In this episode of The Menopause and Cancer Podcast, I’m joined by Dr Susanna Unsworth, GP and menopause specialist at the Cambridge breast unit, to talk about why menopause after cancer can sometimes feel like such a complex and at times controversial area of medicine.

We explore why medical opinions can differ, why this space is not always black and white, and what happens when new research starts to challenge long-held assumptions.

A big focus of this conversation is the PIONEER trial, a Cambridge-led study looking at whether megestrol acetate — a drug that acts on the progesterone receptor — could be used alongside standard anti-oestrogen treatment in oestrogen receptor-positive breast cancer and how it may also help with hot flushes!

It’s a bit mind-blowing when you think that all we hear all the time is NO to any HORMONES after breast cancer!

So we talk about why that finding has caught so much attention.

We also talk about the very real emotional burden of endocrine therapy, the impact on quality of life, and why so many patients feel stuck between wanting to reduce recurrence risk and wanting to feel more like themselves again.

Susanna also shares how the Cambridge breast unit is developing its menopause service, including group education sessions to help prepare patients earlier and improve access to support.

This is a really thoughtful conversation about evidence, uncertainty, quality of life, and why people affected by cancer deserve honest, nuanced menopause care.

Episode Highlights:

00:00 Introduction

04:49 "World Menopause & Cancer Day"

06:21 GP Turned Women's Health Specialist

09:44 "Menopause, Breast Cancer, and Controversies"

13:29 Progesterone Trial Slows Cancer Growth

17:13 Hormonal Interplay and Cancer Risk

22:40 "Balancing Treatment Choices Carefully"

26:46 "Menopause, Social Media, and HRT"

32:05 Creating seminars to deliver information to more women

About my guest

Dr Susanna Unsworth is a GP and menopause specialist working within the breast unit in Cambridge, supporting patients experiencing menopause symptoms after breast cancer treatment. She also works more broadly in women’s health and community gynaecology. You can find her here: You can find Susanna here https://cambridgewomenshealth.co.uk/about

Resources and links

1. The Cambridge-led PIONEER trial article is here https://www.cam.ac.uk/research/news/hot-flush-treatment-has-anti-breast-cancer-activity-study-finds

Connect with us:

For more information and resources visit our website: www.menopauseandcancer.org

Or follow us on Instagram @menopause_and_cancer

Join our Facebook group: www.facebook.com/groups/menopauseandcancerchathub

Today, we’re exploring the evidence with medical acupuncturist Maria Vega.

Many cancer survivors experience menopause symptoms such as hot flushes, joint pain, insomnia and anxiety — often while navigating complex treatment plans or endocrine therapy. For some, HRT may not be an option, which leads many people to explore complementary approaches like acupuncture.

But does acupuncture really work? And what does the research say?

In this episode, I’m joined by Maria Vega, a medical acupuncturist who works in integrative oncology supporting people after cancer with a whole array of evidence-based strategies.

We explore the evidence behind acupuncture for symptoms such as hot flushes, aromatase inhibitor–related joint pain, sleep disturbances and anxiety, while also discussing safety considerations and how acupuncture may fit into a broader, integrative approach to managing menopause after cancer.

1. What is acupuncture and how does it work?
2. The science behind acupuncture and menopause symptoms
3. Research on acupuncture for hot flushes and joint pain after cancer
4. Safety considerations for cancer survivors

Episode Highlights:

00:00 Introduction

05:42 Integrative Oncology Nurse Specialist

07:52 Acupuncture: TCM and Western medical acupuncture

12:25 "Acupuncture and Medications Evidence"

16:02 "Improving Menopause Care Approach"

17:49 "Managing Hot Flushes Effectively"

24:50 "Acupuncture Safety in Oncology Treatment"

27:53 Acupuncture Recognition in Oncology

33:39 "Acupressure: Empowering Patient Self-Care"

You can find Maria here https://holohealth.co.uk/

This paper sums up the recommendations Maria speaks about:

https://ascopubs.org/doi/10.1200/JCO.22.01357

Here is an open-source link as the ASCO paper requires a subscription.

https://www.liebertpub.com/doi/10.1089/jicm.2024.0452

Highlight from ASCO - SIO guidelines: Among adult patients, acupuncture should be recommended for aromatase inhibitor–related joint pain. Acupuncture or reflexology or acupressure may be recommended for general cancer pain or musculoskeletal pain.

Connect with us:

For more information and resources visit our website: www.menopauseandcancer.org

Or follow us on Instagram @menopause_and_cancer

Join our Facebook group: www.facebook.com/groups/menopauseandcancerchathub

On this episode of The Menopause and Cancer Podcast, we’re marking Anal Cancer Awareness Day (21 March) by shining a light on a cancer that is often misunderstood, stigmatised, and rarely talked about.

Anal cancer is caused by HPV, just like cervical cancer, yet it doesn’t receive the same awareness or open conversation. It might not feel as “pink” or as socially comfortable to talk about as breast cancer. It’s not a cancer that gets glossy campaigns or big awareness drives. There’s often stigma. There’s embarrassment. There’s silence.

And that silence can leave people feeling incredibly alone.

I’m joined by Ali, who shares her honest experience of being diagnosed with anal cancer; what treatment involved, the physical and emotional impact, and how it affected her confidence, menopause and sexual wellbeing.

We also explore an important question: can treatment for anal cancer induce menopause?

Pelvic radiotherapy and chemotherapy can affect ovarian function, sometimes triggering sudden or early menopause. We discuss what that means, and whether HRT or local oestrogen may be options.

This episode is about inclusion.

It’s about making sure everyone — regardless of cancer type — feels seen in menopause conversations.

If you’ve ever felt that your cancer isn’t the “right” kind to talk about, this episode is for you.

Episode Highlights:

00:00 Introduction

04:33 Cancer Diagnosis: Fear and Isolation

12:15 "Stage 3 Cancer Challenges"

14:32 "Breaking Stigma Around Cancer"

23:22 "Menopause, HRT, and Cancer Journey"

27:07 Burnout, Anxiety, and Menopause Journey

30:36 "Pelvic Radiotherapy: Long-Term Impacts"

36:01 "Barbie Butt: Finding Joy Amid Struggles"

41:38 "Menopause, Cancer, and Support Gaps"

About our guest Ali:

Ali Stripling is a qualified Menopause Wellness Practitioner who was diagnosed with Stage 3 anal cancer in October 2024. She now speaks in workplaces about menopause, cancer and life in remission. Ali is also the author of #TweakAWeek, a practical framework helping perimenopausal women make positive changes without overwhelm. https://www.linkedin.com/in/alistripling/

Links:

Macmillan Anal Cancer Support Forum: https://community.macmillan.org.uk/cancer_types/anal-cancer-forum

The Farrah Fawcett Foundation https://thefarrahfawcettfoundation.org/

This podcast episode was supported by an unrestricted grant from Incyte Biosciences. Incyte had no involvement in the development, content, or editorial review of the activities associated with this initiative.

Connect with us:

For more information and resources visit our website: www.menopauseandcancer.org

Or follow us on Instagram @menopause_and_cancer

Join our Facebook group: www.facebook.com/groups/menopauseandcancerchathub