The great hormone debate

As I sit here typing, my little moon rocks bigger than they were when I woke up (now with more saline!), I've put to bed yet another damned if you do, damned if you don't decision.

I saw my onc on Wednesday and she was all glowy (as glowy as she can be) about my progress and the state of my boobzillas and even complimentary about my resilient ovaries, chugging away so soon after the end of chemo. She wrote me up a prescription for Tamoxifen, an estrogen-blocking drug, and told me that a study on the use of Tamoxifen vs. the use of Tamoxifen + an aromatase inhibitor (which induces menopause in pre-menopausal women) has just been completed, the results likely to become public in a year or two. The aromatase inhibitor would block all estrogen floating around in my bod and end the production of the eggmeisters. It can lead to early osteoporosis, so fun with fake hips at 45. No thanks.

Then I was on my way, tripping happily over to the cancer clinic pharmacy to stock up on Tamoxifen when Dr. A. came rushing over to tell me that on my little side effects handout there was a mention that Tamoxifen can cause endometrial cancer. Well, there's nothing that a cancer cowgirl likes hearing more than "this could give you more cancer". Then it tweaked. My mom took tamoxifen and was diagnosed with endometrial cancer two years later. It was swiftly removed, but still. I told her this and gave her gigantic pause. Which gave me gigantic pause. Which gave the pharmacist gigantic pause, so my Tamoxifen prescription was shelved.

"Go home and think on this," Dr. A. said. "I can apply to give you the aromatase inhibitor shot, and I'd get approved, no problem, but you'll go into menopause and then there's the risk of osteoporosis... And just because your mother had endo cancer, doesn't mean you're likely to get it."

So I went home. Usually cancer vs. osteo would be a no brainer, but I did some research, talked to a few peeps and had a sleepless night. Why can't someone just tell me what to do?

I talked to Dr. A. again yesterday and asked her to put me on Tamoxifen for one year to start (it's generally a five-year run). From everything I'd read, it's the prolonged use that gets a woman's bits in trouble, so I asked for a biopsy after a year to make sure all is well. She agreed with me and said she also did a bit more research and couldn't find a single case in her files where a premenopausal woman got endometrial cancer from tamoxifen.

"After everything your body has been through the past year, to put you into early menopause and increase your risk for early osteoporosis is too much to ask. The risk of endometrial is small enough to ignore for now."

So there. I feel as good as I can about my decision and I begin the wonder drug tomorrow. It's supposed to come with some narsty feelings the first few weeks, but chances are, I'll be downing it with a bottle of tequila by week four.