Hormonal Therapy

It’s been a while since I posted as I gave myself a good break and have been dealing with skin issues.

My skin seems to be progressing well.  The spots where is separated under the breast seem to be healing and closing, and my collarbone is looking a little more normal.  The big problem from the weekend is under my arm where they were radiating the lymph nodes.  The skin broke in a huge area there and it hurts and pulls whenever I move my arm.  It is still in the peeling phase and I can tell the area is going to be even bigger tomorrow.

But once I get past the peeling, it takes about 3 days to start feeling better.  So strange as it seems, I am hoping it will finish peeling today so I can feel better by the weekend.

There is one part of my treatment that I haven’t mentioned too much, and that I haven’t really seen anyone mention outside of forums and that is hormonal therapy.  Not everyone does it as your cancer has to be susceptible to it which is determined by the tests they do on the cancer they remove.  It’s a simple enough therapy, I take a pill once a day for the next 5 years.  No regular hospital visits or needles, just a pill.  Like a birth control pill–only the birth we are preventing is a cancer reoccurance.

This is how it was explained to me:

Some breast cancer cells have receptors on them that allow them to seek out and feed on specific types of hormones (estrogen and progesterone).  With these receptors, the cancer cells essentially use these hormones to feed themselves and reproduce and grow more cells.  When removed cancer cells are looked at under a microscope, the number of receptors on each cell is counted for each hormone and if they are present (not all cancers have them), a percentage is given based on how many.  My tumours were 100% Estrogen receptor Positive and 80% Progesterone receptor positive.

That makes me a strong candidate for hormonal therapy as the main ‘food’ for my cancer was my own hormones.

From what I understand, the hormone therapy suppresses the ability of certain cells (most of which are female-type cells) to use estrogen.  It keeps the estrogen from attaching to the receptors on the cells (whether healthy or cancercous), therefore cutting off a big part of their food supply.  It also keeps my body from producing extra estrogen and suppresses my ovaries.

It basically creates a form of temporary menopause, and like menopause will come with it’s own set of side effects.  The main ones are fatigue, nausea, hot flashes, muscle soreness, and moodiness.  The good news is that the body should usually adjust to the treatment after approximately 3 months and the side effects should lesson.  I remember something similar when first starting to take birth control pills many many years ago.

The only hiccup (besides having to get through 3 months of unknown varying side effects), is that the pills can also put you at a high risk for blood clots.  This means that I will have to stop taking it 3 weeks before my surgery to clear it out of my system and avoid that complication.  It also means I will have to start taking it again once my plastic surgeon determines I have healed enough from my surgery to be able to do so, and the clock on the side effects starts over.

Unfortunately, because of the length of time between radiation and my surgery, my oncologist didn’t feel it would be safe for me to wait to start the hormone therapy until after.  I do get some similar lasting benefit for a while after chemo, but it is temporary and that is running out, so I have no choice but to start/stop/start again.

I am trying to stay optimistic that perhaps I won’t have hardly any side effects from this therapy, there are some people who do experience that.  I just know I have a bad track record of hormone issues, so that makes it harder to be so optimistic.  All I can do right now is take the pills and see how it goes.

Fingers crossed.

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