Adventures of the Flat and Infertile

adventures of the flat

My next step in treatment is about to commence. Yes, the dreaded hysterectomy has been scheduled for next week.

Nothing like sitting in the waiting room of a gynecologist’s office to make you feel a bit conspicuous. Childless, flat, and there to schedule a hysterectomy.

When I met with the doctor and had my initial exam, I was somewhat surprised to find out that I wouldn’t be able to have a laparoscopic hysterectomy due to my size, fair skin, and lack of childbearing.

Who knew that being a petite, redheaded woman with breast cancer and no history of childbirth would be a drawback when it came to this surgery?

I will be undergoing a full abdominal hysterectomy, with the one large incision on my abdomen. The average hospital stay is about two days, with recovery about six weeks.

Honestly, I’m dreading this surgery, but I’m ready to have it done. At least this will eliminate the Zoladex from my current medication regimen. Although it doesn’t cause me any side effects, I will no longer have to go in for the monthly injection of the implant.

Too, as a patient with Cowden Syndrome, I’ll be eliminating one more possible risk in having this surgery done on a prophylactic basis, way ahead of any cancer developing. As I’ve already had my thyroid and breasts removed, I suppose I’ll doing pretty well as far as future risks are concerned.

And frankly, I’m pretty sick of cancer at this point. I’ll do what I can to avoid any further encounters with the beast.

I’ll be offline for a bit so that I can get things prepared in real life and psyche myself up for this next round in the surgical suite.

See you soon!

Mother’s Day and Breast Cancer

Mother's day cancer

My mother died in 1999 after a recurrence of breast cancer.

With little information at the time–no internet, only the beginnings of patient rights–we didn’t recognize the signs of a recurrence until it was too late. Her behavior began to change over time, showing signs of recklessness and forgetfulness. And then she suddenly had trouble walking, having collapsed at home.

Doctors in the ER informed my father that a scan revealed tumors along her spine. She was released home with pain medication, but little else to do as far as next steps. Her extreme reaction to chemotherapy in 1992 precluded any more chemo treatment for the recurrence, and so we were left with pain management and the awareness that her time with us would be limited.

After a call from my father, I drove home from college. She died the next morning on our couch.

Since then, I have regularly avoided going out on Mother’s Day, and that now includes social media as well. People say that the pain and loss of losing your mother–or any other family member, for that matter–lessens over time, but I believe it is more your learning to live with the loss.

And now this year, I have breast cancer yet again. The same cancer that killed my mother so long ago.

I am finding this day to be more difficult than I expected. My flat chest, many medications, and constant pain only serve to remind me of my mother in the most horrible way, that of a shared illness and possible death. And the celebrations that litter my Facebook stream only enhance that awareness.

My mother was loving but a rather complicated woman in that she had a misdiagnosed mental illness. If she had lived longer, she might have been able to receive the treatment that she needed. I know that she did the best she could considering her struggles, and I will honor her for that.

But I cannot join in on the celebration of this holiday, especially this year. I loved my mother despite everything, and the pain of her loss is still too great even after all these years.

If this is the first Mother’s Day that you face alone, please know that my heart and prayers are with you.

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.

Mutation Certification Letter

mutation-certification-letterI have received what I jokingly refer to as my “Mutation Certification Letter.” Part joke, part reality. It is a letter from my genetic counselor explaining the PTEN mutation, along with the diagnostic criteria and symptoms of Cowden Syndrome. Additionally, the letter includes a list of the scans that should be performed in the future to screen for any problems that might arise.

As you can imagine, it is quite a lengthy letter. Part of the reason for the delay in receiving it appears to be that the letter was returned by the post office for insufficient postage. Yes, it’s huge.

Toward the beginning, the counselor describes Cowden Syndrome as a “cancer susceptibility syndrome.”  Seriously. My radiation oncologist asked me if I felt like a “tumor factory,” and I had to nod in agreement.

Cowden Syndrome puts me at risk for a variety of cancers as well as having a second cancer, both of which have proven true in my case. My doctor said that the chance of my having Invasive Ductal Carcinoma (Triple Negative) and Inflammatory Breast Cancer were astronomical, however, even with the mutation.

Regarding the “second cancer,” I was a bit confused after reading the letter and the literature online. Does it mean a second breast cancer? Or another cancer elsewhere?

So I asked my oncologist if I had now fulfilled my “quota” for the second cancer. We both laughed a little at my wording of the question, and then she began to explain the studies. Most of the second cancers found have been in older patients; living longer, they are more likely to have another cancer, with or without a  genetic mutation. Still the research does point to one thing: I’ll probably have yet more cancers in the future due to the PTEN mutation.

Attempting to lighten the mood a bit, my oncologist went on to say that I have a mutation, but I’m not a “mutant.” I responded that she was giving me radiation treatment and so I could become one soon, à la the Incredible Hulk. She seemed a bit surprised at my response, probably along with being a tad weary of radiation jokes.

What else can you do, though, but laugh about the craziness of it all? As Julie Manning says in her newly released book, My Heart: Every Beat Surrendered to Our Unchanging God,

“This life is truly just a breath.”

Frankenstein or not, I’m still here, and maybe something good can come out of all of this.