After my diagnosis last year with breast cancer, I was stunned to discover that my particular type of breast cancer was Estrogen Receptor-Positive. This meant that, even though I had my ovaries removed 22 years ago when diagnosed with ovarian cancer, my body had managed to create more estrogen which was then feeding breast cancer cells and –voila! – It produced a tumor.
Once I was over the shock of having a second primary cancer, I wondered how my body could still produce estrogen. No ovaries, no estrogen, right? Wrong. Apparently, that brilliant human machine, our body, creates an enzyme called aromatase which is found in our muscles, skin, breasts and fat. This aromatase enzyme synthesizes estrogen from other hormones, literally converting them to estrogen.
So, after a lumpectomy and radiation, my oncologist prescribed an aromatase inhibitor named Femara, a pill that I take daily to suppress any future breast cancer cells from growing. Given the stage, grade, and biological profile of my tumor, this course of treatment is the current standard of care.
One little pill a day. What could be easier? And now for the rest of the story . . .
The major side effect that inhibits my daily routine is joint and bone pain and every person I know who’s on the drug is coping with these conditions. Long term use may increase joint disorders like arthritis and joint pain. I manage this by increasing my omega 3 fatty acids, eating an anti-inflammatory diet, and taking a non-steroidal anti-inflammatory drug (Celebrex).
Another side effect is osteoporosis, especially spine, hip and wrist fractures. I try to reduce my risk for falls, not taking the stairs and declining my husband’s motorcycle ride invitations. I also take a quarterly injection of ibandronate sodium (Boniva) to help manage bone loss and I incorporate light weight training as pain permits.
A few other annoying problems include night sweats, headaches, dizziness, fatigue, and (rats!) weight gain. Oh, well . . .
Aromatase Inhibitors were developed specifically for Estrogen Receptor-positive breast cancer patients who are also post-menopausal. Fortunately, they do not increase risk for endometrial or uterine cancer, which can happen after taking Tamoxifen, a popular antihormonal therapy. And, they are relatively effective at stopping or controlling estrogen-based cancers.
So, when I start to hear myself complain about the side effects, I remind myself that we are lucky to have a drug that can nip cancer in the bud. I think of the many women who would gladly trade places with me because they’re out of treatment options. And I remember that this treatment is buying me time, time until something better comes along. And it will.