Thursday, June 7, 2012


You are lucky that you just got the cancer with the 70% survival rate; you could have gotten the one with just the 10% survival rate.

What an awful thing to say to someone who has cancer? The only thing that would be worse is speculating out loud why you have the first cancer in the first place. If no medical reason could be figured out, well maybe a karma reason. People get what they deserve, right?

No one has really said this to me per se. People have recounted all those they knew who had breast cancer and survived with the message You should too! And I was told repeatedly, Don't worry! Easy for them to say, they aren't facing a 30% chance of death in the the next 5 years.
But I have survived though the five years aren't up. Most of the bad stuff happens earlier so I am thinking my chances are fairly good. Cancer isn't my biggest worry.

 I am lucky.

Early on my blog was sort of like an on line pity party. I was very upset with having to deal with BC especially TNBC. I remember writing that those who are estrogen positive are lucky because their survival rates are so much higher and their treatment wasn't initially so horrible. I think I erased this once someone with estrogen positive BC reminded me that was a very poor choice of words. And I probably have more readers who have had ER+ than ER-. No one with cancer feels especially lucky even if it could be worse.

One thing I fortunately do not have to deal with is blocking the little bit of estrogen my body still produces. Not only are these estrogen blockers very expensive, they are chock full of nasty side effects. Post-menopausal women are told that they should take aromatase inhibitors, which prevent estrogen from being formed but for some reason cause crippling joint pain. Tamoxifen causes less joint pain but its side effects are more insidious. It acts as an estrogen antagonist in breast tissue but as an agonist in uterine tissue. It is not clear if it actually can cause uterine cancer but it does encourage it to grow faster if it is there. It can also cause blood clots leading to strokes. So women are left doing their own cost benefit analysis. Their physicians can give them the chances that their cancer will come back minus the drug  and the chances that the side effects will be deadly. Most of the time, the drug presumably has more benefits than risks but the pain and other uncomfortable side effects usually aren't part of the equation.

One of my readers was told she should take Tamoxifen. As her biopsy samples were not preserved due to some horrible error, she could not be accurately staged and so the benefit of the Tamoxifen could not be accurately calculated. Now she has uterine growths suspicious for cancer. She didn't sign up for that.

New research is emerging that 88% of  ER+ breast cancers are also fed by androgens. Blocking the androgens gives the same survival as blocking the estrogens with hopefully less side effects (and a positive side effect, no extra hairs). 25% of TNBC is sensitive to androgens so for those 'lucky' women, antiandrogens could help survival. Do they test routinely for androgen sensitivity? Not yet but maybe they should.

Another friend was not told that the high dose steroids she was told to take could lead to osteonecrosis. Although both hips have damage, one hurts so badly, she can barely move. They both now need replacing.

Yesterday was spent with grandchildren: Maya in the morning and Shanna's kids in the afternoon. I was able to get down to the Farmer's Market very early to buy supplies for my container gardens. Alas no giant phlox!!! So my patio is gradually shaping up with my 3 new containers. The excess plants flank the ground around the patio. I also bought a e angel wing begonia with its huge feathery red flowers. It doesn't like sun and mostly what I have is sun. I am hoping it will survive.
Today I biked and ran. In the next few days, it will be too hot to run far.

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