Letrozole and Life

Letrozole

I admit that it has been difficult to be thankful for Letrozole lately, even if it is keeping me free of cancer at the moment.

It seems like it places me between the proverbial rock and a hard place. Do I take the medication and live longer but with extreme pain? Or do I quit the medicine and feel better in the short term but have at least a 50% chance of recurrence?

At the age of 44, I am too young to become housebound. Even during chemotherapy, I was able to exercise at least one hour per day during my weeks off from treatment. Now I struggle some days to just make it to the bathroom or simply get off the couch.

Also, my thinking became somewhat suicidal last week. I thought everyone would be better off without me. Whether it was the stress of the divorce or the medication, I don’t know. I took a couple of days off from the medicine and feel better. I have resumed taking the Letrozole, so I suppose I’ll wait and see if the thoughts return.

At this point, I’m not sure what I will choose in the long run. I’m going to stay on the medication for now and hope that things improve.

Things have to get better, right? I’m praying that they do.

One Little Pill

One Little Pill

I suspected.

Some would say this might be a self-fulfilling prophecy, but I know more than one woman who would agree with me. Letrozole has had the biggest impact on my life in the short term, and not in a good way. The pain on Letrozole vs. Anastrozole is so much worse than before.

And I have not been on the drug for very long.

Indeed, only two weeks. According to my friend who tried this medicine first, the pain did not really hit her until about now. She was taken off of the drug after her thumbs became frozen.

Doing any sort of work has been nearly impossible for me as it causes extreme pain, so much so that I can’t sleep. The house and yard are going to pot, but I’m still alive, for which I’m grateful.

Some times in your life, you realize just how fragile your body can be. I miss the strong, healthy body that I used to enjoy. One that didn’t cause me pain each and every day.

Still, I’m alive. And that’s a blessing.

Choices in Treatment

Choices in Treatment

Some may believe that making a choice as far as cancer treatment is easy. Suffer for a little bit and live, right?

The difficult part is walking down the path that you have chosen and accepting the consequences, whether good or bad. No matter the decision–strictly allopathic medicine, natural remedies, or something in between–the results may be positive or negative, and often not even the most experienced doctor can predict survival.

And when it comes to long term treatment like anti-estrogen therapy, the choice may be a bit more complicated. For a friend, ten years of medication only added 3% to her survival rate, which was more than enough for her to begin the medicine. On the other hand, considering I had inflammatory breast cancer, a cancer that is much more aggressive and difficult to treat, anti-estrogen therapy added 30% to my survival rate.

So if I follow all of the advice from my doctors–all based on world-wide research–my possibility of living a full life is currently at 80%.

What is often not discussed is the pain associated with these medications. I have been on Anastrozole for a few months now, and the body-wide bone pain has begun to increase dramatically. This may be possibly due to the current stress in my life, or simply just the medication itself building up in my body. Needless to say,  the pain some days can be unbearable.

So in the latest visit with my oncologist, he encouraged me to try Letrozole. This might be a better medication for me in the long run, but it will put me back to square one as far as pain. My body will have to become used to the new medicine, which means more pain in the short term. And this could all turn out to be a fool’s errand, becoming an even worse experience and leading me back to Anastrozole.

Honestly, it would be easier to quit the medication totally.

Reading The Last Arrow by Erwin McManus, I found a passage that made me reconsider that possibility:

“Sometimes the only way to set people free from the past is to create a different future that gives those all around you the inspiration and hope to set their own past on fire.”

Or as a friend told me after my most recent diagnosis, “Perhaps you were not meant to learn something from your suffering. Maybe you were meant to teach others how to live through it.”

So pain will be my companion for awhile. Some days I will break from the exhaustion, but I will not quit. And perhaps my continually rising up after defeat, even in the midst of pain, will give others hope.

 

Things I Didn’t Know about Estrogen…

Things I didn't know about estrogen

Although fertility is an issue for so many women facing breast cancer, it has never really been a problem for myself or my husband. We decided a long time ago that we did not want to have children, and we’re still content with that decision.

Too, if a hysterectomy and anti-estrogen therapy just removed my ability to have periods, I’d be totally fine with that. My periods have always been horrid, and cancer treatment has brought me great relief in this part of my daily life.

But as I get deeper into my anti-estrogen treatment and think about scheduling my hysterectomy, I realize just how important estrogen is to our bodies.

Now, I realize that menopause is a natural occurrence in a woman’s life, but chemical menopause is something else entirely. There is no natural transition over a decade or so into a crone. Chemical/surgical menopause is instantaneous and harsh, affecting every part of a woman’s health and lifestyle.

And all too often, breast cancer patients who face this are much too young to even be in peri-menopause, much less the beginning stages of menopause itself.

And no, HRT is not an option. Some people that hear about my being treated with Anastrozole mistakenly believe that this drug is a form of HRT and thus “balances” my hormones to relieve the symptoms of menopause.

Actually, the opposite is the case. The drugs that I take further decrease any remaining estrogen in my system after a hysterectomy, or as in my current state, in conjunction with Zoladex, which shuts down my ovary function and allows me to take the Anastrozole.

So what have I discovered about estrogen now that it’s gone from my body?

(Or at least being chemically suppressed.)


It’s important for eyesight. Even with my fairly new prescription for bifocals, I am increasingly having difficulty reading, which is one of my favorite pastimes. Books almost have to be loaded on to an e-reader so that I can adjust the print size, and even a large print Bible is too much of a strain on my eyes at this point. This has been a surprising and really disheartening side effect of this treatment.


There are increased problems with insomnia. Stress is obviously part and parcel with cancer treatment, and this can most certainly contribute to an inability to sleep. But when hormones suddenly drop, as with the Zoladex–and eventually a hysterectomy–along with the Anastrozole, it becomes more and more difficult to sleep.


It’s important for memory. Although the linked article seems to have a mixed view on the topic, the significant part in the language seems to be that the combination of chemotherapy and anti-estrogen therapy produces a worse result cognitively. (At least that’s how I’m reading the medical jargon.) Too, I have to wonder how many of these women in the studies are truly post-menopausal or have had it induced so that they can take the anti-estrogen therapy.

I am hoping that more research delves into the experiences of younger women with chemically/surgically-induced menopause who are taking anti-estrogen therapy. You can find comments about Anastrozole and similar therapies from women on The Underbelly’s Facebook page.

I struggle now to complete even simple tasks, and my ability to think creatively and to write has been significantly impaired. Recalling even simple words or memories can be extremely difficult for me now. That “it’s on the tip of my tongue” sort of feeling is a constant, everyday thing. I seriously wonder if I will ever be able to function normally in a workplace setting while taking these drugs.


It’s important for bones. Honestly, I already knew this, but I suppose I wasn’t aware how significant a part anti-estrogen therapy can be in the weakening of bones, thus putting even young women at a high risk for osteoporosis and broken bones. As a part of this, of course, another side effect of Anastrozole is bone pain.


It’s important for your heart. And unlike the information in the linked article, HRT is not an option to deal with this particular side effect.


It’s important for weight control. There is also the additional problem that anti-estrogen therapies often cause weight gain, whether through the effects of the drug itself or the lack of desire to exercise due to the constant muscle and joint pain.


I’m sure I’m missing more of estrogen’s effects throughout our bodies, but you get the idea.

(Just wandering through my virtual home at the moment, scratching my head and wondering why I came into the kitchen. And when someone says something to me, I say, “Eh? What’s that sonny?”)

Although menopause in your 50’s and 60’s may be natural, that experienced by younger breast cancer patients is not. The side effects of the surgery and treatments are severe and long lasting. And pervasive.

I suppose if you are still healthy and enjoy the effects of estrogen in your body, my advice would be something akin to that of Robert Herrick, in his poem, “To the Virgins, to Make Much of Time”:

Gather ye rosebuds while ye may,
Old Time is still a-flying;
And this same flower that smiles today
Tomorrow will be dying.

 

When Life Stops

When Life Stops

It will soon be almost a year since I was diagnosed with breast cancer for the second time.

It seems like life has effectively stopped for me, leaving me untethered from all that provided me with the structure of daily life. While my work once created the boundaries of my days, now the treatments have taken over that role, resulting in new, smaller borders and limited capabilities.

Depression has set in big time.

Although I have struggled with this much of my life, the onset of this most recent episode started not long after I began taking Anastrozole, which can cause depression and insomnia, among other things. The depression with Anastrozole is different than any previous darkness. It is much deeper and foggier, with fatigue as an added weight.

I’m gradually moving out of this depression, but it is taking time. Still, there is some progress.

I was blessed to be prayed over twice this week, and I feel a lightening in my spirit even though my circumstances are still the same.

Things are changing, and I believe that this spring will bring new opportunities.

Right now I feel the need to focus on recovering spiritually and emotionally after all that has happened this past year. That means more private time, more scripture, more prayer. Clawing my way up out of the darkness bit by bit.

Until my writing juices are up and running again, take a moment to read this article that I wrote for Compassion That Compels, a great organization. If you have a bit of extra money this month, please consider making a donation.

And if you need prayer, please comment on this post with your prayer requests. Even if I can’t hug you or offer you a cup of coffee, I can be there with you virtually, praying and believing.

Venturing Out

Venturing Out

I went to church on Sunday. This was my first real outing since my surgery and of course, radiation.

Everything was wonderful except for the pain.

Now that I have technically finished active treatment, people look at me and seem to see just a normal, healthy person. So many memes now mention “hidden” illness and pain, and I suppose I have an intimate understanding of this after beginning Anastrozole. Others don’t get why I continue to experience pain and fatigue, both of which urge me to stay at home.

As one person said when I mentioned that the drug causes pain, “But medicine is supposed to make you feel better!”

Precisely.

Going out and about can be a cause of anxiety for cancer patients. Our bodies no longer look or act like they used to, and facing healthy folks’ reactions can be a bit of a scare. Add pain to the mix, and it’s all too easy to stay at home.

Cancer treatment can often mean accepting the Devil’s own bargain. The various treatments offer the possibility of a cancer-free life, but that life may be one of pain and illness. We accept that awful bargain, though, because we love our families and want to stick around for a while.

Puttering around the house and allowing myself to rest when needed sound much more pleasant nowadays than social interactions. Cancer changes you, and it ages you.

The pain should subside after a few months on the medication, but until then I may have to learn to just say “No” when it comes to going out with others. Hopefully folks understand.

 

 

 

 

 

Now What?

Now What

With cancer treatment, you seem to be maneuvering through an obstacle course in the fog. Just when you scale one wall and begin to run again, you encounter a bunch of rocks that make you slow to a crawl. It’s sort of an endless cycle of doctors and medications and scans and side effects.

You’re often left wondering, “Now what?”

Having finished radiation, I began to recover strength, both of body and mind. After a bit of a break, I started the Tamoxifen. For a while, I experienced no side effects. I was sure I was going to get off scot-free. I congratulated myself on being one of the lucky ones.

“Not so fast,” life said.

The pain and fogginess began gradually. I thought at first that it was simply my body recovering from the radiation, or perhaps just a bit too much exercise. But the side effects only grew stronger each day, and I knew it was the anti-estrogen pill.

I’ve struggled to recall names and facts, or sometimes even form a coherent thought. And the pain is similar to when I was receiving the Neulasta shots. Pain that is constant and limiting, very similar to some of my worst days during chemotherapy.

I’ve found myself thinking, “What fresh hell is this?”

I now understand why women often say that anti-estrogen therapy changed their lives more than chemotherapy or even surgery. And I also know the desire to quit taking those darn pills.

I will be on Tamoxifen for three months, after which I will again meet with my oncologist and schedule a hysterectomy. After that surgery, however, I will begin taking another anti-estrogen medication, a medication regimen that will last for ten years.

It’s possible that the side effects may lessen as my body becomes used to the medication. However, I think it’s pretty certain that my body and my life will never be what it once was. Learning how to live with these changes is now my current challenge.

As Mike Foster says in Rescue Academy, we often let our pain define God. When your life becomes centered around medications and pain and doctor visits and scans and whatnot, it can seem like that’s all that’s left, a shell of a life that once was. But maybe we can turn it around, let God define the pain.

That’s what I’m trying to do at this point. Turn my view around and live.

Just a Totally Honest Post…

Totally Honest PostI have finished radiation treatment and have begun Tamoxifen, with a hysterectomy to follow in a few months.

Since beginning this drug, I just feel empty, discouraged, and have had trouble concentrating, among other things. And writing? That’s flown out the window and is now in the ether.

Luckily, I wrote an article for The Underbelly before all of this nonsense.

Please bear with me while I attempt to reassemble myself while on Tamoxifen. I feel like a bucket full of lego bricks that has been shaken violently.