Dr John Eden1
1Reproductive Endocrinologist and Gynaecologist
Biography:
Reproductive Endocrinologist and Gynaecologist; Conjoint Professor, Department of Women and Children’s Health, Royal Hospital for Women,UNSW; VMO Head of the Menopause Unit, Royal Hospital for Women, Sydney
Dr John Eden (MB BS MD RCOG RANZCOG CREI) is a reproductive endocrinologist and gynaecologist. He is a Conjoint Professor in the Department of Women and Children’s Health, Royal Hospital for Women (UNSW). He is a VMO at the Royal Hospital for Women, Sydney, where he is Head of the Menopause Unit. He is a member of the Breast Cancer MDT at Prince of Wales Hospital Randwick. John is on the executive committee and co-chair of the NSW Health (ACI) Menopause Hub project. His research and clinical interests include managing menopause after breast cancer, early menopause, hormones and mood disorders, PMDD and hormonal migraine.
Abstract:
In the fifties and 60s, unopposed oestrogen was the norm, which resulted in an epidemic of endometrial cancer. Progestins were added to oestrogen in the seventies and onwards to protect the endometrium. In the 1990s, data started to suggest that combined MHT regimens containing progestins, may slightly increase breast cancer risk (and decrease bowel cancer risk). Then, on 10 July 2002, the breast cancer data from Women’s Health Initiative (WHI) was released in quite a brutal way to the world media. Since then, many women believe that MHT causes breast cancer. Over the last 30 years, research has suggested that most breast cancers are initiated in ER-PR- breast stem cells. Exogenous hormones such as hormonal contraception and MHT seem to have little role in this initiation process but may have a role as a minor promotor of an existing ER+ breast cancer. Interestingly, women on MHT who are diagnosed with breast cancer have improved survival, likely due to increased surveillance and mild promotion of small ER+ cancers that have an excellent prognosis.