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Effect of anti-cancer treatment on the onset of menopause
Effect of anti-cancer treatment on the onset of menopause
Treatment of breast cancer consists of different methods: it is an operation and chemotherapy, and radiation exposure, and hormonal treatments. All this can affect ovarian function and leads eventually to the onset of menopause.
Chemotherapy - a very aggressive treatment
These drugs affect not only the tumor, but also to healthy organs and tissues. We have already said that chemotherapy drugs affect primarily of rapidly-growing and cells. But they also have an impact, and ovarian tissue. 50% of women younger than 35 receive chemotherapy in the form of CMF (Cytoxan, methotrexate, fluorouracil), which leads to menopause. In women aged 35-44 years after menopause such therapy occurs in 80% of cases, and in women older than 45 years - 100% of cases.
At the risk of chemotherapy adriamycin menopause is somewhat less in patients younger than 40 years, but for those who are older, this probability is the same as in the CMF therapy. Sometimes, chemotherapy causes temporary menopause.
Hot flashes can be aggravated if the patient receives chemotherapy after tamoxifen - a drug that is its effect on the anti-estrogen. It blocks estrogen receptors, and this hormone can not exert its effect. Although tamoxifen does not cause menopause by itself, since it has no effect on the ovaries, but it can lead to its manifestations.
Very severe manifestations of menopause are in those cases when the diagnosis of breast cancer patient was forced to take hormone replacement therapy (HRT). In this case, it is necessary to stop HRT, plus join effects of breast cancer treatment that exacerbates manifestations of menopause.
In addition to chemotherapy and hormonal therapy, a "momentary" the emergence of menopause results in a surgical procedure, which sometimes have to carry on breast cancer - removal of the ovaries. This type of menopause is the most powerful "kick" to the body, because it simply is not prepared for this and is not adapted.
Menopause or not?
In the middle, and even after treatment of breast cancer is difficult to say whether the patient has come or not menopause. For example, a woman may be a woman was only a half of chemotherapy, or had missed several loops. Either you have had a hysterectomy, but the ovaries were preserved. In this situation, see if you have continuing ovulate or not - is impossible.
On the question of whether menopause occurred, may respond to a blood test for hormones. At the same time is determined not so much the level of estrogens and pituitary hormones - FSH (follicle stimulating hormone) and LH (luteinizing hormone). The fact that these hormones stimulate the ovaries. And because of the menopause when the ovaries produce fewer hormones or do not produce them, the pituitary gland starts to produce more FSH and LH. Persistent increase in FSH levels (normal 13 - 90 IU / l) and LH (15 - 50 IU / L) suggests that ovarian function is extinguished. The level of estrogen in the blood during the month ranged from 150 to 300 pg / ml. Upon termination of ovarian function becomes less than 20 pg / ml.
In women before menopause and at the time of the onset of taking tamoxifen, estrogen levels may be significantly increased due to the lack of effect of this hormone in the body.
Treatment with tamoxifen, and menopause
The hormone estrogen has an effect on the fabric through the receptors. These are protein molecules on the cell walls, which are connected with a molecule of the hormone that appears relevant effect. These receptors are different in different tissues. Receptors in the brain responsible for regulating body temperature (think hot flashes!), Concentration, sleep. Receptors on bone are responsible for its durability and strength. Receptors on the cells of the breast (and on her cell tumors) are responsible for their growth.
Tamoxifen blocks the receptors, where it blocks, unfortunately, not only to receptors located on the surface of breast cancer, but also in other areas. The only thing that can be distinguished in its positive effect on other tissues - it strengthens bone tissue. But it has a negative and "menopausal" effects - hot flushes, as well as a slightly increased risk of endometrial cancer of the uterus.
