Today was my 2 month followup with my oncologist, Dr. Stinnett. We first went over all the of side effects that I had from chemo and the only one that I have left is the hot flashes which will not be going away anytime soon. He was glad to hear that everything else has subsided because sometimes they do not.
Then we went over my list of questions and he answered each and everyone of them. A few of my questions were, can I take vitamins like Biotin to help grow my hair, how often do I need to see my surgeon, how do I know if I am in permanent menopause, when can I get my chemo port out, how often are scans etc. So yes, I can start taking vitamins again. It is up to me how often I want to see my surgeon but he will be taking care of me as far as cancer goes. I am free to get my chemo port out anytime, it was only put in for the AC chemo and I won't be needing it anymore. He said he doesn't like to do scans unless you are having a symptom, they give the patients too much anxiety and he would rather wait for a reason to do them, like if you are having a symptom that won't go away. He said they have done studies where they had two groups of women, one that did regular scans and ones that had a symptom and then did the appropriate scan. Both groups of women lived the same amount of time. Stage 4 breast cancer is fatal so it doesn't matter if you find it 3 months earlier from a scan or wait for symptoms to appear. Either way they will try and prolong your life with maintenance chemo etc. I was glad to hear that because I would rather have my money to live and to make memories rather than paying for unnecessary scans that would honestly cause me a lot of anxiety. Instead he said he will check my blood counts every 3 months and talk to me about any new symptoms I might have. The blood counts will be checked primarily because of the kind of chemo I had, it can cause Leukemia. He also said sometimes the blood counts can give him a hint that something might be going on if there are changes to the counts. At that time he might order a scan based off the blood work results.
The we discussed my next 10 years of hormone therapy treatment. So I have two options. Option 1: Tamoxifen hormone blocker. This drug can cause uterine cancer as well as hot flashes. However option 2 has a 4% better chance that the cancer will not return but it involves a lot more side effects. Option 2 involves suppressing my ovaries with a Lupron shot every 3 months or ovary removal as well as taking an aromstase inhibitor which is another hormone blocker but this one has more side effects than Tamoxifen. Of course the hot flashes are one of them as well as bone loss and joint pain. For now I decided on Tamoxifen and should my menstrual cycle come back I can always try option 2 with the Lupron shots and aromatase inhibitors just to get the added protection. If the hormone blockers are too hard on me then I can always switch back to Tamoxifen. Honestly I want the best quality of life possible even if it shortens my life. It is hard to make a decision like this because I have completed chemo and radiation, now I need to be sure to keep the cancer away. I didn't do all of that just to have the cancer return. I am sound in my decision thus far. I will start the Tamoxifen hormone blockers around June 15th. He said he wants me to heal from my radiation wounds first. I will continue to take Effexor for now. I really don't know if it is helping my hot flashes or not but I am not getting as much as I used to. I am still getting about 15-20 hot flashes in a 24 hour period. He doesn't want to switch the Effexor to something else right now because he wants me to take Tamoxifen with it and see how I do. Later on we can try something else once my body gets used to Tamoxifen.
I am very happy about the way this appointment went. I was honestly dreading the scans and the worry that would be involved. I know my body more now than ever before and right now I know how good I feel with the exception of the localized pain I am feeling from the burns from radiation. My skin is literally falling off under my armpit. It is very painful right now. So I will know if something is not right and that is when I would discuss this with Dr. Stinnett and then he would order the appropriate tests. I love my oncologist so much. I love that he is so in tune with studies and not ordering any unnecessary tests. I love that I might be able to take a vacation each and every year with the money that I would have spent on testing. I am excited to get my life back and make lots of memories.
I called Dr. Grunander's office when we got to the car. I made an appointment next week for a followup and the nurse said I could get my port out on Monday, June 1st. I could tell they were not happy with me because they feel a person should leave it in for two years just in case. Dr. Stinnett assured me that if the cancer comes back they can use my veins in my arm for chemo. Nothing is as strong as AC and won't cause any damage. In fact I met a lot of people who get it in their arms. I am not going to worry about that. I just want the dang thing out. It is a mental thing with me. I never liked when they had to poke it for chemo and anytime they needed to check my blood I had them draw it from my arm anyway. I was going to wait until later this year but I want to be done with EVERYTHING so I figured I am in pain from radiation right now, I might as well add to it and then I can heal all at once instead of dreading another surgery all year long. I have to have it taken out in the hospital under anesthesia which is probably best because it does go up into my neck and then down towards my heart. I don't want to feel the tugging when they take it out. After that I can put this cancer journey behind me.
The last thing Dr. Stinnett said that made my day was that I have more hair on my head than most people have 8 weeks post chemo. Yay, I think my Nioxin products must be working. I think another two weeks I will have enough short hair to cover up any thin spots that I still have and then I can start sporting my new short hair!!!!
Next oncology appointment in 3 months!!! What will I do with my summer? Have fun and live life that is what I will do with my summer!
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