Lung cancer presents clinical and biological pecullarities in women, including a higher frequency of adenocarcinoma, a disease diagnosis in younger age, more cases in non-smokers and a longer survival time in comparison with males, whatever the stage of the disease. These difference could be partially explained by hormonal aspects: estrogen and progesterone receptors are both present in healthy tissue and in non-small cell lung cancer. Many papers, mostly observational studies and two randomized trials, describe a relationship between hormone therapies (estrogen with or without progestins) and lung cancer, providing contradictory results. Overall, observational studies (especially those conducted with appropriate sample) show an inverse relationship among hormone therapies and risk of lung cancer, while the randomized trials (the HERS and the follow-up of WHI study) suggest an upward trend in lung cancer. Epidemiological and clinical data about the relationship between smoking habit, hormones and lung cancer are still controversial. Studies in vitro suggest a negative role of estrogen on carcinogen effect by tobacco smoke. By contrast, estrogen may have a protective role by maintaining the integrity of mucous membranes or by counteracting the affinity of carcinogens to bind to estrogen receptors. The prevalence of protection or damage mechanisms may help in explaining the contradictory data. In conclusion, no well established data on the relationship among hormone therapies and lung cancer are nor available. However, taking into consideration the results in the two above mentioned randomized trials and a possible negative effect on risk disease due to the interaction between hormones and smoke, it would be wiser to recommend the smoking cessation in women who need hormone therapy. © Copyright 2009, CIC Edizioni Internazionali.
Hormone therapy in menopause and lung cancer [Article@Terapie ormonali in menopausa e cancro del polmone]
CAMPAGNOLI, CATERINA;Ambroggio S.;PERIS, CHIARA;Capelletto E.;Novello S.
2009-01-01
Abstract
Lung cancer presents clinical and biological pecullarities in women, including a higher frequency of adenocarcinoma, a disease diagnosis in younger age, more cases in non-smokers and a longer survival time in comparison with males, whatever the stage of the disease. These difference could be partially explained by hormonal aspects: estrogen and progesterone receptors are both present in healthy tissue and in non-small cell lung cancer. Many papers, mostly observational studies and two randomized trials, describe a relationship between hormone therapies (estrogen with or without progestins) and lung cancer, providing contradictory results. Overall, observational studies (especially those conducted with appropriate sample) show an inverse relationship among hormone therapies and risk of lung cancer, while the randomized trials (the HERS and the follow-up of WHI study) suggest an upward trend in lung cancer. Epidemiological and clinical data about the relationship between smoking habit, hormones and lung cancer are still controversial. Studies in vitro suggest a negative role of estrogen on carcinogen effect by tobacco smoke. By contrast, estrogen may have a protective role by maintaining the integrity of mucous membranes or by counteracting the affinity of carcinogens to bind to estrogen receptors. The prevalence of protection or damage mechanisms may help in explaining the contradictory data. In conclusion, no well established data on the relationship among hormone therapies and lung cancer are nor available. However, taking into consideration the results in the two above mentioned randomized trials and a possible negative effect on risk disease due to the interaction between hormones and smoke, it would be wiser to recommend the smoking cessation in women who need hormone therapy. © Copyright 2009, CIC Edizioni Internazionali.
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