I believe HRT gave me breast cancer… and my doctor agrees
07:00 GMT, 25 May 2012
The latest medical advice in the Journal of the International Menopause Society worries me deeply, I have to say. It reassures menopausal women in their 40s and 50s that taking HRT to help cope with their symptoms is completely safe.
It states that the concerns about hormone replacement therapy causing an increased risk of breast cancer, which came to the fore a decade ago, were the result of flawed medical trials and it claims millions of women have been deprived of life-enhancing oestrogen for ten years as a consequence.
I’m not so sure.
Unconvinced: Despite experts claiming HRT is perfectly safe, author Jenni Murray still believes the procedure gave her breast cancer
I wish I could say: ‘Go for it!’, having experienced the misery of the hot flush that sets you alight and dripping at the most unwelcome moment or soaks the sheets at night. That’s not to mention the low moods, the irritation with my nearest and dearest and the lure of what seemed to be the cure for all these ills.
And HRT promised more — glowing, plumped-up skin, thick, shiny hair, boundless energy, strong bones and a reduced risk of heart disease and stroke. All the benefits that the hormone oestrogen confers on the young woman’s body, and which diminish as it fades away with age.
In 1995, at the age of 45, I and most of my close friends went trotting along to the doctor as the symptoms of the menopause began to manifest themselves. There was a blood test to check we were indeed approaching the change, followed in my case by a quick consultation with my lovely, female GP.
‘Yes,’ she said, ‘you’re clearly menopausal. What do you want — pills or patches’ I took the tablets, the symptoms miraculously disappeared and I enjoyed ten energetic years in complete comfort, determined that this miracle potion would be my daily dose for the rest of my life.
Enjoyed renewed energy: Jenni at home in the Peak District in 2001 while talking about her experiences with the menopause
I steadfastly ignored the warnings that began to filter through, particularly from the Million Women Study carried out in the UK, that there was clear evidence of a connection with breast cancer and that the protective claims made for HRT against heart disease and stroke were unproven. Life as an unquestionably young-looking, lively, healthy middle-aged woman was simply too tempting.
Then, ten years on, at the age of 55, I was standing in the shower, doing the prescribed regular breast check, when I noticed a symptom. A quick visit to the GP followed by a speedy referral for a mammogram and the diagnosis was confirmed. I had breast cancer.
Over the next four or five years, three of my closest friends and fellow HRT enthusiasts were similarly diagnosed. I spoke to one of them, Sally, this morning. We agreed we’d been grateful for the benefits HRT had brought us and couldn’t be absolutely certain that our cancer had been caused by it.
We had often enjoyed sharing a bottle of wine and I was unquestionably overweight — both known to be risk factors for breast cancer. But Sally is skinny as a rake and a regular visitor to a gym. Another of my breast cancer buddies is also stick-thin, fit as a flea and a teetotaller — so the only risk factor that unites us is HRT.
My oncologist, Professor Nigel Bundred, a leader in the breast cancer field, has no doubt that HRT played its part in my disease and says there seems to be evidence of a slight fall in the number of women being diagnosed (his figures are from the U.S.) since the uptake of HRT has reduced as a result of the scares.
Bombshell: The radio presenter meets The Queen in 2005, the year she discovered she had a lump in her breast at the age of 55
The first instruction he gave me as we discussed my treatment plan was to stop taking it immediately and never, despite my fear of turning into an exhausted, osteoporotic, wrinkly old crone, to take it again.
To me, it makes absolutely logical sense. The most common form of breast cancer in women in their 40s, 50s and upwards (the risk increases as we age) is the one known as a hormone receptor. It’s fed by oestrogen.
That’s one reason why being overweight is a risk — fat, apparently, encourages the production of the hormone. Add in the HRT and you’re providing breakfast, lunch and tea for any hungry little nasty cell that passes by.
The current advice from those involved in the restoration of the reputation of HRT does acknowledge some connection with cancer, saying statistically there will be one case of breast cancer per thousand after taking HRT for one year, but the risk rises significantly after seven years.
The protocol in practice in the NHS is that the medicine should be prescribed for a maximum of five years, to take you through those unpleasant menopausal symptoms, which, by the way, not every woman suffers. Some sail through, barely noticing anything except the cessation of menstruation.
It’s this regime that makes me wonder whether there’s any point in taking HRT at all. My mother was an early user. In her late 40s and my mid-20s her periods became alarmingly erratic and heavy: a common symptom of the menopause. Her doctor recommended a hysterectomy.
Dark days: Jenni in 2007 after losing her hair following chemotherapy to treat her breast cancer
I had just read a book called No Change — the first to sing the praises of HRT. I sent it to my mum. She persuaded a reluctant young GP to prescribe it. All her problems ceased.
For years, her perfect skin and glossy hair led to her being taken for my sister and she avoided the surgery. (It should be said the menstrual problems would have resolved themselves with a little patience and forbearance as her periods ceased, and modern doctors are less keen on suggesting a major operation as the first line of defence.)
In her late 60s she went to see her doctor about another matter. She was suffering the early symptoms of Parkinson’s Disease. Her GP mentioned in passing that it was, perhaps, time to review her HRT use as there was worrying evidence that it might play a role in breast cancer.
They were words that struck terror into her heart. She went home and threw what was left of her tablets in the bin.
It was just before Christmas and, when she arrived at our house for the family celebrations, she was a wreck. Her mood was low. She needed to change the sheets after a night in bed. On a freezing cold winter’s day she wanted the heating turned down because she was having a hot flush.
It was exactly what happened to me when I followed my oncologist’s advice and threw my HRT away. They say if you wean yourself off it slowly, the symptoms are not so severe, although, anecdotally, among friends, this doesn’t seem the case.
Whether you stop it fast or slowly, it seems the symptoms take a grip again and, this time, there’s no way out. Even the apologists argue it shouldn’t be taken by women in their 60s.
Indeed, the advocates of HRT say the reason we shouldn’t trust the trials showing a significant connection with breast cancer, is that the majority of women in one of the trials were 63.
Well, I took HRT in my 40s and 50s, I had breast cancer, and now I have another pill that I take every day. It’s called Letrozole and its job is to get rid of any vestige of oestrogen that might remain in my body. Its purpose being to act as a preventative measure and help ensure there is no recurrence in the remaining breast.
So, for me, it’s back to the inappropriately-timed hot flushes and rather more effort is required to summon up as much energy as I need to live life to the full. I’m lucky to have good, strong bones and try to do weight-bearing exercise to fight off osteoporosis. I’ve also, happily, inherited Mum’s skin and hair — so I’m not quite a crone yet.
As for whether or not to take HRT — it’s your decision. I remember the treatment’s most vociferous advocate, the former Conservative MP Teresa Gorman, telling me she’d be prepared to face breast cancer in her old age in return for the years of youthful energy HRT gave her.
But then, as far as I know, she never went through the terror of that dread diagnosis, the mutilating surgery and the poisonous impact of chemotherapy. I did and I honestly can’t say I agree with her!