[5 min read]
In this article:
- For many women, breast cancer treatment and menopause coincide, whether naturally or as a result of treatment for breast cancer.
- Some patients choose to interrupt vital endocrine therapy because it can trigger debilitating menopause symptoms.
- A Providence Swedish menopause expert emphasizes the need to re-evaluate the significance of menopause symptoms, especially during breast cancer treatment, and redefine survivorship to support patients' best possible quality of life.
Menopause and breast cancer are significant health concerns impacting millions of women in the United States. Approximately 1.3 million women reach menopause every year, marking a pivotal shift in hormonal balance and overall health. Concurrently, breast cancer remains the most common cancer among women, with an estimated 1 in 8 women receiving a diagnosis in their lifetime. As these two phases intersect, understanding their combined effects is crucial for effective treatment and quality of life.
For many women undergoing breast cancer treatment, menopause is a significant issue —either because of natural or treatment-related onset. Personalized care is critical for navigating this complex journey. To learn more about the importance of this critical transitional period for many women and the importance of support from an expert care team, we spoke with Elizabeth Skelly, ARNP, MSCP, a specialty gynecology nurse practitioner at Swedish Gynecology Specialty Center in First Hill.
Skelly says that we need to shift our thinking about menopause and breast cancer as separate conditions affecting different groups of women at different times.
“The overlap between breast cancer and menopause is profound. As a nurse practitioner specializing in menopause and survivorship care, I have seen firsthand how these two experiences intersect for countless women navigating breast cancer treatment,” she says. “Broader awareness and action are needed, not just in public conversations, but in healthcare policy and survivorship care models that address the unique needs of underrepresented premenopausal breast cancer survivors, whose care is often overlooked and difficult to navigate.”
Recent data from the U.S. Centers for Disease Control and Prevention reveals that 1 in 10 women under the age of 45 now receive a breast cancer diagnosis. While it seems logical to assume that breast cancer treatment ends when a tumor is gone, patients with hormone-receptor positive disease are often prescribed endocrine therapy, mostly commonly combined with ovarian suppression, for five to ten years after initial tumors are treated.
While these medications remain among the most effective tools for preventing cancer recurrence, many women in this population discontinue these treatments because of the sudden menopausal symptoms they trigger, says Skelly.
“These symptoms can be debilitating when left untreated. These interruptions in therapy contribute to lower adherence rates and higher recurrence risk, making this a pressing public health concern,” she emphasizes.
Most people recognize menopause by its classic signs: hot flashes and night sweats. And too often they are viewed as insignificant annoyances related to the aging process.
For women who undergo menopause chemically or surgically as part of cancer treatment, the symptoms can arrive overnight and be exponentially more pronounced than in natural menopause, Skelly notes. Other side effects can include things like brain fog, painful intercourse, sexual dysfunction, weight changes, and urinary urgency, all of which can deeply affect quality of life, relationships, and the ability to stay on treatment.
“There is some contention that limited oncology resources should focus solely on treatment and not the challenges of survivorship, but we have strong evidence showing that addressing menopausal symptoms improves treatment adherence and long-term outcomes, ultimately reducing recurrence and healthcare costs,” Skelly affirms.
To bridge this gap, national cancer centers and hospital systems should adopt policies that integrate menopause management into oncology survivorship guidelines. This could include routine symptom screening and automatic referrals to specialty menopause care programs, like Swedish’s Gynecology Specialty Center which is one of the few programs dedicated to supporting not just women in natural menopause, but also those who experience menopause due to cancer treatment. This kind of care is crucial, and underutilized.
“By integrating oncology, gynecology, and supportive services, Providence Swedish is showing what’s possible when survivorship is treated as part of the cancer journey, not as an afterthought. If adopted broadly, bridge programs like these could improve quality of life, boost adherence to endocrine therapy, and redefine survivorship as not just survival, but restore well-being to countless breast cancer survivors,” says Skelly.
“Breast Cancer Awareness Month and Menopause Awareness Month are in October, but awareness should not end with pink ribbons; it should include the realities of long-term survivorship and the support needed to make it through.”
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