MaryO

http://www.acurian.com/patient....lcthtml Summary: Androgen Replacement Therapy in Women with Hypopituitarism This is a 12-month study investigating the effects of a natural hormone on bone formation, body composition, quality of life, cognitive function and libido. The study involves blood sampling, questionnaires and tests to determine bone density and the amount of fat and muscle in the body. Subjects will receive up to $600 for 6 outpatient visits after a screening visit determines eligibility. Patient Inclusion/Exclusion Criteria: Women ages 18-50 with adrenal insufficiency and/or estrogen deficiency from pituitary problems. Contact: Karen Miller MD Massachusetts General Hospital Fruit Street Neuroendocrine Boston, MA 02115 Telephone: 617-724-7388 Email: kkmiller@partners.org ~~~~~~~~~~~~~~~~~~~~~~ Center Overview The Massachusetts General Hospital has a long, rich, and diverse tradition of excellence in clinical research that continues to expand today. The extensive resources for training clinical investigators and performing top quality translational investigation include: An integrated full service primary, secondary, and tertiary care hospital network with access to large numbers of both local patients with common diseases and national and international patients referred for evaluation of rare disorders, over 600,000 square feet of research space, and a diverse population of thousands of basic and clinical scientists studying topics ranging from very basic molecular biology to direct patient management. The MGH Clinical Research Program (CRP) was established to improve the environment for clinical investigation at the MGH through academic enrichment programs and direct support services, creating a culture in which all forms of clinical research can flourish. Its mandate is to: Enhance bench to bedside research Train clinical investigators Increase clinical trial activity Support outcomes research and disease management Coordinate the MGH's efforts with those of Partners HealthCare System and Harvard Medical School The CRP serves as the institutional infrastructure that encourages and supports its physician scientists by serving as an interface between clinical investigators and sponsors of clinical trials and outcomes research. We work to: Explore preferred relationships with pharmaceutical and biotech companies Link industry to physicians for consulting, advisory board seats, and trials Provide outcomes and disease management expertise Support the administration of clinical trials Negotiate master clinical trial agreements The CRP provides a high level of clinical trial services to help investigators compete and meet the demands on industrial sponsors. Services to PIs include: Assistance with the IRB application Preparation and negotiation of budgets Contact facilitation Assistance in patient recruitment Data management support Assistance with strategy and proposal development for corporate-sponsored and investigator-initiated clinical trials Assistance with the development of large multi-center grant applications In addition to its role as a facilitator, the CRP has developed and sponsored a series of educational courses and seminars for current and future investigators and study coordinators. These activities not only improve the quality of the investigators and study coordinators but also raise awareness within the institution about clinical research. Mentoring is available to young researchers by fostering collaborations with established investigators. New investigators are offered career advice and assistance in developing and conducting research studies. Since communication plays a critical role within the research community, the CRP has developed an interrelated set of communication and clinical research tools: CRnet an on-line information source about clinical research at MGH; web-based query tools and patient data registries to characterize patient populations and assess clinical trial feasibility; software and databases for investigator-initiated patient data registries and disease management studies; and direct technical support for the clinical investigative community. The Clinical Research Program provides the infrastructure necessary to support clinical research on an institution-wide basis. By fostering academic collaboration, effecting communication with industrial sponsors and promoting a focused and streamlined administrative process, the CRP is building a responsive culture conducive to clinical investigation.

Wow, thanks for this, Kristy - I remember when Della's daughter died, we'd wondered what kind of pit tumor she'd had. I guess it wasn't Cushing's, but certainly scary enough! I hope she continues to speak out about this. We need all the "talkers" we can get!

Anyone interested in any of these? ?You can see them, un-logo'd here They're offering for "Back to School": Backpack (black) Metro Bag (black) Unistrap Bag (black) Briefcase (black) Yellow Messenger Bag Ash Grey Hoodie Black Cotton Cap Retro Lunch Box Coming later this month! The black cotton caps and black bags are customized using a 4" x 2" patch with an embroidered edge. Let me know, please, if there's any interest,,,

After I got rolling, it wasn't too hard. I should have planned ahead myself - I got my first t-shirt, totebag last week, then I went back and got some more stuff...then I ordered the travel mug with my name on it for Convention use. I shudda waited, too, but I didn't want to miss the hat sale, either.

A variety of coffee mugs, including personalized and travel, are now available in the Cushing's Store ?There are currently 54 different products to choose from, all of which support these websites and CUSH. I've made some with slogans to put on mugs for endos or other supportive people, but I'm open to other ideas if anyone has any thoughts...

The perfect place! Thanks, Sarah

I'm going nuts here. I just ordered another Tshirt for me (Cushing's Survivor), a Support Staff for Tom, a beach hat and... well, I really love my coffee, so I made myself a personalized travel mug. If anyone else would like something similar, just let me know. If you're interested, you can see what I did here

The $3.00 sale is only until the 28th. I don't know if the hats will go back to normal price then, of if they'll disappear until next summer.

Also done in all 9 shirt styles are Cushing's Support Staff, and Cushing's Survivors. All 36 shirt styles, the hats, mugs, visors and totebag are on one big page click here for the Cushing's Store The Golf and Baseball shirts don't have any design on the back. If anyone wants them on, please let me know. Also, if you want a special order, with your name printed on it, let me know. As always, each shirt provides $1.00 to the running of this site and $1.00 to CUSH.

The Cushie Crusader shirts (9 styles) are done now. View everything here: All Cushie products to date

The first of the Hats and Visors are ready. And, they're on sale! ?$3.00 off each. ?I think that means they're going away soon, since the summer's almost over. View them in http://www.cafepress.com/cp....support

http://health.yahoo.com/search/healthnews?lb=s&p=id%3A25877 Recent Findings from the Women's Health Initiative Trial Regarding Risks and Benefits of Estrogen-Progestin (Combined Hormone Replacement Therapy) in Healthy Postmenopausal Women July 26, 2002, Acurian Source: Brigham and Women's Hospital On July 10, 2002, the results of a large study looking at the effects of hormone replacement therapy (a combination estrogen-progestin pill, also known as Prempro) on healthy postmenopausal women was published. This study, the Women's Health Initiative, is a federally funded, national study. Brigham and Women's Hospital is one of the 16 Vanguard Centers in this study of about 16,000 healthy postmenopausal women, half of whom took a combination pill of estrogen and progestin and the other half took a placebo, or "dummy" pill. 1. Why is this study in the news at this time? The study was stopped early (after average follow-up time of 5.2 years) because the risk of invasive breast cancer was found to be slightly increased in the women who were taking the estrogen-progestin pills. In addition, the overall risks of the hormones were found to be greater than the benefits at this point. 2. What were the key findings of the study? There were slight increases in the rates of heart attacks, breast cancer, blood clots in the lungs, and stroke. The total number of women who had these outcomes was very small, but more women in the hormone group had these events than women in the placebo group. Overall, it was calculated that if 1000 women took the medication for 10 years, there would be 7 more heart attacks, 8 more cases of breast cancer, 8 more strokes, and 8 more blood clots in the women who took the hormones compared to those who did not. 3. If I am taking hormone replacement therapy, should I stop? This depends on why you are taking the medication and for how long. If you have been taking the medication for over five years, you should talk to your doctor about stopping. If you were started on this medication for hot flashes that were preventing you from performing your daily activities, and you have been taking the medication for less than 5 years, you should discuss staying on the medication with your doctor. This would be a good time to review the risks of the medication once again with your doctor. 4. What if I am taking estrogen only? There is a separate study being conducted by the Women's Health Initiative that is looking at the effects of taking estrogen only (no progestin, such as Provera). This study has NOT been stopped, since so far, there is no evidence of increased risk of breast cancer. You should only be on estrogen alone if you do not have a uterus (in other words, if you have had a hysterectomy). If you are taking estrogen alone and have a uterus, please talk to your doctor about this, since there is an increased risk of uterine cancer in women who have a uterus taking estrogen without a progestin. 5. What about transdermal estrogens (skin patches), or other forms of hormone replacement therapy? The Women's Health Initiative specifically studied the effects of the combination premarin (conjugated equine estrogens) and provera (medroxyprogesterone acetate) since this is the preparation that was shown to be beneficial in previous observational trials. Although these findings do not directly apply to other types of hormone replacement therapy, such as skin patches, synthetic estrogens, or other forms of progestin, there is very little evidence that these other forms of estrogen provide any benefit and they are not recommended at this time. 6. Are there any benefits to being on HRT? The study did find small decreases in the risk of bone fractures and colon cancer, but these benefits are smaller than the risks listed above. The National Cancer Institute has stated specifically in response to this study, however, that HRT should not be used for the purpose of preventing colon cancer. 7. Is there a greater risk of death for people on HRT? No, this study did not show an increase in death rates in the women taking the medication. 8. If I choose to stop the medication, can I quit "cold turkey"? Yes. If you have a return of your menopausal symptoms after quitting, you can go back on the medication and discuss with your doctor a slower tapering of the medication. 9. Do I need to quit taking the medication immediately? No, this is not an emergency. The absolute risk of being on this medication is still quite low, but enough to raise concerns about staying on the medication long-term. You may wait until your annual appointment with your doctor to discuss more fully. 10. What else could I use for my menopausal symptoms? Other treatments are available for the treatment of hot flashes, including medications called SSRIs, which are also used for depression or (MaryO Note: They didn't say what went after the "or"). For symptoms of vaginal dryness, vaginal estrogen preparations may be used, which are absorbed only minimally into the bloodstream. Some patients have used soy supplements or increased their dietary soy intake and have found this to be effective in reducing hot flashes, although there are no good studies proving that soy products are really beneficial. 11. What if I was taking HRT to reduce my risk of osteoporosis or heart disease? There are several other excellent treatment options for osteoporosis which you should discuss with your doctor. At the present time, there is no evidence that combination hormone replacement therapy prevents heart disease. However, there are other medications that have been shown to prevent heart disease (such as aspirin, cholesterol lowering drugs, and others) and you should discuss whether any of these medications would be of benefit to you. Finally, many lifestyle changes, such as getting regular exercise, eating a healthy diet, maintaining a healthy body weight, quitting smoking, and limiting your alcohol intake have been shown to be very effective in preventing heart disease.

http://hsc.virginia.edu/medcntr....ch.html Pituitary Research The following pituitary research is underway at the University of Virginia Health System. Neural net analysis in Cushing's disease (Reitmeyer) Visual disturbances in Cushing's disease - corneal edema, lens alterations, glaucoma (Newman) IGF-1 pre- and postop Outcome assessments for Gamma Knife radiosurgery (Vance) Recovery from pit insufficiency after surgery Metabolic (functional) imaging of pit tumors treated by medical Rx and Gamma Knife SPECT studies of pit adenomas (octreotide, MIBG) Intraoperative measurement of ACTH, GH, PRL (Pajewski) Genomic instability in recurrent adenomas (Clayton) Genomic comparisons by age within tumor groups (e.g. PRL, GH, NFA's Cushing's) Genomic comparisons by tumor subtype for acromegaly Genomic characterization of aggressive (malignant) adenomas Probe nl pit for nestin (precursor marker) & correlate with tumors Characterization of DA unresponsive prolactinomas (receptors, genome) Hypothalamic hormones as ligands for treatment ER mutations in pit adenomas (Shupnik) X- inactivation clonality studies in nl pit, 1? tumors and 2? tumors - sheep pits IGF-1 and IGF-1R in invasive adenomas (consider also EGPR, VEGF) (Lopes) CMR or CBF studies in Cushing's (correlation with cerebral atrophy) TRH Stimulated GN adenoma suspects tested for ? su, FSH, LH POMC to follow silent ACTH tumors - in situ hybridization for D2 receptors -? monoclonal origin of tumor Time course of cortisol decrease in operated Cushing's disease patients (Simmons-Thorner) Outcome assessment of pts. with craniopharyngioma (Rogol) CDNA probes for MEN-1 genes in sporadic pituitary adenomas Pituitary tumor cell culture and chemosensitivity testing (Kornblith) Molecular defects in GH adenomas (Cutler & Selman) Maintenance and cataloging of pituitary tumor tissue and blood bank (Wagner-Lopes) Pituitary tumor data base project (Thorner-Boyd) CDNA libraries for aggressive, recurrent and unusual adenomas Cerebral atrophy on MRI in Cushing's patients and control

Ok... Cushie Crusader and Cushing's Supporter coming up on all 9 of the shirts and Cushing's Expert, Cushie Crusader and Cushing's Supporter each coming up on the 3 types of hats we have...visor, beach hat and baseball cap. 27 new products - AARRGGHH.......................... Should keep me out of trouble

Thanks, Carrie

Abbott Laboratories' SYNTHROID® (Levothyroxine Sodium Tablets, USP) Confirmed Safe and Effective Through FDA approval FDA Approves 47-Year Old Drug For Use in Managing Thyroid Disease ABBOTT PARK, Ill., July 24 /PRNewswire/ -- Abbott Laboratories announced today it received U.S. Food and Drug Administration (FDA) approval of its synthetic thyroid hormone replacement therapy, SYNTHROID® (levothyroxine sodium tablets, USP), for thyroid disease management, as replacement or supplemental therapy for hypothyroidism (underactive thyroid) and pituitary thyroid stimulating hormone suppression. Millions of patients and their physicians have relied on SYNTHROID for decades to maintain their thyroid health. Formal approval by FDA of SYNTHROID validates its safety and efficacy. With FDA approval, Abbott is now free to meet full market demand. "Today's FDA approval is good news for the millions of Americans who rely on SYNTHROID every day to control their thyroid disease," said Jeffrey Leiden, M.D., Ph.D., Abbott's chief scientific officer and president, Global Pharmaceuticals. "This approval confirms that SYNTHROID is safe and effective. SYNTHROID is the same drug, and patients should continue to take their medication as they always have." SYNTHROID is the number one prescribed treatment for hypothyroidism and the second most-prescribed medication overall in the United States. It is the most-studied levothyroxine sodium product, the subject of hundreds of clinical studies and featured in articles in prominent peer-reviewed medical journals. Major medical societies and patient-focused organizations -- including the American Association of Clinical Endocrinologists, the Endocrine Society, the American Thyroid Association, the Thyroid Foundation of America, and the Thyroid Cancer Survivors' Association -- publicly supported the continued use of SYNTHROID for the millions of patients on the medication during the FDA's review. Their support reinforces the importance of this product to patients. "Today's FDA approval ensures that patients will continue to have access to this vital medication, which has been relied upon by physicians and patients for almost 50 years," said Paul Ladenson, M.D., director of the Division of Endocrinology and Metabolism at Johns Hopkins Medical Institutions. "The approval of SYNTHROID is an important milestone in Abbott's commitment to patients and thyroid disease," said Dr. Leiden. "Abbott continues to conduct research to bring new and better treatment options to market." Levothyroxine Products Are Not Therapeutically Equivalent to SYNTHROID The FDA publication, Approved Drug Products with Therapeutic Equivalence Evaluations (Orange Book), does not list any levothyroxine sodium products as therapeutically interchangeable with SYNTHROID. Switching SYNTHROID patients to another brand of thyroid medication would require testing and retitration, if necessary. AACE guidelines recommend that patients who are switched must be retested and retitrated, which would be costly, time consuming, and potentially disruptive to patients. SYNTHROID Approved as Safe and Effective Synthroid is indicated as replacement or supplemental therapy for primary, secondary, tertiary and subclinical hypothyroidism. Synthroid is not indicated for transient hypothyroidism during recovery of subacute thyroiditis. Thyroid hormones, including SYNTHROID, either alone or with other therapeutic agents, should not be used for the treatment of obesity or for weight loss. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects. Levothyroxine is contraindicated in patients with untreated subclinical or overt thyrotoxicosis, acute myocardial infarction, uncorrected adrenal insufficiency, or with hypersensitivity to any of the inactive tablet ingredients. Levothyroxine should not be used in the treatment of male or female infertility unless this condition is associated with hypothyroidism. Use with caution in patients with underlying cardiovascular disease. Adverse reactions associated with levothyroxine therapy are primarily those of hyperthyroidism due to therapeutic overdosage. If a patient experiences any unusual symptoms, a healthcare provider should be contacted. The thyroid, a butterfly-shaped gland located in the neck just below the Adam's apple and above the collarbone, produces hormones that influence essentially every organ, tissue and cell in the body. Thyroid disease affects an estimated 13 million Americans, but approximately half do not know they have the condition. Women are five times more likely than men to develop hypothyroidism. Further information, including SYNTHROID full prescribing information, is available at www.SYNTHROID.com or by calling 1 (800) 255-5162. Abbott Laboratories is a global, broad-based health care company devoted to the discovery, development, manufacture and marketing of pharmaceuticals, nutritionals, and medical products, including devices and diagnostics. The company employs approximately 70,000 people and markets its products in more than 130 countries. Abbott's news releases and other information are available on the company's Web site at www.abbott.com . 07/24/2002 17:38 EDT

My shirt and totebag came today. I thought I'd ordered more shirts, so now I have to go back and get some more. I ordered mine before the change in the back, so I don't have the tollfree number there. I was thinking about a couple other designs today. Cushie Crusader on the front and maybe Cushing's Supporter for the others in our lives. Thoughts?

http://www.acurian.com/patient....lcthtml Trial Information Summary: Long-Acting Growth Hormone Study Protocol The purpose of this Phase I research study is to determine if an investigational, long-acting growth hormone preparation is safe for human use, to measure its levels in blood, and to determine the most effective dose to give to patients who produce less growth hormone than normal. If you qualify for this study, you would receive either a single dose of the long-acting growth hormone or two doses 7 or 14 days apart. If you receive a single dose, you would spend 24 hours immediately thereafter as an inpatient in the Clinical Research Center at the University of Pennsylvania and then make 12 or 13 outpatient visits there during the next 27 days. If you receive two doses, you would spend 24 hours as an inpatient at the Clinical Research Center after each of the two doses and then make 17 or 18 outpatient visits there during the next 34 days. Inclusion Criteria: Ages 18 - 65 years Pituitary or hypothalamic disease causing deficiencies of thyroid, adrenal, and gonadal hormones Replacement of thyroid, adrenal, and gonadal hormones Exclusion Criteria: Acromegaly Active significant acute or chronic disease Diabetes mellitus, rheumatoid arthritis, inflammatory bowel disease, lupus erythematosus or carpal tunnel syndrome Cancer within the last 5 years except for adequately treated skin cancer Allergy to yeast products Pituitary surgery within the last 3 months Pregnancy or nursing Contact: Louise Loh, RN, Research Coordinator University of Pennsylvania Health System Division of Endocrinology First Floor Maloney Building 36th and Spruce Streets Philadelphia, PA 19104 Telephone: 215-898-5664 Fax: 215-662-4500 Email: lohl@mail.med.upenn.edu

http://www.acurian.com/patient....lcthtml Summary: Hypopituitary Control and Complications Study Dr. Stanley Korenman of UCLA's Division of Endocrinology is conducting a study to look at the effects of the long-term use of Growth Hormone Therapy (Humatrope, an FDA approved medication). The study involves measurements of blood levels of hormones, bone density and body fat every 6 months for 5 years (a total of 11 visits). Study Criteria: Be over 18 years of age Have known pituitary disease, either as a child or as a result of pituitary tumors Be taking hormone replacement Have health insurance Be interested in Growth Hormone Therapy Contact: Care Felix, Clinical Research Coordinator UCLA Medical Center Office of Clinical Trials 10900 Wilshire Blvd, Suite 170 Los Angeles, CA 90024 Telephone: 310-794-8900 Fax: 310-794-8902 Email: cfelix@mednet.ucla.edu

Ok...toll-free number added, but I don't know how legible it is

I was going to, and I might add it later, but I'm having trouble geting volunteers to answer it. You know I can't do that all the time...or often

Here's the front and back of most of them. http://www.cafeshops.com/cp....es#zoom Some have the front centered, and some are over to the side. Some, like the golf shirt and the baseball shirt are front only. The baseball one has black, red or blue sleeves.

T-shirts are now here! See them at http://www.cafeshops.com/cp/store.aspx?s=cushings Size Chart Jr. Baby Doll T-shirts Small (0-2) Medium (2-6) Large (6-12) T-shirt, Long Sleeve, Sweatshirt, Tank Tops Small (34-36) Medium (38-40) Large (42-44) X-large (46-48) 2X-large (50-52) 3X-large (54-56) 4X-large (58-60) Each provides $1 profit to CUSH and $1 for the running of these boards and websites. Available are: White T-Shirt, $15.99 each, Perfect for wearing to the Convention! Product Number: 1853115 In Stock: Will ship in 2-3 business days. Product Information: The most comfortable t-shirt ever! Our 100% cotton, Hanes Beefy-T is preshrunk, durable and guaranteed. 6.1 oz. fabric - luxuriously soft 100% cotton ring-spun yarn Double-needle coverseamed neck Taped shoulder-to-shoulder Double needle sleeve and bottom hems Our printing is better than ever ? full of detail and color ? and virtually fade resistant wash after wash. Jr. Baby Doll T-Shirt, $16.99 each Product Information: Our super soft 100% combed cotton, ribbed baby doll T-shirt from American Apparel will keep you in style. Special details include 1/2" binding on neck and sleeve with 1" bottom hem. Size Note: Small fits women sizes 0-2, medium fits women sizes 2-6, and large fits women sizes 6-12. Our printing is better than ever ? full of detail and color ? and virtually fade resistant wash after wash. Tank Top, $15.99 each Product Information: When the temperature rises, our 100% cotton Hanes Tank Top will help keep you cool. Preshrunk, durable and guaranteed. 5.5 oz. fabric made with 100% cotton open-end yarn Durable binding around the neck and armholes prevents stretching Double-needle bottom hem Preshrunk to minimize shrinkage Our printing is better than ever ? full of detail and color ? and virtually fade resistant wash after wash. Ladies Tank Top, $15.99 each Product Number: 2691569 In Stock: Will ship in 2-3 business days. Product Information: Always in style, our 100% cotton ladies tank top from Anvil will keep you cool when the temperature rises. Preshrunk, durable and guaranteed. Pre-shrunk heavyweight 5.6 oz. 100% cotton. Fashion cut for ladies. Bound-on rib around neck and armhole. Double needle bottom hem. Golf Shirt, $18.99 each The back is blank. Product Number: 2691576 In Stock: Will ship in 2-3 business days. Product Information: The perfect casual wear for the office, our Anvil golf shirts are made of 100% preshrunk, heavyweight cotton. Soft fashion knit collar and rib sleeve bands. Two woodtone buttons on a clean finished placket with 1/4" reinforced box. Double needle bottom hem. 5.6 oz preshrunk heavyweight cotton Knit collar Banded sleeves Two woodtone buttons Baseball Jersey, $18.99 each No image on the back Product Number: 2691591 In Stock: Will ship in 2-3 business days. Product Information: Our 100% Cotton Baseball Jerseys are popular with both men and women. Choose either Red or Black sleeves. 100% Preshrunk Cotton 5.9 oz Jersey (Tubular) ? Raglan Sleeves Double Needle Sleeves Our printing is better than ever ? full of detail and color ? and virtually fade resistant wash after wash. Long Sleeve T-Shirt, $20.99 each Product Number: 2691608 In Stock: Will ship in 2-3 business days. The most comfortable t-shirt ever! Our 100% cotton, Hanes Beefy-T is preshrunk, durable and guaranteed. 6.1 oz. fabric ? luxuriously soft 100% cotton ring-spun yarn Double-needle coverseamed neck Taped shoulder-to-shoulder Double needle sleeve and bottom hems Our printing is better than ever ? full of detail and color ? and virtually fade resistant wash after wash. Sweatshirt $22.99 each For the winter Product Number: 2691617 In Stock: Will ship in 2-3 business days. Product Information: Stay warm with our Hanes Heavyweight 50/50 cotton/polyester sweatshirts. Thick (but not bulky), comfortable, durable and guaranteed. 9 oz. patented PrintPro? fabric in a 50/50 cotton/polyester blend Double-needle coverseamed collars, armholes and waistband Densely knit fabric for a smooth printing and embroidery surface Spandex trim in the neck, cuffs and waistband Preshrunk to minimize shrinkage Our printing is better than ever ? full of detail and color ? and virtually fade resistant wash after wash.

http://story.news.yahoo.com/news?tm....ne_dc_1 NEW YORK (Reuters Health) - The image of hormone replacement therapy, battered by last week's revelation that the risks can outweigh the benefits in the long term, received another blow from researchers on Tuesday. They report that women who take estrogen-only hormone replacement therapy (HRT) for a long period of time have a higher-than-average risk of developing ovarian cancer. However, Dr. James V. Lacey, Jr. and his colleagues at the National Cancer Institute in Rockville, Maryland found that women who take short rounds of estrogen that is combined with progestin seem to have no higher risk of ovarian cancer than women who have never taken HRT. Typically, only women who have had their uterus removed take estrogen alone because the hormone is known to increase the risk of cancer of the uterine lining. Women who have a uterus take estrogen in combination with progestin, which cuts the cancer risk. In an interview with Reuters Health, Lacey stressed that these results only suggest a link between ovarian cancer and estrogen replacement therapy and do not prove that ovarian cancer is a direct result of the estrogen. Previous research into long-term use of estrogen did not connect it with an increased risk of ovarian cancer, the authors note, which demonstrates how easily the state of knowledge can change. Given the recent report that estrogen/progestin combinations can increase the risk of heart disease and breast cancer when taken for more than 4 years, the choice of whether or not to take HRT can be quite complicated, Lacey added. That study found that estrogen/progestin decreased the risk of colon cancer and hip fractures, but the risks of other problems outweighed the benefits. A second study due in 2005 will determine if estrogen alone increases the risk of heart disease and breast cancer. "Because hormone therapy may influence so many conditions that affect women after menopause--cardiovascular disease, osteoporosis, breast cancer, uterine cancer, gallbladder disease, blood clots, and now potentially ovarian cancer--we should no longer think of a woman basing her decision to use hormones on the potential risk of just one condition," he said. While millions of women choose HRT to reduce menopausal symptoms, many used it as a preventative therapy to reduce their risk of heart disease or the bone-thinning condition osteoporosis. The findings, reported in the July 17th issue of The Journal of the American Medical Association, are based on a follow-up of 44,241 women who began taking HRT when they were an average of 57 years old. Some of the women had a hysterectomy but still had one or both of their ovaries. During the study period, 329 women developed ovarian cancer. Women who took estrogen for longer periods of time had a higher risk of the disease, and the researchers noted a 7% increase in risk associated with every extra year of estrogen use. Those who took estrogen for at least 10 years were twice as likely to develop ovarian cancer and those who used the drugs for 20 or more years were three times as likely to develop ovarian cancer as those who did not take the hormone, the report indicates. An important caveat, Lacey and his team note, is that this study included women who began taking HRT in the 1970s, when the therapies contained higher doses of estrogen than what is in use today. "Whether long-term use of lower-dose estrogen replacement therapy increases the risk of ovarian cancer is not known," they write. Women who took estrogen/progestin alone, or after using estrogen alone, appeared to be no more likely to develop ovarian cancer than women who did not take hormones, the study reports. However, the jury is still out on whether estrogen/progestin combinations can have an impact on ovarian cancer risk, the authors note. "This recent emergence of an increased risk (of ovarian cancer) in long-term (estrogen) users should remind investigators that it is premature to conclude that estrogen/progestin replacement therapy has no association with ovarian cancer until other large studies specifically assess ovarian cancer risk among persons with short-term or long-term estrogen/progestin replacement therapy use," they write. In an interview with Reuters Health, Dr. Kenneth L. Noller of Tufts University and the New England Medical Center in Boston, Massachusetts, who wrote an accompanying editorial, said that there is no obvious biological explanation for why estrogen might cause ovarian cancer. "In general, this is one of those times when we have an observation without a good biological basis," he said. "There seems to be a clear-cut increase in ovarian cancer, but we really don't know why." The finding is especially puzzling given that long-term use of oral contraceptives, which contain hormones similar to HRT, can reduce the risk of ovarian cancer, he noted. He emphasized that the increased cancer risks reside with women who take HRT for long periods of time. As such, women who have "terrible menopausal symptoms should not be afraid to take HRT for a short period of time," he said. However, for women with less severe symptoms, the answer is less clear. "With all of the new information about HRT, it seems to me that we must take a new approach to its use," Noller said. SOURCE: The Journal of the American Medical Association 2002;288:334-341, 368-369.

Hi, Susan! I was wondering how Bernie was doing...