Phase 4 consisted of taking a drug called Tamoxifen for 5 years. This medication is the usual anti-estrogen therapy for hormone receptor-positive breast cancer in pre-menopausal women (it can also be the standard for post-menopausal women).
Tamoxifen or T-fen (as I like to call it) is a medication that can block the growth of breast cancer by interfering with the effects of estrogen in the breast tissue.
Some of the most common side effects of T-fen in pre-menopausal women are hot flashes and night sweats, vaginal discharge and dryness and irregular periods. Less common side effects include loss of sex drive, bone loss, cancer of the uterus and stroke.
I took a calcium supplement while on T-fen. I liked Solaray’s Calcium Citrate with Vitamin D-3 because it was gentle on my stomach. Lately, I’ve discovered Vitafusion’s Calcium with Vitamin D gummies – these are delicious.
I did very well on T-fen. During one of my check-ups, I asked my oncologist if the drug was really working since I was not experiencing any of the side effects that I was warned about. She explained that everyone is different and some people do better than others with certain medications.
I felt so lost while in this phase. After all the work and research I had to do in the first 3 phases, I had very little or nothing to do during this one.
I wanted to be in a good place emotionally. I did not feel fulfilled in many aspects of my life and this needed to change.
The first idea I had was to shift gears in my career. I wanted to get certified as a medical interpreter and work at one of the Boston area hospitals in order to help patients with little or no knowledge of English.
I was blessed for having done so well with my treatment so I wanted to give back and I thought this was a great way.
The second idea I had was to learn a sport in order to increase the amount of exercise I was already doing.
Several studies have shown that women who exercise have a 30 – 40% lower risk of breast cancer.
Women with high estrogen levels in their blood have increased the risk for breast cancer and since exercise lowers blood estrogen, it helps reduce a woman’s breast cancer risk.
The American Society of Clinical Oncology (ASCO) released an update to its clinical practice guideline for T-fen in 2014.
For women with the ER-positive disease, continuing T-fen to 10 years rather than stopping at 5 produces a further reduction in recurrence and mortality, particularly after year 10 (a late recurrence).
On my last check-up, my oncologist brought this up. I was not thrilled. I asked her what were the chances of getting hit by this disease twice – I had been cancer free for more than 8 years now!
She said to me that given my age and the fact that I was now a mommy, her recommendation was to take it to avoid a late recurrence. She stressed that I needed to take care of myself even more now that I had my son.
I was not convinced right away, so I told her I would think about it. That same evening I e-mailed her asking her to send the prescription over to my pharmacy.
What was there to think about? If this drug was going to considerably decrease my chances of getting breast cancer again then bring it on, T-fen.
When my doctor prescribed T-fen for 5 years the first time, I did it because I had to – it was the standard of care and what I had to do in order to graduate from treatment.
Right now I have a bigger reason to do it: My son.
I am on my second month of round 2 of T-fen and I have no complaints thus far.