Know the risks about HRT and breast cancer. But don’t panic about them

https://www.theguardian.com/commentisfree/2019/sep/02/risks-hrt-breast-cancer-dont-panic-survivor-doctor

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It was hard to avoid the story, late last week: “Breast cancer risk from using HRT is twice what was thought,” it warned. I read it, because as someone who’s experienced breast cancer I’m always interested in the latest news about it.

The new research doesn’t apply to me: I wasn’t taking HRT when I was diagnosed aged 51, and like most breast cancer survivors, HRT isn’t an option for me now. The latest news is about the risks being higher than previously believed, but researchers have long known there’s a link. In fact it would be remarkable if that wasn’t the case, since for so many women, me included, breast cancer is connected to hormones, which HRT is all about.

What my brush with breast cancer taught me above all was that it’s vitally important to be vigilant

So my main thought wasn’t really about HRT. Instead, it was about how terrified many women would be reading that headline. I remember so well that grip of fear; for many years, my life was blighted by it. Breast cancer seemed everywhere, and somewhere inside I suspected it was only going to be a matter of time before I got it myself.

The weird thing is that the reality of having it turned out to be nothing like as terrifying as the fear that I’d get it. Of course, hearing I had cancer was an appalling blow initially. There were a few weeks when my life was entirely dominated by the need to get information – from a whole raft of tests and operations; about how serious it was; and what could be done about it. But once I and the specialist had all the information, and had worked out a treatment pathway that would both hopefully banish the disease and work for me, I realised things weren’t nearly as bad as I’d feared.

The worst thing about getting cancer was the finding out, and the information-gathering – after that, there was a route to sorting it out.

Sadly, of course I know that’s not how it is for every breast cancer patient. But for a majority of us, my experience is typical. Certainly when I was “in the system” I was very aware that I was surrounded by doctors and caregivers who were used to dealing with women like me for whom the disease would be a temporary problem, rather than a death sentence. More and more women, and again I was lucky enough to be one of these, are also able to deal with breast cancer without losing a breast or having major changes to their bodies. Oncoplastic surgery, which allows surgeons to remove the tumour and rearrange the breast tissue so you’re left virtually unscathed, is improving all the time, and I was very much a beneficiary of it. So too are tests that identify whether or not you need chemotherapy: again, I was one of the lucky ones.

Breast cancer risk from using HRT is ‘twice what was thought’

What my brush with breast cancer taught me above all was that it’s vitally important to be vigilant, to report changes, to listen to your instincts (three doctors told me I didn’t have cancer, before it turned out that I did) and to seek out information if it’s confirmed you do have a tumour. But I wish I hadn’t spent so long living under a cloud of fear, because the reality wasn’t as bad as the anticipation.

Panic, I learned, is the worst way to respond to cancer: it’s entirely understandable, but it doesn’t help in any way. The new research, when you read it all through calmly, shows that the risk of breast cancer if you’re taking HRT is up slightly; so you have a 6% chance of it anyway, between the ages of 50 and 69, and if you’re taking HRT, that rises to 8%.

Now that’s important to know, but it’s equally important not to panic about. If you’re affected by the story, talk to a medic who knows their stuff on it – that’s well worth your time. You need to weigh up the risks based on your individual attitude to life in general, and to risk-taking in particular. After all, you’re a whole person, not just a potential breast cancer candidate: in my experience, you make the best choices for your health if you keep that very much to the front of your mind.