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Women fare
better than Men with Metastatic Colorectal
Cancer — Are Hormones helping?
Newswise — Younger women with metastatic
colorectal cancer lived longer than younger
men. However, this survival advantage
disappeared with age, suggesting a benefit
from estrogen or other hormones, according
to results of a study published in Clinical
Cancer Research, a journal of the American
Association for Cancer Research.
“We’ve known for a while that estrogen
prevents colorectal cancer, but this is the
first study to suggest it may improve
outcomes once you have colorectal cancer,”
said Heinz-Josef Lenz, M.D., co-director of
gastrointestinal oncology and colorectal
cancer at the University of Southern
California/Norris Comprehensive Cancer
Center, Keck School of Medicine.
Using the Surveillance, Epidemiology and End
Results registry, Lenz and colleagues
screened 52,882 patients who had metastatic
colorectal cancer between 1988 and 2004.
Women age 18 to 44 years had significantly
longer survival than men — at 17 months
compared with 14 months. However, older
women had significantly shorter overall
survival at seven months compared with nine
months.
Lenz said these results suggest that
estrogen levels may be playing a significant
role in prognosis. James Abbruzzese, M.D.,
chair of gastrointestinal medical oncology
at the University of Texas M. D. Anderson
Cancer Center and a deputy editor of
Clinical Cancer Research, agreed that
hormones may certainly play a role, but says
a look at the data broken down by year is
also intriguing.
Specifically, those
diagnosed after 2000 have improved survival;
those diagnosed before 2000 had a less
pronounced survival advantage.
“In terms of the chemotherapy we have
available, since 2000 the regimens employ
more agents and have become much more
aggressive. Therefore, it may be expected to
inhibit normal hormonal cycles leading to
lower hormonal levels in these women, so
other factors may be playing a role as well.
It may not just be hormones,” said
Abbruzzese.
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