I’m back from my two follow up appointments today with my oncologist and my surgeon. I took the whole day off work, mostly because the appointments were not back to back, nor were they at the same location.
I have pretty much all good news—because of the kind of breast cancer I have, I already knew that chemo wasn’t on the table. It’s just not a treatment that works on hormone receptor positive breast cancers (or HR+ if you want to abbreviate). Well, OK, it could have been if the cancer had metastasized, but it didn’t.
Instead, the normal treatment is surgery (either lumpectomy or mastectomy plus sentinel node surgery) --> radiation --> estrogen blocking drugs for five to 10 years.
Broadly speaking, there are two categories of drugs for the estrogen blocking. Here’s information about both kinds from the breastcancer.org site:
Selective estrogen-receptor response modulators (SERMs): The best-known SERM is tamoxifen. Tamoxifen acts like estrogen and attaches to the receptors on the breast cancer cells, taking the place of real estrogen. As a result, the cells don’t receive the signal to grow. Tamoxifen can be used to treat both pre- and postmenopausal women. Tamoxifen can reduce the risk of breast cancer coming back by 40% to 50%, and it’s the one my medical oncologist recommended.
(This part is from me) Keep in mind that as a stand-alone statistic, that reduction rate sounds fantastic, but you need to know what your personal recurrence rate might be. By all accounts, I’m in a low risk category, possibly less than 2% chance of recurrence over the next 10 years. Since this drug has some nasty side effects, and also has a risk of blood clots and liver disease, I don’t think it’s worth taking. I can live with a 2% chance.
Aromatase inhibitors reduce the amount of estrogen your body produces. Aromatase inhibitors are most commonly used to treat postmenopausal women but can be used to treat premenopausal women who are also taking medicine to shut down their ovaries. This medicine has fewer side effects but often causes bone loss and bone breakage.
Since I already have osteopenia (the step before osteoporosis) and I’ve already had a bone break, this isn’t the drug my medical oncologist recommended for me, and I agree.
To better assess my risk of recurrence, he’s ordered a MammaPrint test run on my tumor (boy that sounds so weird to say: my tumor. Actually I still have a hard time wrapping my head around me having another kind of cancer.). If I fall in the ultra-low risk category, then I absolutely won’t take the estrogen blocker. The juice just wouldn’t be worth the squeeze. If my risk is higher, then we’ll have to talk further about the options.
My surgeon was also pleased with how I’m healing. I’m typically a fast healer and even though there's swelling he said it's really minimal compared to most. He said the recovery period is six to eight weeks, but I’m OK to work out as long as I don’t go swinging heavy kettle bells or anything.
Next week I see the radiology oncologist to get that process going. She’ll do some sort of mapping using a CT scan to get the locations established, and I’ll get a couple of tiny tattoos that mark where the machine needs to line up. I don’t know how long my radiation treatment will last but generally it’s three to seven weeks, five days a week. There’re some less than pleasant side effects but nothing horrible (although my surgeon did warn me today that my breast will swell from radiation—good to know!), and once that’s done, everything can start healing up.
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| My friend made this for me. |
Instead, the normal treatment is surgery (either lumpectomy or mastectomy plus sentinel node surgery) --> radiation --> estrogen blocking drugs for five to 10 years.
Broadly speaking, there are two categories of drugs for the estrogen blocking. Here’s information about both kinds from the breastcancer.org site:
Selective estrogen-receptor response modulators (SERMs): The best-known SERM is tamoxifen. Tamoxifen acts like estrogen and attaches to the receptors on the breast cancer cells, taking the place of real estrogen. As a result, the cells don’t receive the signal to grow. Tamoxifen can be used to treat both pre- and postmenopausal women. Tamoxifen can reduce the risk of breast cancer coming back by 40% to 50%, and it’s the one my medical oncologist recommended.
(This part is from me) Keep in mind that as a stand-alone statistic, that reduction rate sounds fantastic, but you need to know what your personal recurrence rate might be. By all accounts, I’m in a low risk category, possibly less than 2% chance of recurrence over the next 10 years. Since this drug has some nasty side effects, and also has a risk of blood clots and liver disease, I don’t think it’s worth taking. I can live with a 2% chance.
Aromatase inhibitors reduce the amount of estrogen your body produces. Aromatase inhibitors are most commonly used to treat postmenopausal women but can be used to treat premenopausal women who are also taking medicine to shut down their ovaries. This medicine has fewer side effects but often causes bone loss and bone breakage.
Since I already have osteopenia (the step before osteoporosis) and I’ve already had a bone break, this isn’t the drug my medical oncologist recommended for me, and I agree.
To better assess my risk of recurrence, he’s ordered a MammaPrint test run on my tumor (boy that sounds so weird to say: my tumor. Actually I still have a hard time wrapping my head around me having another kind of cancer.). If I fall in the ultra-low risk category, then I absolutely won’t take the estrogen blocker. The juice just wouldn’t be worth the squeeze. If my risk is higher, then we’ll have to talk further about the options.
My surgeon was also pleased with how I’m healing. I’m typically a fast healer and even though there's swelling he said it's really minimal compared to most. He said the recovery period is six to eight weeks, but I’m OK to work out as long as I don’t go swinging heavy kettle bells or anything.
Next week I see the radiology oncologist to get that process going. She’ll do some sort of mapping using a CT scan to get the locations established, and I’ll get a couple of tiny tattoos that mark where the machine needs to line up. I don’t know how long my radiation treatment will last but generally it’s three to seven weeks, five days a week. There’re some less than pleasant side effects but nothing horrible (although my surgeon did warn me today that my breast will swell from radiation—good to know!), and once that’s done, everything can start healing up.
1 comment:
Your positivity is just so inspirational! I'm glad to hear that you're healing well. It will be nice once you can start working out again!
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