Hormone replacement therapy in female-specific cancer survivors: considerations beyond cancer cure

With rapid advances in disease diagnosis and treatment, patients with cancer will achieve longer survival. Among female cancer survivors, oncologic treatments often lead to premature ovarian insufficiency, negatively impacting their health and quality of life. Hormone replacement therapy (HRT) may mitigate these effects; however, concerns remain regarding its impact on oncologic outcomes. Updating the evidence base could help healthcare providers identify patients who may benefit from HRT without an increased risk of recurrence. This review provides an updated overview of HRT in women with a history of cervical, endometrial, ovarian, and breast cancers. For cervical cancer, HRT is not contraindicated in either squamous cell carcinoma or adenocarcinoma, regardless of stage. For endometrial cancer, HRT is not contraindicated in early-stage disease with no residual tumor, although it should be avoided in low-grade endometrial stromal sarcoma. HRT is not contraindicated in epithelial ovarian cancer regardless of stage, except in low-grade serous carcinoma. Currently, HRT is contraindicated for breast cancer. This review highlights the need to promote long-term healthcare strategies for cancer survivors. A shift in focus beyond cancer cure toward lifelong health management is warranted.