9/28/2020 Follow Up

Monday I saw the oncologist for a follow up. He asked what side effects I am experiencing from the Tamoxifen: hot flashes, night sweats, trouble with regulating my heat, and waking up in the night. I am fortunate that my symptoms are not extreme.

Being a high school math teacher in the COVID era is something else. I won’t get into the details other than to say I’m working about 15 hours each weekend. I have more students than I’ve ever had, a new curriculum and many new technology tools that I’m learning.

It is hard to determine if I’m having a hard time sleeping due to the medication or the stress associated with work. Hopefully I’ll be able to find some efficient processes to make the work manageable. I’ve never been this overwhelmed in September. The doctor did say that by now the side effects of Tamoxifen won’t get worse.

Dr. Byrd and I talked about the benefits of taking Tamoxifen versus another aromatase inhibitor, Letrozole or Anastrozole. We also talked about the benefits of taking Tamoxifen for five versus ten years.

Aromatase inhibitors lower estrogen levels in the body by blocking aromatase, an enzyme that converts other hormones into estrogen. This slows or stops the growth of the tumor by preventing the cancer cells from getting the hormones they need to grow. Aromatase inhibitors include: Anastrozole (Arimidex)

Dr. Byrd told me that I need to be my own watchdog and advocate. I need to keep track of my health and pay attention when things don’t resolve like they should. For example if I get a cough that doesn’t go away or if I have other symptoms that aren’t otherwise explained I should call him to get them checked out. He also told me to do regular exams of my chest, into my armpits, to check for new lumps and bumps.

He wants to see me in six months or sooner if I’m having unusual symptoms.

Also, I’ve been seeing a physical therapist for the past month to improve my arm mobility. I’ve been practicing reaching overhead and doing stretches and exercises to improve my back, shoulder and arm strength. There is still some tightness but I’ve seen so much improvement over the past month that he released me and told me I am clear to do anything I can do without pain. I’m excited to report that I’m ready to start a workout program at home in the garage gym that Chad built during the shutdown.

I also wanted to tell you about this website that Dr. Byrd shared with me: https://breast.predict.nhs.uk/

Predict is a tool that helps show how breast cancer treatments after surgery might improve survival rates. Once details about the patient and their cancer have been entered, the tool will show how different treatments would be expected to improve survival rates up to 15 years after diagnosis. This is based on data from similar women in the past. It is important to note that these treatments have side effects which should also be considered when deciding on a treatment.

When I enter the information associated with my cancer diagnosis, Predict gives me an overall survival rate after 5 years of 96%, 10 years of 90%, and 15 years of 84%.

Predict also tells you the chance of death associated with causes other than breast cancer. When I take that into account the Predict tool tells me there’s a 3% chance I will die in the next 5 years from this cancer, 7% chance over 10 years and 10% chance over 15 years.

This is all encouraging to me. I feel healthy again and capable of great things.