The Colon Club

Hello everyone,
I was diagnosed 3C sigmoid colon cancer in December 2014. I had 12 rounds of chemo and 6 weeks of radiation. I have remained NED and feel very blessed.

By the end of chemo, I was in early menopause. I was 45 at the time. What function I had left in my ovaries after chemo, was shut down by radiation. After one week of radiation, I had no more periods.

Fast forward to now, the menopause has halted my sex life. I have been happily married for 25 years and I now have zero desire. And when IT does happen, IT is terrible.

I have mentioend this to my oncologist. He wrote out a script for Estradiol. I then talked to my gynecologist. He really didn't want to do anythng. I did try the Estradiol and haven't noticed any difference. The gynecologist was against HRT "due to my history."

Last month, I had a physical with the nurse practitioner at my family doctor, who happens to be in an integrative medicine practice. After I told her my complaints, she drew my hormones levels and they all came back extremely low. I received the report in the mail and she basically said that "with my history" she is reluctant to prescribe anything.

Does anyone have experience HRT after treatment? Is colon cancer hormone-fed similar to breast cancer? Any advice appreciated.

I have been taking Estradiol Noreth (Activella) since April 2018. My gynecologist prescribed it and said it is very low risk for causing cancer. She said "all studies prove that estrogen replacement doesn't cause breast cancer." It is a very low dose and is even less estrogen than the body produces naturally. I recently had a blood test and all of my hormone levels were normal. I'm happy because the Estradiol has taken care of my hot flashes and I don't seem to have any other side effects.

I'm sorry your hormone levels are low. I think most colon cancers aren't hormonal, but hopefully someone with more clinical knowledge can chime in and help! Just wanted to let you know that my GYN considers Estradiol safe to use. Perhaps they are hesitant to give you anything with a higher dosage?

Hi! I have also started taking estrogen 4 weeks ago, it is a trade-off, iatrogen menopause is linked to so many negative effects that I decided to take a very slow dose (1 mg) even if it is “promoting growth” according to someone.

Claudia

My gynecologist just gave me Premarin cream to use externally as my vaginal tissue is quite thin due to radiation and normal atrophy. He did mention that I am not a candidate for laser therapy because of radiation. He was going to call a doctor in Cincinnati to see if it could possibly be done on external tissue only. We will see. I don't have any pain, but have had occasional bleeding as the tissue gets irritated. He did not mention anything about hormone therapy, however, I had a hysterectomy 10 years prior to cancer so I did not have menopausal symptoms caused by treatment.

Excuse me while I step on my soapbox. I am on hrt following ovarian cancer. I had to fight for it. I have found in general that oncologists are terrible when it comes to dealing with post chemo side effects. They just don’t deal with it. The attitude I got from oncology and a lot of doctors is that I should be thankful to be cancer free and basically I don’t have the right to ask for a better quality of life. If you beat cancer and are miserable, what was the point? I was on just Premarin for years and it was inadequate. You cannot just replace estrogen in women. You have to consider progesterone and testosterone as well. I am now on bioidentical hormone replacement. I see a pharmacist who specializes in it. He cannot prescribe it though but I see a gynecologist who works with him and she will prescribe whatever he recommends. As long as I see her once a year for a pelvic exam, she will write the prescriptions. I would recommend seeing someone who does bio identical hormone replacement. My pharmacist customizes a blend for me. I am getting estrogen, progesterone, and testosterone. I finally feel like a women after 6 years of inadequate treatment. Fight for a better life for yourself. Doctors are not very supportive of hrt following cancer but be firm about what you want. There are risks of course but we have the right to choose hrt for a better quality of life. They don’t get to decide for us.

I had similar issues with hot flashed and bleeding due to thin tissues. My gynecologist prescripbed Prempro which contains a combination of conjugated estrogens and medroxyprogesterone. I am still getting hot falshes but they are definitely getting milder, not so much bleeding but that is all getting better the farther I am from chemo. The tissue which we irradiated, butt checks and between legs became raw again in the last rounds of chemo. Happy to say healing up at last.

I might suggest an herbalist, my mother found a chinese medicine specialist who made up something that has helped her 20 years out of menopause.

It was my understanding that HRT was not recommended from women with history of breast cancer in their family, you didn't mention that.
S

KimT wrote: You cannot just replace estrogen in women. You have to consider progesterone and testosterone as well.

My ovaries and uterus were removed during LAR, so I don’t need progesterone. Some hormones are also produced by the fatty tissue and surrenal glands. I am curious about checking my hormon levels. The doctor of integrative medicine that is following me was against estrogen and said to eat a soya yogurt instead, but also phytoestrogens are under debate and less controlled. It is really difficult to make a choice in this field.

Claudia

I have complete pituitary failure - total loss of all pituitary hormones.

Hormones are more than estrogen, progesterone, and testerone. Hormones are potent chemical messengers that play key roles in the regulation of the body’s many organs and systems.

A low level of estrogen is produced by adipose tissue. This is one reason that women have more fat stores than men. Adipose tissue serves a protective role in maintaining some level of estrogen, even after menopause or other factors that contribute to estrogen interruption.

Do not diminish the overall body effects brought on by radiation induced menopause or low estrogen. It can affect many aspects of one’s self (mood, emotions, bone density, vaginal atrophy and tissue thinning).

I took bio-identical hormone replacement (estrogen, progesterone, testerone, and a sprinkle of androgens) for about one and a half years, then titrated off of hormone replacement.
Hormone replacement need not be for years and years and years. Hormone replacement, for women, can serve an important role in quality of life as a transitional tool when dealing with abrupt hormone loss.
Karen

KimT wrote:Excuse me while I step on my soapbox. I am on hrt following ovarian cancer. I had to fight for it. I have found in general that oncologists are terrible when it comes to dealing with post chemo side effects. They just don’t deal with it. The attitude I got from oncology and a lot of doctors is that I should be thankful to be cancer free and basically I don’t have the right to ask for a better quality of life. If you beat cancer and are miserable, what was the point? I was on just Premarin for years and it was inadequate. You cannot just replace estrogen in women. You have to consider progesterone and testosterone as well. I am now on bioidentical hormone replacement. I see a pharmacist who specializes in it. He cannot prescribe it though but I see a gynecologist who works with him and she will prescribe whatever he recommends. As long as I see her once a year for a pelvic exam, she will write the prescriptions. I would recommend seeing someone who does bio identical hormone replacement. My pharmacist customizes a blend for me. I am getting estrogen, progesterone, and testosterone. I finally feel like a women after 6 years of inadequate treatment. Fight for a better life for yourself. Doctors are not very supportive of hrt following cancer but be firm about what you want. There are risks of course but we have the right to choose hrt for a better quality of life. They don’t get to decide for us.

How long did it take before you started to feel normal? Now often do they check your levels? That's a great idea about seeing a pharmacist.

RenLew wrote:
How long did it take before you started to feel normal? Now often do they check your levels? That's a great idea about seeing a pharmacist.

I felt better within 30 days. It was discovered when we did the initial lab tests that I was hypothyroid so I started medicine for that at the same time as starting the bio identical hormones. My energy level really shot up. I had been exhausted for 6 years. I was a bit discouraged in lack of improvement in sex drive but my gynecologist advised givIng it a few months before messing with the doses. She was right and I saw significant improvement around 2 and a half months in. My thyroid levels have been rechecked but not the hormone levels. We will do that again around February. I really appreciate that they haven’t pushed retesting the hormones but are treating me based on how I feel. It’s not always about what the lab numbers are, but about how a person feels. Also insurance covered very little of the lab tests and does not cover the hormones at all so I appreciate keeping costs down as much as possible. They pharmacy gives me a discount to buy 3 months at a time so that is what I do. The costs are $128 for 3 months of the hormones and the labs were nearly $400.

I did some research and found a local pharmacy that does this, I plan to go for the consult just to hear what they say. Thank you all.

I waited for a while after chemo before I asked my Gyno for Hormone Replacement Therapy. I have done hormone pellets (estrogen and testerone) and oral progesterone. My gynecologist does not believe colon cancer is hormone related and had no trouble giving it to me. Like you, my hormones were in the tank. I feel so much better. Energy, moods, sex life. Until someone says to stop, I am will continue.

This may be a controversial suggestion, but I say the first thing you should do is find a FEMALE ob/gyn.

Hi,

My understanding is that HRT can be slightly protective against colon cancer, and while it can cause breast cancer, the risk is minimized if you stop treatment within five years.

I had both ovaries removed in 2009 because of suspicious looking cysts that turned out not to be cancerous and I was on Prempro for five years afterward. When I first tried to stop after 2-3 years, I had massive hot flashes (like 30 per day), and no interest in sex. When I weaned off after five years, I had fewer, by far, hot flashes. I did have diminished sex drive, but it came back over time.

Like so many things, you have to weigh the risks and benefits, but I think the risk is minimal if you stop within five years. Good luck to you!