Weighing the Pros and Cons of Secondary Treatment


02 May
02May

Armed with the results of the Oncotype DX recurrence score I skeptically approached the secondary treatment for my breast cancer. Since my cancer cells were estrogen-receptor-positive (ER+), the prevailing protocol recommended that I be placed on an estrogen blocking medication for up to 10-years.  In return for having low to no estrogen I was told that I will likely experience a 30% improvement in reducing the likelihood of cancer recurrence. 

But here's my issue: my DX recurrence score is 3%.  Meaning, I have a 3% risk of my breast cancer recurring in the next 9-years. So, do the math!  A 30% improvement on a 3% risk leaves me with 2.1% risk of my cancer recurring.  But in exchange for the 0.9% improvement in risk I will go without the health benefits of estrogen throughout my entire 6th decade.  And even though I've been through "the change" the residual levels of estrogen are important for bone health.  And given a family history of degenerative bone disease, I'm highly motivated to do what's necessary to avoid the debilitating impact of bone loss resulting in nerve pain and loss of mobility. 

I avoided seeing the medical oncologist for as long as I could - blaming them for not following up on the surgeon's referral (which they hadn't), "forgetting" to call my surgeon's office to request another referral, etc.  I was able to drag this out until the end of April.  For 90-days my apathy about secondary treatment dragged on until finally, my breast surgeon convinced me to give it a try. 

When I shared my logic she was somewhat surprised that I was even considering not taking the medication but said that she had other patients who felt the same way.  She also explained that the medication would reduce the risk of any other ER+ cancer that might develop in my body.  Her recommendation was to at least try it and if I didn't like the side effects I could always stop taking it.  

Stunned, I left her office realizing that much more needed to be done in secondary cancer treatment to minimize the impact of the current blunt instrument of a one-size fits most protocol.  For now, I'm taking Anastrozole (generic for Arimidex) (1mg) every evening before bed but am keenly (almost obsessively) monitoring side effects.   

The jury's still out on my secondary treatment! 



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