Can hormone therapy used in cases of breast cancer reduce risk of Alzheimer’s? Oncologist explains the link

Hormone therapy has been a game changer for menopausal women, reducing cardiovascular issues, helping in diabetes management, and easing osteoporosis symptoms. However, its safety and effectiveness in breast cancer treatment are still under research.

A 2024 study published in JAMA Network Open found that hormone-modulating therapy (HMT) in breast cancer patients led to a “7 per cent lower relative risk of Alzheimer’s disease and related dementias (ADRD),” with variations across different races and ethnicities of the subjects partaking in the study.

Indianexpress.com spoke to Dr Karishma Kirti, consultant breast specialist and oncoplastic surgeon, to understand whether this beacon is a positive scope for breast cancer treatment in India as well. “More than 70 per cent of such cases occur in women over 50. Breast cancer cases have been increasing since the 1970s, but the mortality rate is decreasing. This means more patients are living longer and subsequently contracting associated diseases,” she said.

 Kirti cautioned that the said JAMA study lacks sufficient data on certain risk factors and doesn’t adequately represent the Indian population (Representational Photo)

How are the two connected?

Kirti explained that breast cancer treatment often involves a combination of therapies, including chemotherapy, radiation, hormone therapy, and targeted therapy, and that over 70 per cent of women with breast cancer are hormone receptor-positive, meaning hormones in their bodies can promote cancer cell growth. To combat this, long-term anti-estrogen therapy is used, which improves survival rates.

However, this has been linked to decreased cognitive function over time, potentially increasing the risk of Alzheimer’s and dementia.

According to Kriti, estrogen has neuroprotective effects but also raises the risk of cancer recurrence. “When hormone therapies are conducted, there are two kinds used: a tamoxifen, which is a selective estrogen receptor modulator which blocks estrogen receptors on the breast cancer cells and the other thing used on menopausal patients is aromatase inhibitors that reduces or prevents production of estrogen in the peripheral fat which is the main source of estrogen in such women because their ovaries aren’t working anymore,” she said.

“These therapies could influence the risk of Alzheimer’s by mimicking estrogen or the way they impact estrogen production or the changing estrogen levels of the body or they may affect the way we clear a protein called beta amyloid or the stability of TAR protein, which are very important factors in Alzheimer’s treatment,” she said.

However, Kirti cautioned that the said JAMA study lacks sufficient data on certain risk factors and doesn’t adequately represent the Indian population. While the findings open new avenues for research, they aren’t conclusive enough to change current practices.

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