Cancer And The Single Gal, Part 1

It’s been a while since my last post. This blog was a bit of a security blanket during the worst of things..somehow recovery and the return to “normal” life made it less of a pressing need. Now that life is not so normal anymore, I’m feeling the old familiar urge to pour out my thoughts and feelings in black and white.

Life has taken quite an unexpected turn over the past year. My health is still good as far as I know. I mean, I get the routine pat down and once over, but my oncologist is of the belief that scans and cancer markers are only to be done if symptoms warrant them. And I’m ok with that philosophy being a firm believer in the power of suggestion to create illness. My body and I have a sort of “don’t ask, don’t tell” agreement going on. It’s working for us so far.

No, what has floored me is my sudden evolution from a sometime chiropractor/fulltime domestic engineer to a single mom who finds herself navigating uncharted territory and needing to support a family. SINGLE…MOM. Not words I ever expected to actually apply to me, even though Lord knows the marriage was a roller coaster ride of alcoholism (his), codependency, and a failure to communicate. To actually take the leap and start a new life after the million times I fantasized about it…terrifying and exhilarating all at once!

Last summer, after a nasty argument fueled by a weekend binge, my husband decided to accept a transfer to another state while we weren’t speaking. I found out when my suspicions led me to check his e-mail and I saw that he had been looking at apartments in Atlanta. He admitted that he had accepted the job, and it appeared that he was leaving without us to start a new life. Things eventually settled down and we agreed to work things out and make the move as a family, selling our home in North Carolina to relocate to Atlanta. He started the new job in July while I dutifully stayed behind to pack, clean and handle every detail of getting the house ready to market while also setting up our new lives in Atlanta.

The girls and I headed South to Georgia the first week of August. No more beautiful 2 story house overlooking the mountains. We were in a dark, depressing apartment for a month with rented furniture, broken kitchen knobs and huge cockroaches in the corridors…four of us, and a dog and cat. The girls had to start new schools in the space of a week and adjust to brand new friends and a very different curriculum. My high schooler was way behind, which became evident despite doing 4 hours of homework each night. She was miserable. I was miserable. Atlanta was miserable. We would come back to Asheville to “check on things” at the house every 2 weeks or so. We let out a collective sigh of relief each time we unlocked the front door. Home.

In the meantime, our house wasn’t selling despite rosy predictions. With every passing day of anxiety and frustration, something in me snapped. I couldn’t do it anymore, so I made the decision to bring the girls back to Asheville and let them finish the school year in familiar surroundings. My husband and I agreed that we would try again this summer. My daughter would graduate and things would be easier…somehow.

Of course, once we got back, the house sold within a month. We were just about to take it off the market as the holidays approached, but we felt that we couldn’t let a solid offer get away. As Thanksgiving rolled around, we found ourselves scrambling to figure out our next move….

 

And We Close The Chapter on Tamoxifen…Farewell

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I know I’ve devoted a great deal of time and space these past few weeks to the agonizing decision of whether or not to take the hormone blocker Tamoxifen as the final piece of my breast cancer treatment. Frankly, I’m as tired of thinking about it as you are of reading it, so you’ll be glad to know that something happened yesterday that allowed me to put the subject to rest.

I was sitting at my kitchen table, browsing through some blog posts and dreading my afternoon oncology appointment with every bone in my body. I had already postponed the appointment for 2 weeks because I was not looking forward to being scolded about the Tamoxifen…again. Now, scold is a harsh word when it comes to my doctor. He is about as threatening as a teddy bear wrapped in velvet sitting on clouds.

No, I think I was really dreading….the look. You know the one. Like your favorite grandparent who catches you doing something wrong and doesn’t spank you. That would be too easy. Instead, they sit you down, their head hanging with the weight of their disappointment, and tell you that they never would have expected this of you…and it hurts them that you would do such a thing. By the end of the lecture, you feel like the lowest of the low, and you’ll do anything to get back in their good graces.

That’s how I felt after our last appointment. I came in ready to fight, ready to bring in research and statistics to back my argument. And I left in a haze of confusion and shame. I even went to the drugstore and filled the prescription. I couldn’t bear to let Dr. A down. He cares so much; it’s palpable.

So, back to yesterday. I hopped over to one of my absolute favorite blogs, chrisbeatcancer.com. He was diagnosed at 26 with Stage 3 colon cancer and refused chemo and radiation, choosing to heal himself through nutrition. He is now an eleven year survivor who lectures around the country and offers much of his wisdom for free on his site. I’ve visited many times before, but this video struck a chord in me for some reason.

I’ve been somewhat beaten down by the medical establishment over the past year, and I’ve started to compromise my core beliefs. Namely, The belief that our bodies are designed to express health, not sickness. Yes, there are genetic aberrations, environmental insults, etc. that challenge us, but this is not destiny. We can radically transform the terrain inside the body by the way we treat ourselves. Proper nutrition, sleep, stress management, and healthy relationships are essential to disease prevention.

Chris is a very articulate, warm person who expresses these ideals perfectly. I am in no way against doctors or medicine when it is necessary, but the whole “fear culture” surrounding cancer puts so much pressure on patients to “go with the flow” or face dire consequences. Take Tamoxifen, for example. In my case, the statistics show that I have a 12% reduction in recurrence over the next 10 years if I take the drug. The mortality reduction is about half that.

For these slight statistical improvements, I will endure hot flashes, night sweats, depression, fatigue, joint pains, weight gain, and the possibility of aggressive uterine cancer, blood clots, and cataracts, or worse. There are very, very few people who have pleasant tales to share about this drug. And the kicker is.. the research will show that Tamoxifen is not curing cancer, but rather putting it to sleep. And it almost always finds a way to get around this “trance” eventually.

So..yesterday I had what could almost be described as a revelation. I found my convictions once again and decided that my body is not suffering from a Tamoxifen deficiency. I plan to do a hard core re-examination of my life and change the things that need changing. I went in to the doctor’s office, ready to defend my decision once again. Dr. A must have seen the look of determination in my eyes. He asked if I was taking the Tamoxifen. When I explained why I wasn’t, he simply looked at me and said, “Ok.”

I think that in a way he knows he is asking a lot of women, but he feels that it is his duty to try. I wouldn’t be surprised if he even has a sliver of doubt about the standard treatment in his most private moments. As for me, the Tamoxifen train has left the station, and I’m at peace as I wave goodbye.

 

The Doctor Said “Eek!”

shouting doctor

I had my 3 month check-up with the oncologist this week. I’ve been dreading this appointment like a case of shingles for weeks. Why? Let’s see. Not only did I not start my Tamoxifen like a good girl in January, but I have been doing the polar opposite of what was recommended. I moved the appointment back 3 weeks to stall, in the guise of waiting for my BRCA genetic testing results (negative) to come back, but the truth is I would have told him anything to delay the inevitable. “I can’t come in right now because I’m recovering from ebola”, etc.

So, my oncologist has been in sweet denial for the past 3 months, thinking that I’m a compliant patient, resting comfortably at night with the knowledge that he is in charge. Let’s just say I burst that bubble with a pitchfork on Wednesday.

He walked in the room after knocking gently. He greeted me warmly and asked how I’d been. “Fine, really well”, I offered, almost sheepishly. I thought that maybe my fears had been unfounded, maybe he was just going to check in and leave it at that, assuming everything was going as planned. It wasn’t to be.

“Are you on Tamoxifen?” he asked as he sat down and flipped open my chart.

“Oh, crap, here we go!” I thought, the red heat of shame traveling steadily up my chest to my neck.

“No…I…decided not to take it.” There, it was out.

He looked at me for a minute, not quite sure how to respond. “What happened?”

“Well, I’ve done a ton of research and reading about it, and I don’t see anything good. I know four people who’ve had to quit taking it because they felt that they would rather live 2 years happy than live with the side effects.” I was scanning his face for a reaction.

“I see. So, did you even try it?”

I felt at this point that I had to offer up something to make my case seem stronger and more logical, so I began to spill the beans.

“Ok, Dr. A, I like you a lot and I respect you as a person, so I’m going to tell you something, but I’ll spare you all the details because I don’t want you to have a stroke.” His eyes widened and he sat back in his chair. “I’ve been seeing that integrative MD that I told you about.” He nodded. “We’ve been doing a little experimenting.” Deep breath. “He put me on some bioidentical testosterone and gave me Arimidex to keep it from turning to estrogen in my body. After 5 days on the Arimidex, I was in such a pit of depression that I stopped taking it. Now, that pretty much tells me how the lack of estrogen is going to affect me, no matter what drug we use.”

mouse

Dr. A sat up straighter and looked in my eyes. “Eek!” I thought that probably wasn’t because he saw a mouse out of the corner of his eye. “First of all, I had no intention of putting you on Arimidex because that is for post-menopausal women. There is no guarantee at this point that you’ll stay that way. I’ve seen women older than you resume their cycles after chemo. We just don’t know how the aromatase inhibitors effect pre-menopausal ovaries.”

He went on. “So I don’t know why he would put you on Arimidex; well, I understand it biochemically, but it’s not the path I think is best for you. Second, I would feel a lot better about your decision if you had tried the Tamoxifen and told me that you hate it and absolutely can’t take it. Try it for 10 days or 2 weeks. But don’t assume that you know how it will affect you. If you tell me you absolutely won’t take it, then we’ll figure it out and monitor you more closely, but give it a shot.”

Uggghhh! Dammit, why does he have to always pull out the logic? I tried another tactic. “The side effects aren’t my only worry here. I honestly don’t think long-term estrogen deprivation is healthy. I think everyone forgets that estrogen does some good things, like protect your bones and keep your brain functioning, not to mention allow you to have sex without pain.”

I could see that he understood my dilemma and really did sympathize. He almost teared up as he said something about his mom having osteoporosis and how he worried about her falling. But, no dice. “I agree. And if you didn’t have this”, he pointed to my chart, “we’d be in a totally different discussion. But we have to weigh the risks in your case.” He got really quiet for a minute and I could see him trying to find a way to frame his next sentence delicately. “I don’t want to sound crude”, he went on, “but the long-term side effects of estrogen deprivation will be kind of a moot point if this comes back, and I feel like the window of opportunity for the Tamoxifen to work is closing.”

Ouch! After an hour of gentle prodding, he finally wore me down. “Ok, Dr. A. I’ll try it just because I like you.”

“Don’t do it for me. Do it for you. I’m your advocate here, and I want you to live a long time.”

So, here I am again, doubting my choices and in turmoil. Now tell me how good that is for healing. I almost want to fill the prescription so I won’t disappoint the doctor, with his big pleading puppy dog eyes. I have an appointment, meanwhile, with the hormone doctor next week, and boy do we have a lot to discuss! I think my bottom line for him is “If this were your wife, would you feel comfortable making these same recommendations?” Waivers and consent forms aside.

heart couple3

But, I have made one decision. I am absolutely madly and deeply in love with my oncologist. I have never met a man with his combination of intelligence, honesty, and compassion. And I have never met a doctor who wears his heart on his sleeve. I’ve decided that we’ll leave our respective spouses and make a new life together once the boobs are complete. They’ll just have to understand that fate has stepped in. Phew! At least I’m sure about something:)

Playing Chicken With Cancer, Part 1

80’S CANCER JAM OF THE DAY:

Two roads diverged in a yellow wood,
And sorry I could not travel both
And be one traveler, long I stood
And looked down one as far as I could
To where it bent in the undergrowth;

I’ve been reminded of this, my favorite poem, several times over the past few days as I wrestle with the decision of whether or not to take bioidentical hormones. I know, you’re thinking at this point that I’ve finally lost my mind. After all, I just finished treatment in December for a cancer that was 95% positive for both estrogen and progesterone receptors. Do I have a death wish?

Quite the contrary. I have a life wish, a desire for a full, vibrant life. For those who have been down the path of being suddenly and completely thrown into a premature hormonal black hole from the effects of chemotherapy, you can attest to the fact that it takes away something of your essence. You may not be a raving lunatic, but the light in your soul is dimmed.

Of course, some will fare better than others, but it nevertheless leaves you forever changed from the person you were before. Last June, I was a young woman with a regular (albeit overzealous) menstrual cycle; fertility was a stretch, but still within sight. Boom! In July, I was menopausal, my ovaries poisoned and relegated to the role of dusty internal decorations.

Now, if you are diagnosed with cancer in your 60’s, as most women are, hopefully you have been allowed to gracefully cross over the threshold of menopause, and perhaps some of the hormonal side effects of chemo are less pronounced. But at 45, or God forbid 30, like some of my blogging sisters, you are asked to live like a woman 20 or 30 years your senior and just be grateful to be alive at all.

To add insult to injury, the final step in breast cancer treatment is often Tamoxifen, Femara, or one of their ugly step-sisters. These drugs eliminate whatever poor, lonely molecule of estrogen that might remain in your body, trying desperately to hang on. The side effects of these drugs can include: joint pain (post-menopausal arthritis), mood swings, weight gain, cognitive impairment, depression, uterine cancer, osteoporosis, heart problems, etc. If you complain to your doctor, you’re likely to get a pat on the shoulder and a prescription for pain meds and anti-depressants.

I understand the thinking in the medical community that IF estrogen drives breast cancer, the best course of treatment is to eliminate the offending substance, thereby creating a “cure”. What puzzles me is that there are a few chinks in this hypothesis. First, the times in a woman’s life where she has the highest level of hormones, i.e. pregnancy and in her late teens/early 20’s, also happen to be the times with the lowest incidence of breast cancer. You are much more likely to be diagnosed in your 60’s or 70’s, when estrogen levels have been low for some time.

Also, I see all around me women on these blogs who have towed the party line, done the chemo, radiation, and estrogen-blocking drugs, only to see the cancer recur in a more aggressive, or metastatic form. Sometimes it works, sometimes not, which would lead me to believe that cancer is a multi-factorial disease which can’t be watered down to a simple “kill the estrogen” approach.

I wrote about the work of Dr. Jonathan Wright, the doctor for Suzanne Somers, in this post. Dr. Wright is the pioneer of bioidentical hormones in this country, and he has had Suzanne on them since her breast cancer diagnosis over 10 years ago. He believes that estrogen (in it’s natural form and when properly balanced) does not cause breast cancer and may help prevent it.

He uses a formula made of a small fraction of estradiol (the aggressive estrogen), and a large fraction of estriol (a weaker protective estrogen). He believes that the estriol acts as a sort of Tamoxifen, attaching to beta receptors on the cell, which actually discourages cell growth and proliferation. He then balances the formula with progesterone and other hormones as needed.

I’ve read his book, and it makes a lot of sense. But, being me, I feel more comfortable consulting with someone who is knowledgeable and respected in his field, so I had an appointment this week with an integrative MD. Yes, I’ve been down this road before, but the previous guy I saw, while a lovely person, didn’t project the confidence that I need to see in such a serious matter. I don’t mean this to sound arrogant, but most of the time I leave a doctor’s office feeling like I know more than he does about nutrition, supplements, and the relevant research that’s out there. I want to be wowed.

I spent 3 hours at the new doctor’s office on Tuesday. Good start. For the first hour, I sat with the nurse as she took a detailed history and listened to my issues. She then gave the doc a synopsis while I had vitals taken. The next hour was spent with the doctor, going over his thoughts on my case and his recommendations. He told me right off the bat that he is not an oncologist and he wants me to be monitored by my own doctor. He also said that while he is an MD, he would be offering things that no mainstream doctor is willing to do, often at the risk of being attacked by the medical board.

I appreciated his honesty and his willingness to step “out of line” in spite of the repercussions. It was clear that he must have tangled with oncologists before, as he included in my packet a “Dear Medical Oncologist” letter that he had written in response to an angry doctor who challenged his use of hormones in a breast cancer patient.

He wasn’t the kind of warm and fuzzy that I prefer, and I actually put off going to him because I had heard that he is very arrogant. In truth, he is not so much arrogant as confident and efficient. He stared at me intently as he laid out his plans in a no-nonsense fashion. I scanned his eyes for signs of hesitation or self-doubt as he spoke. I saw none. I asked tough questions. He answered them, sometimes in a surprising way.

So what did the doctor suggest as the next move in this high-stakes chess game? Stay tuned tomorrow for the results of my visit and my decision.

Would You Rather Be Shot Or Jump Off A Cliff?

80’S CANCER JAM OF THE DAY:

Go ahead. Take a couple weeks before you give us your decision. It can wait until after the holidays. Now keep in mind that 2 out of 10 women actually survive being shot, while the whole cliff thing is really sketchy…not much good going on there. But…and this is a big but…being shot can lead to all sorts of complications, depending on where you choose to take the bullet. So you may just wish you were dead.

This is something like the conversation I had last week with my oncologist, slightly paraphrased of course. Yes, I’ve finished radiation and been issued my platinum invitation to board the Tamoxifen train. Toot! Toot! He actually turned to me at one point and said “Have you done any research about Tamoxifen?” I just looked at him with wide eyes and replied “Really?”. He quickly realized what a foolish question that was and chuckled softly. “Oh yes, what was I thinking? Go ahead, tell me what you found.”

Of course I had been feverishly burning up the internet for days trying to tease out minute details about survival and recurrence statistics from mountains of muddled data. And let me tell you, they make it next to impossible to find “the bottom line”, which in my book is the absolute survival advantage in those who take this drug. I don’t care about relative risk or any other statistical shenanigans that pass for science. I was finally able to get a 10-year absolute survival difference of 10.9%, meaning that of 100 women, 11 more will be alive in 10 years if they take Tamoxifen than if they don’t.

I told the oncologist about this, and he agreed, saying that the odds might be slightly better for someone my age with my cancer, perhaps 12-15% greater survival. I’m not sure where he gets those numbers, as I was unable to find them. However, I also told him that I had serious concerns about the potential side effects of the drug versus the benefit. Common side effects include: hot flashes and night sweats, mood swings, depression, joint aches, cognitive difficulties (such as forgetting words), weight gain and headaches. Rarer side effects include blood clots, stroke, and uterine cancer.

Now, I don’t know about you, but I am just not dying to get on this train. First of all, I am deeply mistrustful of drug studies. I’ve taken enough research courses to know that data can be manipulated to say just about anything. I also know that the FDA does not require these companies to submit data showing adverse outcomes or data which doesn’t support the benefit of the drug. You only have to look at the long list of drugs which have been approved and later pulled from the market due to serious, often fatal events, or lack of efficacy to realize that you can’t always count on the “peer-reviewed research”.

Those concerns aside, I am feeling healthy for the first time in a year. I ran 8 miles last week. My color is good, and my hair now looks like a cute, short style instead of a chemo-ravaged patchwork quilt. I don’t want to be sad and have achy joints. I don’t want to be fat and wringing wet every morning. It feels very unnatural to take a body that is on the mend and feed it a drug that wreaks such havoc. The doctor said we will deal with whatever side effects come up, meaning he can give me different pills to add to the first pill.

I think the photo below shows a much better idea of what can be done with Tamoxifen bottles and a little creativity. I have to give credit to “The Sarcastic Boob” at http://thesarcasticboob.com/2012/08/16/ten-things-to-do-with-tamoxifen/ for this hilarious post.

tamoxifen boobs

All kidding aside, I truly believe in the ability of the body to heal if given the chance. I’m not against medical intervention when necessary, but I don’t think it’s natural to have zero estrogen, which will be the effect of the Tamoxifen. I understand that my tumor was fed by estrogen, but I’m not sure if it was that simple. Cancer is a very complicated, multifactorial disease. My fear is that the cancer will outsmart all of these outside interventions and come back more ruthless than ever. I expressed this to the oncologist, and he had to agree that if we use Tamoxifen and the cancer metastasizes anyway, it will likely be very aggressive and difficult to treat.

So…here I am again, at the edge of the cliff with a 9 millimeter in one hand. I think I may just lay the gun down and back away slowly. You’ll be the first to know.

 

Estrogen Replacement To Prevent Breast Cancer Recurrence?

80’S CANCER JAM OF THE DAY:

 

For women with estrogen positive breast cancers, or any breast cancer for that matter, it’s a given that hormone replacement therapy is off the table forever. Or is it….? Surely if the cancer is driven by estrogen and/or progesterone, it would be a suicide mission to even contemplate this possibility. Yet I’ve often wondered if the link is really this simple.

I actually asked my oncologist about the link between hormones and breast cancer at our last visit. Intuitively, it makes sense to me that if cancers are hormonally driven, then the greatest incidence of cancers should appear at the time in a woman’s life when her estrogen and progesterone levels peak, namely pregnancy. Yet, it is extremely rare to hear of a pregnant woman diagnosed with breast cancer. Instead, the odds seem to increase as we age, with the great majority of women being diagnosed after menopause, when hormones should be in decline.

According to the latest  “Cancer Statistics Review” or “SEER” report put out by the National Cancer Institute, you have the following odds of being diagnosed with breast cancer per decade of life:

  • Age 30 . . . . . . 0.44 percent (or 1 in 227)
  • Age 40 . . . . . . 1.47 percent (or 1 in 68)
  • Age 50 . . . . . . 2.38 percent (or 1 in 42)
  • Age 60 . . . . . . 3.56 percent (or 1 in 28)
  • Age 70 . . . . . . 3.82 percent (or 1 in 26)

Although I love my new doctor, I didn’t feel like he adequately answered my question. He said something about a woman still being able to produce a little bit of estrogen via her adrenals and her fat cells (particularly if she is overweight) after menopause. True. But this amount would still pale in comparison to the amount produced by a woman in the height of her reproductive years. In light of the above statistics, it would almost make more sense that a lack of adequate hormones increases the risk of breast cancer.

DSCN1875As some of you know, I’ve been reading a really fascinating book by Suzanne Somers about alternative doctors who are curing cancer with mostly non-toxic methods. Some of them do use low-dose chemo, but the low doses are made possible by the combination with the natural treatments. Even if you choose not to step off the mainstream path, I highly recommend reading this just to increase your awareness of what’s out there.

 

DSCN1876One of the doctors interviewed for Somers’ book is Jonathan Wright, who is one of the pioneers of hormone replacement in the U.S. His interview captivated me so much that I just bought his book, which is pictured here. He talks about using Estriol, which is the estrogen most abundant in pregnancy, as a kind of “natural Tamoxifen”.

The role of Tamoxifen in breast cancer therapy is to act as an estrogen receptor blocker to prevent the more potent and agressive estradiol from taking this spot and potentially causing cell proliferation. Tamoxifen is the “goalie”, so to speak. This works well in breast tissue; the problem comes in other parts of the body, where Tamoxifen acts more like estrogen. We see this mainly in the uterine lining, where a dangerous proliferation of tissue can occur, leading to uterine cancer.

Dr. Wright describes three types of estrogen: Estradiol (E2), Estriol (E3), and Estrone (E1). E2 and E1 are the more agressive forms, while Estriol or E3 has been shown to be cancer-protective. According to Wright, Estriol will block the estogen receptors in our cells like Tamoxifen, without the other side effects that we see so often. But, it will also help ease quality of life issues caused by menopause, which is a subject currently only addressed with anti-depressants or blank stares.

In addition to reading these books, I have been doing random PubMed searches entering “hormone replacement therapy breast cancer” . Surprisingly, most of the studies that I looked at found no increase in breast cancer recurrence or mortality in women using hormones following a breast cancer diagnosis. Granted, many of the studies did not specify whether the women were estrogen receptor positive or not, but this is the most common diagnosis.

Why do we care about all this? I can tell you from a personal standpoint that Tamoxifen scares the hell out of me. I’m not even talking about the prospect of getting uterine cancer here. I have serious concerns about my mental health if my hormones decline any further. Just the beating that they have taken during chemotherapy has reduced my quality of life. Estrogen stimulates serotonin receptors in the brain, and serotonin is responsible for feelings of happiness and self-esteem. I like those feelings.

This is a very controversial debate, but one that is deserving of attention. It’s just a shame that women who don’t fall obediently into the “medical model” have to search so hard to find alternatives. And it’s unethical that there is no funding to do the kinds of studies that would truly ease our minds about taking a different path. It’s not easy being a rebel!

Breast Cancer Is All In My Head

80’S CANCER JAM OF THE DAY:

As I did my 2 mile walk-run last Sunday at the park, I felt the breeze on my face and watched the river flow by next to the trail. It felt good to be there again. I tried to remember back to last summer when my world was intact and everything chimed along without the constant interruption of doctor’s visits, tests, and statistics. What a different time that was. I was training for my half marathon, and I had almost gotten to the point where I could do 10 miles with just a few minutes rest. It seems like a million miles away….before my body betrayed me.

looking at my phone

I’m not going to lie to you. I’m a positive person, and I love to laugh and make fun of myself, but this crap is starting to wear me down. It’s getting in my head. This odyssey began in March like an atomic bomb, and then it was off to the races. CT scans, bone scans, surgery, endless combinations of pharmaceuticals, blah, blah, blah…..

I know that a lot of my current mindset has to do with the medically induced menopause that may or may not be permanent. I’m now 3 months into chemo with one more month to go, and the drugs are slowly but surely killing my ovaries.  I have hot flashes at night that interrupt my sleep and dark thoughts that creep into my days, and I don’t like that.

Today I was looking at Naturopath programs online. This is an area that really fascinates me, and I think it would be very fulfilling to help people heal with natural methods and nutrition. I was excited for about 10 minutes when I caught myself thinking “I don’t know if I have time for that. It’s a 4 year program.”  Low estrogen does not create a happy place for me. I knew this before I was ever aware of “the cancer”. That’s why I was taking bioidentical hormones. They just made life better all around. It seems cruel that just when I found a good balance, it was pulled out from under me with no alternative.

Aside from the hormonal roller coaster, cancer just plain messes with your head. I don’t think I ever realized how powerful knowledge is. The knowledge that you have a potential death sentence hanging over your head. Last summer, I was blissfully ignorant. I had this time bomb ticking inside of me, but I went about my business, and I ran, and I feared nothing. I remember thinking that they must have the wrong chart when they told me I had breast cancer. I felt so alive and healthy. I wondered on the way home today if I would still be going full steam without the limits my mind has imposed.

They say that my 10 year survival rate is 82%, which is much higher than the statistics I saw on the internet when I was first diagnosed with Stage 3 breast cancer. I should be happy with the news, yet I still question all the time whether I’m doing the right thing in following the “standard of care”. It just never quite made sense to me that I could heal my body by destroying my immune system with poison and radiation. This is a daily struggle in my mind. Sure, I’m doing a lot of alternative things to minimize the damage, but can my body overcome it? It’s a gamble at best and a very difficult road to travel.

I guess the bottom line is that I’m tired. I’m just tired. And there’s a lot more of this journey left to endure. In less than a month, I’ll face a whole new set of decisions surrounding radiation therapy and Tamoxifen. Some women do fine with both. Some suffer miserable, long-term side effects. I’ll face this with the same rebellious determination that I’ve relied on to this point. The doctors are going to have to prove to me why I should inflict more trauma on my body and my psyche. 82%. Those are my odds with just surgery and chemotherapy; I think it will be hard to improve much on that.

Tomorrow, I’ll be back in the cancer saddle, making a morbidly twisted joke. But sometimes even a funny girl has to let her guard down.