Wednesday, September 11, 2019

Tom Petty was correct... waiting IS the hardest part.

In my last blog, I wrote about the BCI ( breast cancer index) test, and how that it takes six weeks to complete and come back to the doctor's office. I have one more week before the test is back. Then, my oncologist has to find the time to look at the test results. The nurse said that the office would mail a copy of the test results out to me, but that my doctor would also call me so that he could explain the results. I have tried to think about other things, but of course, my thoughts keep returning to the test and what it might mean for me.

 I should also mention here, that one of my blog readers reminded me that the BCI test is also used to determine if chemotherapy may be appropriate for patients with breast cancer. Of course, this is just one " tool in the arsenal ". The course of treatment that  our physicians recommend, breast cancer staging, and the patient's opinion are some other factors in the decision to have chemotherapy or not. The BCI test was not available to me 4 years ago,when I had to make the decision to have chemotherapy or not. I decided, at my oncologist's urging, to have the chemotherapy. And while it was perhaps one of the harder things that I have had to go through, I do not regret that decision. I am fighting this with everything that I possibly can, you might say.

And since this is a " 2Fer blog" I will also mention the fact that I did not have my thyroid cancer check up on September 5th. My endocrinologist was out of the office, and has rescheduled my appointment for October 17th. I will also have a bone density test then as well. There are at least two factors that put me at risk for osteoporosis. One, is the Letrozole that I take for breast cancer recurrence. This drug, while almost 98% effective in preventing recurrence, has some pretty troublesome side effects- one being that it can cause osteoporosis. I will not get into the mechanism of action of the drug, except to say that this is a product of estrogen blocking. The other factor is the fact that my endocrinologist has been keeping my TSH basically at zero. While this is useful in preventing a recurrence of the thyroid cancer, this too can cause osteoporosis.

Before I started taking the Letrozole, and even when my TSH was essentially zero, my bone density scores were great. Now, after 4 years on the Letrozole, and 9 years after having my TSH at zero, I have osteopenia- which is just a fancy way of saying that osteoporosis is just around the corner. I feel that if I am able to stop the Letrozole, my bone density tests would improve. But would I have a recurrence of the breast cancer? That is where the BCI test will (possibly) help my oncologist and I make an informed decision of how long that I would benefit from being on the Letrozole. Let me add here that quality of life is also an issue. I will not go into details, but there are many side effects from the Letrozole- and I have several of them. I would feel better if I were to stop taking the Letrozole. I would probably have less joint and muscle pain, better sleep, I have occasional low grade fevers- which I believe is caused by this drug, less fatigue( which is even more important when you do not have a thyroid), less hair loss, better skin texture, less swelling of my hands, feet, ankles and lower legs, and the list goes on...

As with any medication that one takes on a long term basis, one needs to compare the benefits versus the side effects. This is not an easy decision. Yes, the side effects are affecting my quality of life. BUT, I certainly do not want a recurrence of the breast cancer. My husband, for whatever reason, seems to think that my BCI score will come back somewhere in the middle. That it will not be a clear cut and dry result, you might say. If this does indeed happen, I will probably go with the quality of life decision. I am not an elderly person, but I am not a young person, either. I want to be able to enjoy my life as much as possible, and feeling better would certainly help.

So, I am waiting.... waiting on the BCI test, waiting on my thyroid cancer checkup, waiting on the bone density test. I know that every cancer patient, or every patient with a serious medical condition, is familiar with the waiting game. I have found that the best way to deal with the stress of waiting, is with distraction. I enjoy spending time with my grandchildren. I am thankful that I am retired and am free to go to their school and sporting events. I love doing my crafts- making my beeswax candles and doing a little stained glass work. I enjoy getting together with my friends and family. I like to be outdoors- walking or doing some light gardening. I try to practice gratitude in all that I do, and in every day of my life.

Thank you to all who take the time to read my blog. I like to provide information that might help others. And honestly, it helps me work out my feelings and make my decisions when I take the time to write things down. So, now I wait...