The relationship between estrogen and ovarian cancer is obscure. It is known that there are both estrogen and progesterone receptors present in many epithelial ovarian tumours. Unfortunately, the effects of exogenous hormones on these receptors are not well known. There is no convincing evidence that estrogen has either the potential to promote recurrence or to decrease the time to recurrence.
In the absence of scientific evidence to the contrary, it is not necessary to withhold estrogen replacement therapy from any symptomatic woman with ovarian malignancy regardless of risk category.
- In the absence of a uterus and when the cancer is not endometriosis-associated, estrogen alone can be considered.
- With uterus in situ, continuous estrogen plus progesterone.
- For endometriosis-associated cancers with residual endometriosis, estrogen plus progesterone may be considered even if the uterus has been removed.