The gift that keeps on giving

Yesterday, Ken and I went back to the oncologist's office at the bi-weekly chemo appointment time - 8:30 am.  But for the first time in 20 weeks it was for a follow-up visit, not a treatment, and it actually felt very different.  They still weighed me (damn them!) and poked my finger, and then we got down to brass tacks planning the next five years of my life.

I start Tamoxifen now, and will take it for five years.  It's classified less-than-scientifically as an ESD - that is, an Estrogen Sucking Drug.  As that label implies Tami suppress my estrogen in an effort to reduce "feeding" my estrogen-receptive cancer with, well, estrogen.  Technically Tami is considered "treatment," but I don't see it the same as the chemo and radiation I have done, although there are considerable side effects with this drug, too, including cervical and uterine cancer, and ovarian cysts.  So much fun...

I learned yesterday, too, that I now have osteopenia - a decrease in my bone density.  I did not have osteopenia prior to starting chemo.   It is caused by - drum roll, please - a loss of estrogen.  Interestingly enough, runners are also often affected by osteopenia.  It doesn't appear that I can reverse this - but I can work towards preventing it from going to the next step - osteoporosis. 

I asked my wonderful nurse-practitioner about follow-up testing like PET scans and tumor marker blood tests, and she said matter-of-frankly, "There aren't any tests that will predict if your cancer will come back.  Tumor marker tests are only one piece of the pie."  In the end, the reality is that if I notice something "different" or I feel significant pain for longer than a couple of days, I contact their office and we go from there.  There's no way to know if the cancer will come back - until it actually has.  And this is okay, really.  Because I can spend my time worrying about a recurrence, but that doesn't change anything.  In the end, it is what it is - and I don't want to waste my time worrying about something I cannot control.

My clinical trial coordinator shared with me two wonderful gifts before we parted:  a delicate crystal bracelet with a pink ribbon charm, and a book about Life After Treatment.  There is a chapter that provides numerous statistics indicating that recurrence - both local and metastatic - tend to occur in the early years (typically three) after the end of treatment.  However, recurrences can happen 20+ years later.  In this way, breast cancer is different than most other cancers, whereby at a certain point survivors are considered "cured."  This is yet another reason why we hear the rallying cry for "The Cure" so frequently - we are rarely ever "cured" but rather "dancing with NED" (No Evidence of Disease).  As the author points out:

"This is why, when it comes to breast cancer, there are no absolute guarantees of cure after treatment.  It simply isn't possible to reduce risk of recurrence to zero - to say positively that you are cured as of this moment and there is no change you will ever have to worry about breast cancer again.  There is no magical five-year or ten-year point in time when breast cancer can be described as cured.  For women who are living with NED there is only a steadily declining risk."

So I hope to be dancing my own Happy Dance with Ned here pretty soon.  In the meantime, BC continues to be the gift that keeps on giving.  Life will never be what it was - but it will be - it is - very, very good.  I'm so grateful for each and every day.