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January 09, 2005

HRT/Oophorectomy & Strokes

In my continuing crusade to inform women about the value of their ovaries, I saw this article in a UK newspaper online yesterday.

HRT shown to increase risk of strokes:

A study released by the University of Nottingham using a base of 40,000 women and found that women on HRT had a 29% greater risk of strokes.

This comes in the same week that I saw the results on HysterSisters.com of their annual survey, which includes a base of respondents of a little less than 6,000.

The most startling thing of course is that half of the women who'd had hysterectomies also had oophorectomies (I think that's about 2,580 of the respondents since not all had hysterectomies at the time they took the survey).

79% said that they had moderate to high intensity of menopause symptoms (and let's consider all those symptoms that aren't "felt" like osteopororis and arterial damage).

42% of women who went on HRT were not satisfied with the forumlation

62% who changed formulation reported better results, but 11% still didn't have their mix right.

What disturbs me so much is that I still see ladies in their forties being told that their doctors prefer to remove their ovaries at that time to reduce their risk of ovarian cancer - or worse, because they don't need them anymore. I, of course, and doing my best to help show them the most recent information. The American College of Gynecology and Obstetrics abandoned the prophylactic removal of ovaries for women over forty-five back in the nineties.

One of the ladies on the board pointed to an excellent article (PDF file) called - Rationale for Ovarian Conservation by Donna Shoupe MD. Any woman considering any gynecological surgery should read that article. The article is five years old and seems to have made very little dent from what I've seen on the hystersisters boards. For every woman who asks for advice on the topic, I'm guessing there are five that blindly follow their doctor's counsel.

Posted by Elizabeth M. at 09:35 AM | Comments (0)

September 25, 2004

Save a Life, Protect Your Own

How often do you get the chance to save someone else's life and have it be good for you too? I'm not talking about a good feeling, I'm talking about it actually making you healthier.

First of all, I've suspected for many years (since my grandmother started having heart attacks after her hysterectomy) that it's not just hormones that protect women from heart disease. It's also bleeding. I know it sounds weird, but a lot of westerners have very high iron levels. The only folks who don't are menstruating women.

Too much iron causes a condition known as hemochromatosis which can cause stress to the liver, kidneys and heart.

Studies have shown though that too much iron may be the cause of some heart problems.

But the cure is so simple, just donate blood.

I know, it sounds practically medeival - bloodletting.

But it's for a good cause. At this time blood cannot be synthesized and is needed for treatment of accident victims, burn victims, those undergoing surgery and those with diseases like hemophilia. It costs you nothing but an hour or so to go donate.

I used to donate all the time - I've donated more than three gallons in my lifetime but have not been allowed to donate for the past three years because of my anemia. Now that I've had my hysterectomy, anemia is not going to be an issue any longer. Not only that, I feel that I need to donate blood to stay healthy. And to just be a good neighbor. I was a little disappointed that they called yesterday evening and asked me if I could donate (I'm A negative, so I get called a lot). Alas, I have to wait for another month or so.

Posted by Elizabeth M. at 10:17 PM | Comments (0)

September 15, 2004

New Tests on their way for Ovarian Cancer

I know I wrote a lengthy article last week about keeping your ovaries. One of the things that I mentioned is that there will be tests available soon to detect ovarian cancer before it advances into the less treatable later stages.

There was great news in last month's issue of Cancer Research. Johns Hopkins Kimmel Cancer Center have developed a test examining three markers in the blood. Used in conjunction with the existing CA-125 test it was 83% effective at diagnosis early stage ovarian cancer. Not only that, the false positives were reduced from 48% of the time to 6%.

The blood test screens for three different proteins that are unique to those with ovarian cancer. Not only does this allow doctors to diagnose the cancer earlier, but it may eventually lead to a better understanding of how the cancer develops, what causes it and to find the genetic markers that predispose women to this disease. The test still needs more testing with a larger group of test subjects before it will be widely available. More info here.

In other news, the Fox Chase Cancer Center have taken a different tactic for detecting ovarian tumors by searching for indications of hypermethylation of two tumor-supressor genes. I don't fully understand this approach, but because it's not looking for protein markers like the Johns Hopkins test, it seems that it offers yet another front to attack this elusive cancer. This same team used the same approach with detecting prostate cancer and kidney cancer with the same tactics. More info here.

Other encouraging findings include a study out of the University of Southern Florida College of Medicine point to using aspirin to inhibit growth of ovarian cancer. Trials are underway in order to determine if women should be directed to take aspirin to prevent ovarian cancer. More info here.

My hope is that one or more of these tests will be available within a year, even if it's just a limited trial. My confidence is that within the next five years there will be a simple battery of blood tests that women take just like a pap smear to screen for not just ovarian cancer, but other cancers that can be easily treated when found early.

Any questions or feedback? Feel free to email me.

Posted by Elizabeth M. at 06:38 PM | Comments (0)

August 27, 2004

Fibroids & New Genetic Research

I found a fascinating article about a study that was released a couple of months ago about the genetic connection to uterine fibroid tumors and keloid scarring.

It was a study conducted by Uniformed Services University of the Health Sciences (USUHS) and the National Institute of Child Health and Human Development of the National Institutes of Health and published in July 2004 in the journal Genes, Chromosomes and Cancer. You can read an article about it here at the National Institutes of Health. (The actual study bears the name "Involvement of fumarate hydratase in nonsyndromic uterine leiomyomas.")

Basically it found that the lack of a key protein that helps to bind tissues is lacking in women who have fibroids and women who have keloid scarring. It seems (and this is me making assumptions form the article which is rather technical in spots) that the lack of this protein means that structures supported by collagen are disorganized, instead of being in the normal discrete strands pattern that allows cells to grow in an organized fashion, they grow in disjointed strings and it seems the the body doesn't know where it's supposed to start and end and it can cause lumpy, disorganized, out-of-control growths.

I find this interesting on a lot of levels. First, when my doctor did my pre-op appointment we talked about how she was going to close the incision and at first she said staples, but then asked me what my scars look like. I showed her a particularly bad one which started as a half inch, five stitch thing where I had a biopsy done when I turned eighteen and is now two inches long and almost a third of an inch wide in the center. She called it a keloid and said that she'd do a plastic surgery incision to avoid scarring like that. So I'm guessing that there's a good chance that whatever made me make keloids is what allows fibroids to grow in me too.

I also think it's promising that someone's working on this and perhaps there can be some gene therapy for this or maybe just some injections to supplement this key protein that's missing in women who start developing fibroids in order to stop them from growing.

Any questions or feedback? Feel free to email me.

Posted by Elizabeth M. at 07:34 PM | Comments (3)

July 21, 2004

A little off topic

About a year ago I was introduced to Dr. Lee's book, What Your Doctor May Not Tell You About Premenopause. I read it, cover to cover and then went back and re-read the portions about fibroid tumors.
 
I'd not yet been to the doctor to confirm the fibroid diagnosis. I didn't have any other peri-menopausal symptoms. My bleeding was heavy, but had always been since I went off the pill when I was 22. My cycles were rather regular (a few hiccups, but usually attributable to illness or jetlag). The only thing that lead me to believe I had a hormone imbalance was the large mass that was amassing in my abdomen. So I tried progesterone cream for about six months, in hopes that it would do something about the largeness of my belly and perhaps make weight loss easier.

 
It did neither. I put on weight in January and February when I got a very bad case of bronchitis and kept on the cream until March when I started looking for a new doctor.
 
The thing about Dr. Lee's books is that I didn't care for the hyperbolistic style. I don't like how it seemed to make judgments about women who followed their doctor's recommendations. The book suggested that hormone creams and hormone balancing were a cure all. I don't think that's true. I'm not sure all of modern women's ills are caused by hormone imbalances that we can control.
 
Surgery is very serious and though we know a lot more about hysterectomies and the removal of ovaries, I'm not quite comfortable just tossing aside my uterus just because it has these abnormal and invasive growths. But how much time and effort can I invest in a therapy that takes so long and has such a low incidence of helping? The point really becomes, what caused these fibroids to grow in the first place? As far as I can tell, it's a genetic pre-disposition. My maternal grandmother's largest fibroid was the size of a grapefruit when it was removed, when she was five years older than I am now.

That was 35 years ago. Was she a victim of modern living, chemicals and hormones invading her body? Or is it just the way our family is built?

My grandmother lived to be 79 years old, died from congestive heart failure. Her first heart attack was only a few years after her radical hysterectomy. She was overweight and smoked. Do we blame the hysterectomy for her heart attack? No, we point the finger at genetics and her weight.

So why not point the finger for fibroids where it belongs. I'm just built to make them. Some women make ovarian cysts. I make fibroids.

And I've made the choice to stop making fibroids and remove my fibroid factory and only my fibroid factory.

Any questions or feedback? Feel free to email me.

Posted by Elizabeth M. at 03:09 PM | Comments (1)