Prometrium vs progestin for endometrial cancer

[sarahspranza]

Hello everyone.
I am 47yo and 3 years ago I was diagnosed with Stage 1a endometrial cancer. I refused a hysterectomy since the tumor was small and contained, so instead my oncologist prescribed megestrol, a progestin. I have been taking this for 3 years, and my oncologist wants to keep me on it until I get a hysterectomy, but things will have to get a lot worse for me to agree to that! After reading the Hormone Repair Manual, it seems to me that "oral micronized progesterone" would be a much better alternative than what I'm currently taking. My question is, is Prometrium used for endometrial cancer? Is there any reason I shouldn't push to make the switch? Are there articles that I could show my oncologist to support my case? Thanks in advance.

[sarahspranza]

Also, I should note that as of over a year ago, no cancer was detected in a biopsy and no tumor with an MRI, so either my lifestyle or the progestin or both have been working! I did have extremely scary heavy periods in the time leading up to the diagnosis, (and had just left an abusive relationship) so Progesterone does seem like a good idea for me I think regardless of the cancer.

[Lara]

In some cases of endometrial hyperplasia or cancer, progesterone is not strong enough and a progestin is required. Best to check with your GYN.

[Dreamfree]

I'm so glad you posted! I'm thrilled for you that you are cancer free and able to avoid surgery!
I'm curious what dose you were on?
I am in a very tough spot right now. I'm dealing with endometrial cancer EC 1B, 6cm mass and I would like to keep my anatomy if I can. I've taken 250mg megace for 2 months and I now have adrenal insufficiency. So I'm going to have to come off of the Megace.
I had an MRI and the tumor shrunk a little bit and there has been no spread over 3 months and I'm very thankful. The endo thickness increased from 31 to 38mm. My estrogen is less than 5. I'm not sure why the lining increased.
Does anyone have any thoughts or ideas for healing from EC?
I plan to take 400mg prometrium 2x a day vaginally and pray that works.
Your story is very uplifting that your treatment worked! It takes time. Thank you.

[sarahspranza]

Hi there,
I'm thinking of you through your process. The dose of progestin (megestrol) that I was prescribed was 160 mg daily. I reduced that dose within the first year (with agreement from my oncologist) to 80 mg daily for 3 weeks and then I take a week off per month in the hopes that my body will stay sensitive to it (my own idea). I'm so sorry the megace didn't work for you. I really hope that the vaginal prometrium works for you.
I have also followed other guidelines, such as reducing my sugar and alcohol intake, greatly reducing my stress levels (especially by leaving an emotionally abusive husband), increasing whole foods, exercise, simplifying my life, and some intermittent fasting.
I read somewhere that cortisol and progesterone share receptors, so even if you produce enough progesterone, if your cortisol is continuously high, the progesterone wont be able to do it's jobs. So stress may play a very important role.
The other thing my oncologist did in the first year was a D&C (basically clearing out my uterus including the tumor). She thought there was theoretical risk that it would spread the cancer, but that didn't happen. As far as I can tell, the cancer didn't return after that.
Wishing you all the best.