I saw the oncologist this morning and now it’s official. My oral chemo, the daily letrozole tablet that I’ve taken for five years, ended today. I’d be in a celebratory mood, except that I’m supposed to see the doctor again in six months and, in the meantime, be weighing whether I want to take the letrozole for another two years. Two more years is a compromise with some standards of care that now suggest a total of ten years. It depends on what type of cancer you’ve had and what side effects you may be dealing with. He said it could reduce my chances of a recurrence by about 2%.
I’d pretty much come to terms with the idea that my thinning hair and really annoying hot flashes were likely just due to my age and that stopping the letrozole wouldn’t make much difference. But the doctor seemed quite confident that the letrozole has indeed been the cause and that those things should soon stop. That would be more than welcome.
If stopping does make an obvious difference — in the thinning hair, hot flashes, and general fatigue — it will be tough opting to take the drug for two more years. I hate having to make decisions like this. Especially if I feel notably better between now and October.
I’d been worried about assorted aches and soreness in the operated breast for a couple of months after Christmas. Vague, off and on kind of thing. First time since the original surgery that I’ve experienced any discomfort. I considered an earlier appointment but dragged my feet. Who wants to hear that their cancer has come back?
Anyway, the doctor wasn’t worried. He said temporary swelling or fluid build-up could cause that sort of thing, even though it hasn’t happened before. Didn’t sound to him like a recurrence, and he recommended massage if it bothers me again.
My next mammo is scheduled for August, but if I get concerned, he’ll schedule it earlier.
So that’s about it. I’m obviously relieved that he wasn’t concerned about the soreness and eager to have the damned hot flashes go away.
I got my four-year mammogram and ultrasound yesterday, so it’s now official. I’m still free of cancer and have been for four years. Hurray. And a great relief. I don’t normally give cancer recurrence a lot of thought until a few weeks before these annual checkups. Then the anxiety sets in.
I’ve got something new to consider, however. For some time I’ve been taking letrozole every day (the aromatase inhibitor, or AI, that keeps my body from producing estrogen). And, as I have for four years, I mentioned to the doctor that I was still being bothered by hot flashes and, more importantly, hair loss. If I lose much more hair on my crown, a combover won’t be adequate camouflage. (Pink scalp is already visible through the thinning hair and while I can make it a bit less obvious, I can’t hide it completely.) He could not reassure me that it will grow back when I stop taking these meds in a year. In other words, permanent hair loss is one of the potential downsides of these drugs.
Just noting that today is the four-year anniversary of my cancer surgery. Free and clear so far, although my 4-year follow-up exams don’t come for another month or two.
One year to go with the letrozole treatment.
I came across an interesting quote this morning in a Washington Post article from Feb. 1, 2018. The headline was “Breast cancer treatments can raise risk of heart disease.”
I was well aware of the concern about my heart when I was in treatment. I knew Herceptin in particular could pose a risk, and I saw what great care went into planning my radiation treatment so it would affect my heart as little as possible.
The New York Times today grabbed my attention with the headline “For Women With Early Breast Cancer, Herceptin Treatment Can Be Much Shorter.”
You may recall my concern when my oncologist decided against the standard year-long Herceptin treatment because he suspected Herceptin had caused my pneumonitis. As he reminded me at the time, I’d already had four Herceptin treatments because it was included in my chemo cocktail with two other drugs. And my diagnosis of HER2 positive was not definitive, having been only “maybe” or “negative” in some tests and having occurred not in the primary tumor but in a satellite nodule. Continue reading
It’s taken a few months for it to really sink in, but my hair is thinning. Rapidly. The bathroom looks like one of my exes has moved back in. If the thinning stopped right now, it would be manageable with a bit of fluffing and arranging over the crown, but I’m afraid it won’t.
I saw my oncologist Tuesday for my 6-month checkup and he confirmed my suspicion — that the aromatase inhibitor (aka AI, either Aromasin or Femara) I’m taking is the culprit. It stops all estrogen synthesis by the adrenal glands, so I’m getting zip, less even than a normal post-menopausal woman would have. The result is thinning hair, leaning toward what is called male-pattern baldness. Continue reading
I saw my oncologist yesterday for my quarterly followup check-up, and as I expected, it was pretty much:
“Hi, how ya doin’?”
“Any new issues?”
“Okay, great. Come back in six months.”
After months of indecision, I called my oncologist last week and told him I was ready to switch from exemestane (Aromasin) to letrozole (Femara). He’d suggested several months ago that if I wanted to, I could make the change because the letrozole might have fewer, milder side effects. And I’ve been wrestling with the decision ever since.
Despite the title of my post a few days ago, today is my real one-year anniversary. My cancer surgery was exactly one year ago, May 20, 2015, and was the first salvo in my war against the invading malignancy.
I hasten to say, however, that I’m not a “hero” for “fighting courageously.” And I’m not “brave” or deserving of praise. Few cancer patients really are, although that’s the way we’re often depicted by others. We really have only one decision to make: We decide to fight and go through whatever treatment the professionals deem necessary, or we decide not to fight and just let the cancer grow and spread until it kills us. Continue reading
I need a secretary (er, make that “administrative professional”) to keep track of all my medical stuff — the notes, the meds, the appointments, the instructions, etc. And I needed that secretary yesterday when I saw my oncologist for the first time since mid-January. So much had happened that he wanted to know about, and I had a bunch of questions saved up for him. It all amounted to a ton of details flying back and forth. Details I wanted to remember. Needed to remember. But I didn’t take notes because I wanted to give him my full attention. Besides, it’s routine to get a four-to-six-page printout after each appointment, detailing everything.