Having a cancer diagnosis is a lot to take in. You are focussing on getting through your treatment to try cure the cancer, which can be an overwhelming experience. The thought of hormone-related side effects is often an easily forgotten topic by cancer doctors and their patients.
Any symptoms after cancer can be incredibly worrying, so it is crucial to be aware that menopause symptoms can be triggered early due to various treatments for several cancers, including the five gynae cancers. Understanding that those symptoms are due to menopause and not your cancer is really important. However, hormone symptoms can hamper your well-being during and after you complete your cancer treatment. So, for many reasons, it is essential to talk about this so that you can find helpful ways to resolve those symptoms.
Understanding why your treatment has caused menopause or menopause symptoms is the first step in understanding what is happening and finding solutions.
Chemotherapy, used to treat several cancers, can damage your ovaries, which produce hormones before menopause in women and people with gynae organs. Some of the gynaecological cancers, especially ovarian cancer, often need to be treated with a salpingo-oopherectomy (removal of the ovaries), which plunges you into a surgical menopause. If you have had a hormone-driven breast cancer, you may receive medications that can cause menopause symptoms or early menopause. Pelvic radiation may also do this. So, cancer treatment can often trigger the onset of menopause, even in very young women.
Menopause can be a difficult time even if you haven’t just gone through a significant life event, so it can be even more challenging after a cancer diagnosis when cancer treatments might also make you feel unwell. The worry around the cancer is at its peak. And menopause symptoms can feel like the straw that breaks the camel’s back.
But there are always options available that can help.
Younger women treated with chemotherapy for non-hormone-related cancers can usually safely have hormone replacement therapy (HRT), which should ease symptoms associated with early menopause. However, women with hormone-driven cancers, such as womb or breast cancer, are usually advised that HRT may not be safe. So, a toolkit of strategies to help with menopause symptoms beyond HRT is needed. That can feel frustrating, especially now, because many women are extolling the virtues of HRT on social media. But there are many things you can do to smooth the menopause transition without using hormones. It’s also important to be aware that HRT is not a panacea for menopause; many women who try it don’t find it helpful or experience many side effects. And that’s not often shared on social media!
Several non-hormone medications can help with a variety of menopause symptoms. Which one you choose will need to be a discussion between you and your doctor, as different treatments are helpful depending on your specific symptoms. For example, the treatment that can help you may differ if you have hot flushes or sleep problems, compared with weight gain, anxiety, low mood or aches and pains. Local vaginal treatments may benefit vaginal symptoms, including vaginal oestrogen, which is safe for most cancer survivors. It is best always to discuss such therapy with your doctor to check whether it is safe for you.
Plus, addressing your lifestyle is helpful for everyone, as lifestyle strategies can help with your menopause symptoms, well-being and long-term health. For example, smoking and drinking too much alcohol can worsen menopause symptoms and increase the risk of several cancers and cancer recurrences. That’s something that you can address that can help in many ways. You can ask your doctor for support with quitting smoking and help with reducing your alcohol consumption. Daily movement and exercise staves off cancer and recurrence and improves your well-being and long-term health. There is lots of sound scientific evidence for this. If you feel exhausted and achy, remember that any movement is better than nothing. Walking around your house or the block for a few minutes is better than staying on the sofa all day. I call it “micro-dosing” movement. Focusing on small tweaks to your daily routine makes such changes more sustainable over time. Carrying excess weight is also a risk factor for several cancers and cancer recurrence. Eating the rainbow of fruit, vegetables and other natural foods, and reducing your ultra-processed food intake can help keep your weight healthy and help your gut health, among other benefits. You can get the benefits from fruit and vegetables when they’re frozen and tinned as well as when they are fresh, so there are lots of ways you can add a few more into your diet each day.
It takes time to notice the benefits of lifestyle interventions; they don’t work overnight, and it is best to start gradually to make any changes sustainable for the long haul. That will reap many rewards in the future.
If you would like any further information or advice, our Ask Eve nurse service is here to help. You can get in touch for free and confidential advice on nurse@eveappeal.org.uk or 0808 802 0019.