therapy, but that it “will need to be explored in further studies.”

Commenting on the results, John Stevenson, a consultant physician at the Royal Brompton Hospital, remarked that while HRT should not be administered solely to prevent colorectal cancer, “women who are considered to be at increased risk…should be actively encouraged to initiate HRT early in the menopause if there are any other indications for it, and should be encouraged to consider long-term use since there is evidence of greater benefit with duration of use.”

Source: FirstWord

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