From tamoxifen to zoladex + femara

Hi all!  Happy New Year!  May 2009 be the year that there are no cancer scares for me or for you or your loved ones!  The good news:  I’m feeling better overall than I have for years, so take heart.

The bad news: I’d like to request prayers for my aunt, who astonishingly enough is facing her 4th primary breast cancer.  She’s 64, and her first cancer occurred when she was younger than I am, and her third 12 years ago.  Her docs say “there is no convincing evidence of metastatic disease.”  Wild, right?  Who woulda thunk?  There’s hope for us all.

And no, we are not BRCA positive.


This post is in response to several requests for an update to my post “Tamoxifen and I are not the best of friends” from April 08.   Alert, TMI begins here, so if you’re a guy, you may want to skip this post.  Moving on – in May of 08, I, like many of the young survivors I know post-chemo, got my, ahem, “cycles” back.  12 months after beginning chemo.

It was slightly traumatic and embarassing because I didn’t know what was happening, and neither did my doc. I’d been throwing up, and had intense lower back pain, and was curled up on the couch moaning when I finally conceded that I had to call my PCP.  Whose lovely triage nurse, Fran, whom I will forever be indebted to, talked me off the couch into taking major painkillers.  (Duh, right?!)

Then she tried to convince me to come in, and I told her as soon as I could walk (it was a LOT of pain), I would.  Which prompted her to call me every 2 hours until I could get in.  (Note that there was no flow whatsoever – in fact it took 3 days for that to come!  It took me all day to realize what it all felt like and I tried to convince the doc who saw me that I had a sneaking suspicion what was going on, because it felt like it did when I was a teenager, but they weren’t buying that theory until later.)

My estrogen (estradiol) spiked to 176 from 13 or something like that, which, with estrogen positive cancer is not. good.

So there’s all the TMI.  The oncologist wants to take my ovaries out.  I don’t.   I know he’s right, but I don’t want more surgery.   So, after a summer filled by 8 weeks of a cancer scare (more on that later, all’s well that ends well), in September we finally reached  our current compromise: I get zoladex shots every 30 days (ovarian suppression) and I take an aromatase inhibitor (femara).

At least menopause is a bit easier the second time around (hah, how many people get to say that?!)  in that I know what to expect a bit more.

Zoladex causes bone pain for about two weeks, but the trade-off is that I’m not in PMS pain etc. for a week every month, and femara makes me a bit queasy, but hey, I lost 5 lbs, so if that keeps up I’m happy.

The wrinkle in the femara was that I had some quirky heart issues, but the cardiologist convinced me that a) I’m fine and b) it wasn’t the femara, so, after momentarily stopping the femara and causing my oncologist so much consternation that he gave me the “I’ll still be your doctor, but…” speech I am finally taking the femara on a regular basis and am “in compliance” with an acceptable course of treatment.

This makes me feel much better – we’re reducing that dratted 7% risk of recurrence, plus, as a nearly straight-A student for much of my life, I hadn’t realized the drive to be a “good” patient was so strong.  Also, my onc. helped save my life and I really like him for that.  And I still need him.  And there’s joy in my life, so our current course of treatment is doable.  I can be me.  (Which with tamoxifen was just not happening.)

So that’s the scoop.  One final detail – Celexa helps even out all the hormonally caused irritability and anxiety, so even though I’m achy, it bothers me less, if that makes sense.

Life is good and the world is just so darn beautiful.  I even got to ski up and down my block a few weeks back.  (Portland had perfect powder – the ski resort came to us!)  There’s so much to tell that’s good, but for the post-tamoxifen crowd I hope that’s what you wanted to know.  Not all fun and games but there are options.



Filed under breast cancer, healing, quality of life, recovery, tamoxifen

2 responses to “From tamoxifen to zoladex + femara

  1. Glad to see you back and I am glad you are doing well! I will pray for your Aunt!

  2. Corinne

    wow, I am going thru such indecision right now ! I am scheduled to have my Ovies out because the Tamoxifen wasnt taking. I got the shot and are on Femara until the sugery date. I am SO confused as I dont want to go thru the surg again either. I was est+ but dont have the bad genes….

    Your post really helped me alot and now I am awaiting a call from my oncologist to see what they think

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