Q&A Medical Oncology

By Jay Wang, MD –

Q: My mother just started hormone replacement therapy.  I have heard that this can be a contributing cause to cancer.  Should she stop taking her hormone replacement medication?

Oncology

A: Hormone replacement therapy (HRT)  is often used to ease symptoms of menopause, such as hot flashes and protect against osteoporosis and bone loss. However, findings from large studies such as Woman’s Health Initiative reported an increase risk of breast, ovarian and endometrial cancer, while it decreases the risk of colorectal cancer. If you do decide to take HRT, it should be the lowest dose that helps and for the shortest time needed. Discussing the health risks and benefits with your doctor is important.

Q: My doctor says that I will have to have an operation to remove my lung cancer. Why does he want me to have chemotherapy and radiation before the surgery?

A: Lung cancer is one disease that has been treated the same way for decades. However, major advancement in translational and clinical research has transformed the disease into a posture child for personalized medicine. Questions that are important to know when a lung cancer is diagnosed include what is the cell type that cancer originated, stage, mutation status such as EGFR and EML4-ALK. Combined modality with chemotherapy, radiation and surgery may be recommended to have the best outcome.

Q: I have heard that women who have had breast cancer before the age of 50 are twice as likely to develop ovarian cancer.  Has this been proven?

A: While most breast cancer patients do not have a family history or known gene mutation, there is a subset of women, particularly women whom develop breast cancer at an earlier age, who have an inherited breast-ovarian syndrome called BRCA 1 and BRCA 2. BRCA are tumor suppressor genes that when mutated predispose cancer development. If suspected, there are several blood tests available; however, genetic counseling is recommended before and after the testing. When mutation is detected, closer surveillance, chemoprevention and prophylactic mastectomy and oophorectomy maybe recommended.

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