B(r)e(a)st Wishes Part 4

And so in my last blog, I wrote that I was diagnosed with DCIS (ductal carcinoma in situ). According to cancer.org, when you have DCIS, it means the cells that line the milk ducts of the breast have become cancer, but they have not spread into surrounding breast tissue. DCIS is considered non-invasive or pre-invasive breast cancer. If in stages, they call it Stage 0. But when you have a word like “carcinoma”, it doesn’t sound good right? 😔

The good thing, however, which I am grateful for are the words “clear surgical margins” in my results. A clear, negative, or clean margin means there are no cancer cells at the outer edge of tissue that was removed.

So further tests were requested, which were called ER, PR, HER 2 NEU. My specimen was brought to the Ospital ng Muntinlupa and I had to wait for 2 weeks. When the results came back (many thanks to Joie, MCM’s kind histopath medtech. This time, the name is real 😉), my surgeon asked me to come right away.

Hormone receptor studies such as ER, PR, and HER2 NEU are routinely done in breast carcinoma. You can actually Google what these tests do, but for the benefit of ordinary folks like us, my doctor just wanted to know (and the tests would tell us) what treatment would be right for me, so that the cancer cells would not aggressively grow and progress to Stage 1.

All three (ER, PR, HER2 NEU) tested positive. Dra. Kat told me that I will be placed under hormone replacement therapy (HRT). But I need to have an ultrasound for clearance first. She sent a TVS request. This is to ensure that my uterus (and everything down there, as a pre-menopausal woman) is clear before starting the HRT. 

Except for an endometriotic cyst in my right ovary, I was good to go. I asked Dr. Reyes, the OB-GYN-sonologist (from Westlake Medical Center, IKR I have been busy hospital-hopping) about it, and she said that it’s small and my surgeon will probably refer me to an OB-GYN. I guess she was too professional to tell me I can go to her for consultation. “Monitor lang,” she said. Just one look at it and she asked if I am having dysmenorrhea, and I said yes. So the cyst is the culprit for my painful periods.

So that was a Thursday. On Saturday, I saw Dra. Kat and she prescribed Tamoxifen, to be taken once a day, for 5 years. Yes, you heard it right, 5 years. I am trapped. Both doctors asked me if my periods were regular, and I confirmed. They told me the same thing: that I will miss my periods once I start on HRT. This apparently causes forced menopause to pre-menopausal women.

According to breastcancer.org, Tamoxifen is the oldest and most-prescribed selective estrogen receptor  modulator (SERM). It is given to those who are diagnosed with hormone-receptor-positive, early-stage breast cancer after surgery (or possibly chemotherapy and radiation) to reduce the risk of the cancer coming back (recurring), or to reduce breast cancer risk in women who haven't been diagnosed but are at higher-than-average risk for the disease.

Tamoxifen attaches to the hormone receptors in the cancer cell, blocking estrogen from attaching to the receptors. This slows or stops the growth of the tumor by preventing the cancer cells from getting the hormones they need to grow.

It can cause other serious side effects like blood clots, stroke, and endometrial cancer. I may feel the following, too: hot flushes, hair thinning, mood swings, nausea, fatigue, depression, headache, and so on. And oh my God, weight gain. I hate this. After more than a week of taking Nolvadex (Php32/pc), yes, I do notice how easily tired I become, how sometimes I don’t feel good, no appetite, masama pakiramdam. 😩

Dra. Kat reminded me to have regular blood tests to monitor my cholesterol levels, 2D echo, aside from ECG. And I also have to have my annual mammogram and breast ultrasound every 6 months. Sounds a lot, right? (On top of my annual visit to my endocrinologist.)

And I have to visit my OB-GYN. Which I did the following Saturday. Oh yes, another hospital, this time, Family Care Hospital (where I gave birth to my two damulags). Dra. Antonil gave me the clearance, and at the same time, telling me we won’t be doing anything (yet) to the cyst. But I have to see her for my annual pap smear. I have to take Calcium, too. In this same consultation that she was amazed at how cheerful I was, nakakapagjoke pa. Because she knew people who experienced the same and got depressed.

Although both she and Dra. Kat confirmed that I can still take my usual vitamins (C and E), I’ve read in recent studies that somehow, these two reduce the effectiveness of Tamoxifen. I have been so dependent on these vitamins for a long time, of course with Vit C to help us strengthen our body’s natural defenses, and Vit E for my skin. Kaya po ako maganda sa picture 😆 I think I will consult them again regarding this. And also pineapple juice. Eh di ba nga, for the heart. Ano ba talaga, kuya. Oh, lordy. So many bawals. Including beer huhuhu 😓

So there...this is Part 4 of my journey. And thank you for giving me the opportunity to share it with you. Again, it’s not yet over and I’ve just started a new chapter in my life. Thank you, Lord for looking over me and sending angels my way. I am thankful to my family and loved ones for the support; to my friends and prayer warriors; and those who shared with me their own stories. Salamat po sa inyo. Let us stay strong and prayerful. And never lose hope. Take care, everyone. God bless us all.

#talesofthegoodgirl