The MRI and Drug Decision

Had my MRI yesterday. An uneventful event. We just have to wait for the results and hope everything is clear. It will be nice to know that there is only this one area that needs attention. I’m not in the mood to have anyone find suspicious cells in another spot or in the other breast. Right?

Dave and I met with the oncologist yesterday, Dr. Beverly Bowker. She’s very enthusiastic; she said that when she read the reports she looked forward to working on my case (because of the early stage and the apparent ease with which this should be handled and completed). I always knew I was easy.

Anyway, she walked us through the pathology report, and I’m glad she did. Dr. Nath did the same thing a week ago, but I think the information was too new and fresh, and still a little scary at that point. We’ve had a week to think and research, and it’s easier now to translate the information and process it.

Dr. Bowker’s role is to determine what drug/s I will take following radiation and to monitor that portion of treatment. I will be on drugs for five years and under her care for an additional five as precaution.

She is looking into two kinds of drugs:
• Estrogen blocker such as Tamoxifen
• Estrogen decreaser such as Arimidex (other brand names include Femara and Aromasin)

Because of my age (53, “You’re young!” she says), she is leaning toward Arimidex. Apparently I’m cranking out estrogen and she wants to slow that significantly. But because I also have a history of pre-melanomas, she says she can’t rule out the Tamoxifen.

Both kinds of drug will prevent recurrence and prevent new breast cancers. Both encourage hot flashes (yea!), blood clots in smokers and older patients (remember, she says I’m young). Tamoxifen can lead to cataracts but decreases cholesterol and prevents osteoporosis. It also leads to liver cancer in rats (but so do bacon and Coke). Arimidex increases cholesterol and the risk of osteoporosis (a recent bone density test shows I have no such worries at the moment).

One hand gives, the other takes away. Decisions, decisions.

There is a third drug she is looking into for me, Tykerb. That’s appropriate because the pathology showed my HER-2-NEW level amplified at +3 as well as a pathology level of III, which is more aggressive. (I’m not 100% clear on this; I’m reading right off her notes and a copy of the pathology report—my healthcare savvy friends will understand.).) She didn’t necessarily seem concerned about this, but made the point of making the point, and based on the rest of the consultation, I interpreted this as something she needs to give careful consideration.

As I am with Dr. Nath, I’m comfortable with her and with the plan as it stands at the moment.

Yes, I have the pathology report. I know I’m entitled to have it, but I wonder how many people ask for theirs. Working in healthcare publishing has given me a little insight into my rights as a patient, as well as sympathy for healthcare workers and facilities that I’d never have otherwise.

So that’s what’s new to this point. It’s July 4, Independence Day. My oncologist refers to me as someone who “had” breast cancer. At the moment, that’s my favorite kind of independence.