Cancer Treatment Today

Vaginal atrophy (atrophic vaginitis) is thinning, drying and inflammation of the vaginal walls that may occur when your body has less estrogen. Vaginal atrophy occurs most often after menopause. INTRAROSA is a steroid indicated for the treatment of moderate to severe dyspareunia, a symptom of vulvar and vaginal atrophy, due to menopause. Intranosa was used and the claimant wrote that it worked. She previously had inthciness, dryness, and she beleives that it caused UTIs.
The appeal letter states that the claimant had tried OTC lubricants and suppositories with no relief.
Five percent of patients with breast cancer used vaginal estrogen therapy after breast cancer diagnosis. In vaginal estrogen therapy users compared with HRT nonusers, there was no evidence of a higher risk of breast cancer-specific mortality in the pooled fully adjusted model (HR, 0.77; 95% CI, 0.63-0.94). There are studies that indicate a higher recurrence rates when used concurrenlty with cacner therapies ( McVicker et al).
McVicker L, Labeit AM, Coupland CAC, Hicks B, Hughes C, McMenamin Ú, McIntosh SA, Murchie P, Cardwell CR. Vaginal Estrogen Therapy Use and Survival in Females With Breast Cancer. JAMA Oncol. 2024 Jan 1;10(1):103-108.
Treatment of Urogenital Symptoms in Individuals With a History of Estrogen-dependent Breast Cancer, Clinical Consensus ACOG, Number 2, December 2021.
Agrawal, Pranjal BA; Singh, Sajya M. BS; Able, Corey BS; Dumas, Kathryn MD; Kohn, Jaden MD, MPH; Kohn, Taylor P. MD, MPhil; Clifton, Marisa MD, Safety of Vaginal Estrogen Therapy for Genitourinary Syndrome of Menopause in Women With a History of Breast Cancer. Obstetrics & Gynecology 142(3):p 660-668, September 2023.
Intranosa Prescribing Information 2014