Checkup

I had my blood test done on 3 July, Friday, so that I could collect my results today when I went for my checkup.

Unfortunately, I had my blood samples taken by a male staff, one whom I have never seen before. There were always comments that my veins are too fine that it is very difficult to draw blood from them. But the regular staff here are experts, as they have been sitting there everyday drawing blood from one patient after another, and no matter what they always managed to take my blood samples without problems. There were others who had to poke more than once before blood could be drawn. So, when I saw the new face, I instinctly expected him to have problems taking my blood sample.

True enough, he made the same comment about my veins on my arm, and went for a vein on the back of my hand. Well, my blood wasn't co-operative that day and refused to flow smoothly, and it took him a long time before he managed to collect the first sample. When he was done with the second sample, he told me to wait in case the first sample was unsuitable. Later, I was called to have another sample taken because the first sample 'had clotted and unsuitable for analysis'.

Cancer marker - CA 153 : 13.1 (up from 12.9 on 13 Mar 2009. Looks like it's been on an uptrend since Jan 2009.)

6 July 2009, Monday - checkup.

My regular medical onco had left NCC and I had a new one, Dr TCK. First impression - young, nice guy, friendly. Either he is a really nice onco, or he has not seasoned himself up to adopt the 'stone-faced look' in order to face questioning patients.

He asked the usual questions - any discomfort, breathlessness, pain and got all negative answers. He noticed that I am not on any conventional medication and asked if I am taking something else. I said, 'yes - ayurvedic', - thanks to the H1N1 that I was masked and had to repeat my answer a few times before he figured out what I was saying.

After the physical checkup, he asked if I wanted to start on the hormonal therapy now. I'd forgotten that my previous onco had included hormonal therapy for me. I wanted to consider first. I asked what the ht was for and he said to block the cancer from coming back.

He said, 'the cancer WILL come back, it's just a matter of time'. So, does that mean if I take the ht, it's going to buy me some more time? I had lots of questions and doubts and left NCC without paying my fees and collecting my appointment card, that I had to turn back.

I googled 'hormonal therapy' and found the following :

Hormonal therapy medicines treat hormone-receptor-positive breast cancers in two ways:

• by lowering the amount of the hormone estrogen in the body
• by blocking the action of estrogen in the body

Most of the estrogen in women's bodies is made by the ovaries. Estrogen makes hormone-receptor-positive breast cancers grow. So reducing the amount of estrogen or blocking its action can help shrink hormone-receptor-positive breast cancers and reduce the risk of hormone-receptor-positive breast cancers coming back (recurring).

Hormonal therapy medicines are NOT effective against hormone-receptor-negative breast cancers.

There are several types of hormonal therapy medicines, including aromatase inhibitors, selective estrogen receptor modulators, and estrogen receptor downregulators.

In some cases, the ovaries and fallopian tubes may be surgically removed to treat hormone-receptor-positive breast cancer or as a preventive measure for women at very high risk of breast cancer. The ovaries also may be shut down temporarily using medication.

There are three different types of hormonal therapy medicines:

• aromatase inhibitors:
  • Arimidex (chemical name: anastrozole)
  • Aromasin (chemical name: exemestane)
  • Femara (chemical name: letrozole)
• SERMs (Selective Estrogen Receptor Modulators):
  • tamoxifen
  • Evista (chemical name: raloxifene)
  • Fareston (chemical name: toremifene)
• ERDs (Estrogen Receptor Downregulators):
  • Faslodex (chemical name: fulvestrant)

I am ER, PR and HER2 positive, so I am a good candidate for ht. Tamoxifen is a ht. After chemo, I had collected two prescriptions of tamoxifen, but had only taken it for one week and had donated the rest of it to the hospice care.

Tamoxifen, when taken over a long period, has the possibility of causing cervical cancer in time to come. Furthermore, I had found out that SH, another breast cancer patient, was still on tamoxifen when she had a relapse and the cancer had spread to her bones. She had then gone for another round of chemo.

If this is what ht is all about, with all its side-effects, then my answer is going to be 'no'. I am taking my chance with the AM and I will be consulting him this Friday.

Furthermore, Doc had said that my blood test results showed that I am already menopausal, so I really don't think I need it.