If a person is diagnosed with breast cancer, a doctor runs tests on the cancer cells to determine if they are:
1. Estrogen receptor positive;
2. Progesterone receptor positive; and
3. HER2/neu positive.
What does that even mean?
Well, for the first two, do estrogen and progesterone (hormones that naturally occur in the body) cause the cancer cells to grow? Approximately 75% of breast cancer patients test positive for estrogen receptors, and 66% of patients for progesterone receptors. Hormone receptor positive cancer grows slower than cancer that isn't hormone receptor positive.
The latter category, HER2/neu, occurs when there's a gene mutation and the cancer tests positive for an excess of proteins on the cells. These proteins cause the cancer to be aggressive and fast growing. Only 20% of patients test positive for HER2/neu.
I had triple-positive breast cancer since I tested positive for the hormone and protein receptors. My aggressive strain of cancer was thankfully caught early, and I can benefit from the use of drugs that help prevent a recurrence and lower the amount of estrogen and progesterone in my body.
Once every three weeks for a year, I receive an IV of Herceptin to kill the protein receptors on my cancer cells and reduce the change of this returning. (Thanks to chemotherapy, radiation and Herceptin, my rate of a Stage 4 (metastatic) recurrence within 10 years went from a minimum of 60% to 15%!)
Compared to chemotherapy, receiving an IV of Herceptin is a breeze! The side effects are mild, and the IV takes only 30-40 minutes out of my day. Once I finish receiving Herceptin in late September, I should be done with visits to the Chemo Room!
If you meet someone who says that she has triple negative breast cancer, she has the most aggressive type of breast cancer. Aside from surgery, chemotherapy and radiation, there’s nothing yet available to help prevent the cancer from recurring. I hope and pray that research will advance in the very near future to change that.
For those of us who are hormone receptor positive, the most commonly prescribed oral medication to block estrogen in our system in the hopes of preventing a recurrence is tamoxifen.
I prefer to call the drug: The Evil Cancer Med.
Tamoxifen is taken once a day for five years. When I read about the potential side effects, I was concerned. I talked to my oncologist about the fact that tamoxifen causes a lot of the side effects (nausea, vomiting, dizziness, headaches and fevers) that I already have from my other health conditions. By early May, I was finally starting to feel more like myself, and I honestly didn’t want to be sick again.
My doctor assured me that the majority of patients tolerate tamoxifen well. Tamoxifen has been used for over 30 years, and it's as essential to preventing a recurrence as chemotherapy.
“Okay,” I thought to myself. “This is important.”
I said a prayer before I took the first dose. That evening, I started to feel nauseous and then vomited. Several hours later, I got a very bad migraine. I took my strong migraine medicine, but the pain and vomiting lasted through the morning.
I called the oncologist’s office, and they suggested that I switch to a half dose of the medication. As the week progressed, the side effects – even on a half of a dose – increased. I was still nauseous with a dull headache. I felt dizzy, I had trouble sleeping, and I would cry for no reason. It took me an entire afternoon to edit a few pages that I wrote. And, sapping my body of estrogen sent my sex drive from 100mph to 0mph. (Did I still have sex? Of course. But, I had a really hard time reaching orgasm.)
I’ve had hot flashes since early November when I started to have chemo-induced menopause. But, the tamoxifen quadrupled them.
This is City Girl.
This is City Girl having a hot flash.
Notice how my face matched the color of my hair and dress!
I wondered how my body would handle the full dose of tamoxifen – everyday for FIVE years! But, then, something happened that made my doctor stop my use of the drug immediately.
To be continued…