Thursday, August 5, 2010

The Oncology Oracle Speaks

 I was so fortunate that my oncologist had an opening first thing Monday morning.  The waiting is the worst of any of these processes.  The data and opinions I’ve been accumulating over the past month gave me valuable perspectives I would not have otherwise considered.  It’s important to follow your gut, but equally important to know that the gut and brain are closely connected.  The more relevant information I have, the more reliable my gut will be.

Here’s some of what we covered, and other tidbits I’ve collected:

What lowers my risk factors:
  • I did not test positive for BRCA genes
  • Keep my vitamin D levels in a high zone (50-60)
  • I finally got my lazy butt up and participate in a regular exercise program.  VERY important, by the way.
  • No family history of breast cancer. Although the majority those diagnosed have no family history.
  • Normal weight (took off 20 lbs post-chemo)
  • Minimal alcohol intake.  Maybe 1-2 glasses of wine a week.  For the most part, it just doesn’t taste as good any more.
What increases my risk: 
  • I have breasts.
  • I’m female
  • Increasing age – as of next week I’ll be over 60
  • A personal history of breast cancer
  • Radiation exposure – damned if you do, damned if you don’t
  • Beginning your period before age 12 (I was 11)
  • Beginning menopause after age 55 (I was 58)
  • Postmenopausal hormone therapy: 3 months of bio-identical, but messing with nature nonetheless
What could reduce my risk:
  • Keep exercising.
  • Move to another planet
  • Arimidex and similar aromatase inhibitors – these are out of the question for me; the pain was debilitating.
  • Tamoxifen:  I’ll be doing a lab test to determine if tamoxifen will be effective for me.
Here’s the thing when they say these drugs “reduce your risk by [60%, 70%, etc.].  That is the percent of the percent of your risk.  So if you have a 2% risk of getting breast cancer, taking a drug that reduces that risk = 60% x 2% = your risk is now 1.2%.

On the other hand, there is a significant increase in the percentage of women taking Tamoxifen that develop uterine cancer. In this 2008 study, it increased the risk 3:1 compared to women not taking Tamoxifen.  Is that a risk I want to take?

And let us not forget – no test is perfect; there are always exceptions. Science and medicine are learning processes based on likely outcomes and we are the long term test subjects. For the first 3 years after I found the lump, no one thought it was even enough concern for a biopsy, based on the mammograms, ultrasounds and thermogram.  Much has changed since then, but my first pathology test diagnosed the wrong type of cancer.  This is not unusual.  Prone to Error: Earliest Steps to Find Cancer

(Thanks to Join Our Loop for that link – stop by & visit this dedicated group.)

The bottom line we agreed upon is that I am not the best candidate for a prophylactic mastectomy AND there are no guarantees. 

My insurance does not cover Dr. Hackert, but it does cover the hospital etc., so back to the drawing board and financial planning department.

What is your experience with Arimidex and/or Tamoxifen? Your thoughts on using these?
Have you been through mastectomy, reconstruction or reduction?  What is your opinion?