Tag Archives: aromatase inhibitors

there are always choices

On Tuesday I had the best conversation I’ve had thus far with my medical oncologist. I walked out of the consulting room feeling that my concerns about aromatase inhibitors (AIs) had been heard. He gave me his rundown on all the options including doing nothing at all. He made it clear that it was my choice, not his, as to how I might proceed from here.

While preparing for the discussion, I had fallen into the trap of assuming what his response would be. Fortunately for the sake of good manners, I had also made the decision to listen to him before launching fervently into my pages of notes.

My highest concerns on the list of side effects related to loss of bone density. Despite the fact that the good doctor would prefer I took the AI route, the options laid out included trying Tamoxifen which, while it has its own list of interesting potential side effects, will leave my bones alone.

So that’s what I’ve decided to do. A suck it and see approach to Tamoxifen knowing that all of the other options are still available should I change my mind.

When I visited the pharmacy to collect my first vat of tablets, they provided me with an information pamphlet. I am pleased to report that I will be totally compliant with this note.

Must not do

In other news, I’m two weeks into my new disciplined eating approach which includes taking care of what and how much. It’s so far so good on the red wine count. I’m allowing myself 2 standard drinks a week. Thus far, two kilograms (or 4.5 pounds) have left the building.

Painted in Waterlogue

And now that I’m almost over a cold which sapped energy levels just as they were starting to rise, the daily walks are up and strolling. It’s almost six months since I discovered the lump in my breast. It feels so good to be at this end of those six months.

 

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decisions, decisions

This morning I saw my surgeon for the first time since the end of March. He wins the prize for my favourite specialist thus far. He’s a listener, empathetic and easy to chat with.

All’s looking good on the wound front.  While I had him as a captive audience, I asked questions about the aromatase inhibitor regime I may start in August.  I’m particularly concerned about the bone density impacts of these drugs.  He accessed my last bone density scan and confirmed that given already established loss, in his view, I would need to consider bone strengthening drugs to counteract the effects of the AI drug.

Sigh. There are so many unanswered questions. We’re talking about drugs to address what other drugs damage. Drugs that also have their own negative impacts. Drugs that may/are likely to/will affect quality of life factors for years.

There is much to mull over.

hormonal therapies - Cancer Australia

excerpt from Cancer Australia’s Guide for Women with Early Breast Cancer

 

 

looking ahead

grevillea - 18 June 2014 - Tokyo & inverted - FX Photo Studio PROI’ve finally come up for air after the last chemo dose, just in time for 20 zaps of radiation over four weeks starting next Wednesday.

What’s exercising my mind, however, is what comes after that.

You’re saying, “Wait, there’s more?”

Yes. Yes there is.

The majority of breast cancers are Endocrine Receptor positive meaning that oestrogen, once a useful friend, has become another F word.

This foe will require 5 years of daily tablet popping. In consultation with my oncologist, I will get to select one or other from a family of aromatase inhibitors. Aromatase is an enzyme responsible for converting androgens to oestrogen. Don’t you think androgens sound a bit like alien life forms?

This seems all very straightforward until you start researching the suite of potential side effects*. These may include but are not exclusive to:

  • loss of bone density;
  • back to the future menopausal symptoms;
  • fatigue (universal to all of the treatments thus far);
  • joint and muscle pain (more common than you’d hope);
  • mood changes (watch out!)
  • poor sleep; and
  • weight gain (really?)

As someone who has low bone density already, I was concerned enough about these impacts to have a chat with my GP yesterday. Thankfully, she didn’t minimise my concerns and took the time to outline a range of potential options.

There’s one word that keeps coming up in conversation and reading.

E X E R C I S E.   That doesn’t start with the letter F so it looks like I’m going to have to learn to love the E word.

*As an aside, nobody mentioned any of this at the start of the treatment planning. I don’t know whether people feel as if you can’t handle too much information up front, but I would have appreciated a heads up a bit earlier.