Estrogen replacement therapy and ovarian cancer

Estrogen replacement therapy (ERT) has been shown to be of benefit for meno pausal women, especially in prevention of coronary heart disease and osteop orotic fractures. Cancer fear is an important obstacle to use of ERT. From our literature review, there is a weak or no association between ERT and ov arian cancer risk. Individual risk of cancer should be considered before ER T use. The second issue in this review is ERT in patients with ovarian canc er. The majority of patients with ovarian cancer are postmenopausal or beco me menopausal after surgery. ERT is considered by many physicians to he con traindicated in patients with cancer. However, there is evidence that ERT i n selected cancer patients may be of benefit for survival and quality of li fe. After weighing the evidence from studies on ERT in patients with ovaria n, breast or endometrial cancer, we propose the use of ERT in selected ovar ian cancer patients who are suffering from or are at a high risk of debilit ating menopausal symptoms, osteoporosis, and coronary heart disease. The be nefit of ERT to selected patient's health and quality of life appears to ou tweigh the risk of cancer recurrence.