Friday, August 12, 2011

Oncologist Visit

I finally stopped my boycott of all doctors on Wednesday. My tamoxifen prescription ran out and I had to make an appointment to get a new one. I had a good run though from the beginning of March until this week. I made it almost through the whole appointment before he gave me a hard time about the length of time between visits. I put my head down like I felt badly about it and promised it wouldn’t happen again. But between you and me, it was worth it! It has been a great doctor free spring and summer.

But I am now back in the medical fold. He suggested that I change from tamoxifen to an aromatase inhibitor (AI). He said that there is a better chance for survival on an AI for someone with my cancer history and since I had the hysterectomy and ovary removal. In an oversimplified nutshell – tamoxifen stops your body’s ability to use estrogen while AIs stop the body from making any estrogen. Of course ovaries are the main source of estrogen in a female body so women with their ovaries who have not gone through menopause cannot take them. But in the case of those of us without ovaries, the body also makes estrogen in other ways. Taking an AI will stop those other ways. My cancer was estrogen positive – meaning it fed and grew off of estrogen. So, if there is no estrogen, any cancer cells left in my body will not grow. OK – simple enough, I buy it. I tried to read the different studies concerning tamoxifen vs. aromatase inhibitors. One I read said that in women who have been on tamoxifen for two to three years and then switch to an AI, there is a 50% better long term survival rate. I don’t know who did the study, maybe it was the manufacturer of the AI I am going to be taking but I like the sound of that. Other studies show the opposite. So, it all boils down to my decision. Through it all I have always taken my doctor’s advice and I start taking letrozole on Monday.

The list of potential side effects is as long as the tamoxifen list and then some. I hope I do not have the hair thinning, the debilitating joint pain, the brain fog, or the sky high cholesterol that others complain of. I was worried about how much it was going to cost but it seems that there has been a generic version since last year. My pharmacist called today and said that it will only cost me $15 a month. Awesome! AIs do cause the body to lose bone density each year so I will have to go twice a year to have some sort of infusion to counteract the osteoporosis. I have my first one next week and I’ll find out more about it, I didn’t ask. My oncologist did say that I may feel achy like I have the flu for a few days afterwards. I can handle that. It is no chemo. I also go back in three months (I promised!) and we will discuss any side effects I am having and I can decide then whether I want to change back to tamoxifen again.

We also discussed how long I was going to continue to take medication. He had told me when I started on tamoxifen that it would only be for five years. I asked about the letrozole hoping it would be the same. He said that there have been some promising studies out of Europe showing that ten years is the most beneficial for both tamoxifen and AIs. He said we could discuss it again in three years.

So, I went to the doctor’s office this week thinking I had two years left of taking a medication which is causing me no bad side effects to seven years of taking a medication that could cause me all sorts of problems. See why I avoid doctors as much as I can?

But of course, if there is any chance that this new medication can give me a large chance of survival, I am obviously going to give it a try. And after spending too much time reading about the negative side effects, I’ve decided to not worry about them. Life is too short for worrying about something that may not happen. I’ll let you know………