Hormone Therapy Has A Stronger Impact On A Woman’s Quality Of Life Than Chemo, Study Finds

A French study has found that hormone therapy has a greater impact on a woman’s quality of life than chemotherapy two years after a breast cancer diagnosis.

Hormone therapy (also called endocrine therapy) is given to breast cancer patients whose cancer is fueled be either estrogen or progesterone, or both. Roughly two out of every three breast cancers is hormone-positive. Hormone therapy is systemic — meaning that it targets cancer cells throughout the body, not just in the breast. It is typically taken for five to ten years.

Chemotherapy can be given before or after breast cancer surgery, and is the primary treatment for metastatic breast cancer. It is given in cycles, which can least weeks to months at a time. Chemo attacks fast-growing cells like cancer cells, but also the quick-growing cells in your bone marrow, hair follicles, and digestive tract.

Side effects for both treatments can range from mild to severe. Yet a common perception is that chemotherapy has worse side effects and more negatively impacts a woman’s quality of life. This study found that perception to be wrong.

The study was published in the Annals of Oncology and was conducted by Institut Gustave Roussy. The data was pulled from patients who were part of the CANTO cohort (“CANcer TOxicities”). This cohort is a group of 20,000 breast cancer patients who will be studied over a period of ten years, with the specific goal of quantifying and preventing chronic toxicities related to treatment.

Researchers measured quality of life in 4,262 breast cancer patients from the CANTO cohort, using two different tools: one which assessed general quality of life in patients with all types of cancer (EORTC QLQ-C30), and a tool that specifically assessed quality of life in breast cancer patients (QLQ-BR23).

All the patients in the study had localized breast cancer that was stage I, II, or III. Quality of life was measured at the time of diagnosis, one year after the diagnosis, and two years after the diagnosis.

For all of the women in this study, the primary treatment method was surgery. Some of them also had chemotherapy and/or radiation. About 75-80% of them had to take hormone therapy for a minimum of 5 years. Roughly one-third of the women were premenopausal, with the other two-thirds being postmenopausal.

Researchers found that, overall, quality of life was worse two years after diagnosis for patients who were taking hormone therapy, especially patients who were menopausal. Quality of life was also worse for a longer period of time compared to chemo. Hormone therapy had a detrimental effect on a variety of areas and symptoms, including role and social function, pain, insomnia, systemic therapy side-effects, breast symptoms, emotional function, and future perspective recovery.

Chemo had a negative impact on physical and cognitive function, dyspnea, financial difficulties, body image, and breast symptoms. But, while rough at the onset, chemo lasts only a short time in comparison to hormone therapy, and was not shown to have a persistent negative impact on quality of life at two years post-diagnosis.

The effects of each treatment were different for premenopausal and postmenopausal women. Chemo had a stronger negative effect on quality of life for premenopausal women at first — especially on cognitive function. But for postmenopausal patients, hormone therapy was more frequently associated with lowered quality of life.


The findings of the study suggest a significant downside to hormone therapy, and this is something patients need to be made aware of. However, the benefits can certainly outweigh the risks in many situations. Additional support for patients undergoing hormone therapy should be considered.

“It is important in the future that we are able to predict which women are going to develop severe symptoms with anti-hormonal treatment so that we can support them,” said Dr. Inès Vaz-Luis, a specialist breast cancer oncologist and researcher who directed the study. “It will also be important in the future to differentiate prior to treatment patients who are at high risk of relapse from those at lower risk in order to tailor hormone treatment. This may be done to avoid escalation of anti-hormonal treatment in certain patients.

“Hormone therapy is extremely effective in treating breast cancer, resulting in a reduction by approximately 50% in the risk of relapse. The finding of adverse effects does not in any way put into question the excellent risk/benefit ratio of this treatment.”

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Self silencing can lead to cardiovascular diseases in women

While people might think that letting out your true feelings can be good for the mental being, it is equally beneficial for your physical health.

A new study associated self-silencing (inhibiting one’s self-expression) with greater carotid plaque buildup which could lead to stroke and other cardiovascular problems.

Individuals engage in a range of behaviors to maintain close relationships, some of which may be costly to their own health. One such behavior is self-silencing, which is sometimes used to avoid conflict or relationship loss.

Although self-silencing has been linked to worse mental and self-reported physical health in women, it has not been previously examined in relation to women’s cardiovascular health.

In this new study of 304 premenopausal and postmenopausal non-smoking women, researchers tested whether self-silencing was associated with carotid atherosclerosis.

They found that greater self-silencing was related to increased odds of plaque independent of socio-demographics, CVD risk factors, and depression.

The results were based on women’s self-reporting on a range of factors such as how often they expressed anger or put someone else’s needs before their own. Ultrasound imaging was used to quantify carotid plaque.

The findings will be presented during the North American Menopause Society (NAMS) Annual Meeting in Chicago, September 25 to 28, 2019.

“Given increased public health interest in women’s experiences in intimate relationships, our results suggest that women’s socio-emotional expression may be relevant to their cardiovascular health,” said the lead author of the study.

“Studies like this one are valuable as they highlight the importance of understanding how a woman’s emotional disposition can affect her physical health,” added the Dr.

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Weak Upper Body Strength in women associated with depression, anxiety

Weak upper and lower body fitness can cause serious depression and anxiety in midlife women, a recent study suggests.

Although several studies have previously linked depression in midlife women with self-reported low physical activity, this new study evaluates objective measures of physical performance in relation to depression and anxiety in premenopausal, perimenopausal and postmenopausal women.

Depression and anxiety are prevalent symptoms experienced by midlife women. This latest study of more than 1,199 women aged 45-69 years found , in fact that 15% of participants, especially those of younger age, reported depression and or anxiety.

Because depression can cause disability, reduced quality of life, mortality, and heart disease, researchers felt it was important to identify potentially modifiable risk factors that could reduce morbidity and mortality. 

The study observed significant associations of objective physical performance measures with depression and anxiety.

Specifically, they found that weak upper body strength ( hand grip strength) and poor lower body strength ( longer duration to complete the repeated chair stand test) were associated with elevated depression and or anxiety symptoms.

According to the researchers, future trials will be needed to determine whether strengthening exercises that improve physical performance might similarly help reduce depression and anxiety in midlife women.

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Air pollution exposure linked to breast cancer

Women working near busy roads are at high risk of developing breast cancer, due to traffic-related air pollution, researchers have warned.

The team, analysed the case of a woman who developed breast cancer after spending 20 years working as a border guard at the busiest commercial border crossing in North America.

The woman was one of, at least, five other border guards who developed breast cancer within 30 months of each other and, at another nearby crossing, a cluster of seven other cases was noted.

According to the researcher, the findings “infer a causal relationship” between breast cancer and very high exposures to traffic-related air pollution containing mammary carcinogens. A link between night-shift work and cancer was also identified.

“This new research indicates the role of traffic-related air pollution in contributing to the increasing incidence of breast cancer in the general population,” the researcher said.

The group of women all developed a cancer believed to have been caused by exhaust fumes in what researchers have branded a ‘new occupational disease’.

 There is a one in 10,000 chance the cases were a coincidence, the study published in the journal New Solutions said, because the cancers were all so similar and close together.

A review of previous research confirmed that BRCA1 and BRCA2 genes — which try to stop tumours growing — can be “silenced” by exposures to dioxins and polycyclic aromatic hydrocarbons – both found in exhaust fumes.

BRCA2 gets rapidly degraded in the presence of aldehydes – also components of exhaust fumes.

“There is much more research to be undertaken,” the researcher said. “But we now have plausible mechanisms for inferring how the BRCA1/2 tumour suppressors in this highly-exposed border guard became dysfunctional and likely contributed to the ongoing epidemic of sporadic, early onset, premenopausal breast cancer among her colleagues.

 “With this new knowledge, industry and government can plan for new designs for industrial and commercial facilities to cut down on the occupational exposures to traffic-related air pollution,” the researcher said.

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Vitamin D may offer protection against cancers

Vitamin D may offer protection against cancers, new research suggests, although experts are split over whether individuals should start taking supplements.

The vitamin plays an important role in the body, including in bone health and muscle strength and in preventing conditions such as rickets. 

It is produced when sunlight hits our skin, can also be found in certain foods such as eggs and fatty fish, and can be taken as a supplement.

Now researchers say higher levels of the vitamin are linked to a lower risk of cancer, in particular liver cancer.

“We believe vitamin D has a maybe weak, but beneficial effect across many cancers,” said the coauthor of the study.

It is not the first study to suggest that people with low levels of vitamin D might be at increased risk of a number of cancers, but the evidence is far from clear, with some studies showing no such effect and others suggesting protective effects against particular cancers but not others.

The latest study, sought to unpick the issue. The team looked at levels of the biologically active form of vitamin D in blood samples taken from more than 30,000 middle-aged individuals at health centres across a country during the early 1990s. The participants were followed up over a median of 16 years.
The researchers based their analysis on data from 3,301 participants who developed cancer after signing up to the study and 4,044 randomly selected participants, 450 of whom developed cancer.
After taking into account factors including age, sex, smoking status and family history of cancer, as well as seasonal differences in circulating vitamin D, the team found that higher levels of circulating vitamin D are linked to a lower risk of cancer overall.

Compared with the quartile of participants with the lowest levels of circulating vitamin D, the quartile with the highest levels had a 22% lower risk of cancer. The team say there was no difference in the effect of vitamin D based on sex.

Looking at specific cancers, the team found about a 50% lower risk of liver cancer, once diet was also considered, for the group with the highest vitamin D levels compared with the lowest.

A weaker effect was found for premenopausal breast cancer but there was no clear link for other cancers, including lung cancer, colorectal cancer, prostate cancer or breast cancer as a whole. 

The team found that the link to a lower total cancer risk was seen even when liver cancer was taken out of the mix. That could be because smaller effects of vitamin D on other cancers might add up when they are considered together.

However, the authors note that the study has limitations, including that levels of vitamin D were only taken at one point in time, that participants might have been more health-conscious than the general public and that the number of cases of rare cancers was small.

Another researcher said: “Although this study suggests that higher vitamin D levels in the blood could mean lower cancer risk in Asian populations, overall the evidence for a possible link has been mixed.”

The Dr. added that it was not clear whether being deficient in vitamin D has a direct impact on cancer risk or just reflects poor health in general. “Enjoying the sun safely, while taking care not to burn and increase skin cancer risk, should help most people get enough vitamin D in summer,” she said.

A professor of dermatology and vitamin D expert, said the study chimed with others that had found a protective effect from vitamin D against cancer deaths. 

A Dr. said the latest study was consistent with findings from the scientific advisory committee on nutrition, which recommended that Britons should be taking 10 mcg of Vitamin D per day, given the variability in sunshine around the country and with seasons.

The Dr. added: “I suspect from this paper and from other papers that vitamin D does have an effect, but it is relatively modest and it is more about avoiding a low level than taking high levels.”

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