Tag Archive | tamoxifen

No small thing

As I continue in this cancer treatment I am amazed at all that is involved with it in order to give me the best possible chance of no recurrence.  I am also in awe of how specific treatments are for the type of cancer you have, the stage it was diagnosed in, what the cancer tests positive for, etc.  My latest addition is taking an aromatase inhibitor drug.

What a strange word, “AROMATASE.”  The word sounds like “tasting a smell” to me.  Aromatase is actually an enzyme that turns the hormone androgen into small amounts of estrogen.  Certain cancers require estrogen in order to grow.  In treating these types of cancer, it is important to lower the amount of estrogen in order to starve any possible remaining cancer cells of estrogen so that they will die.  To do this, “aromatase inhibitors” are prescribed in postmenopausal women like myself whose cancer tested  ER+ or estrogen receptive positive.   There are three AI’s (aromatase inhibitors) approved to treat breast cancer; Aromasin (exemestane), Arimidex (anastrozole) and Femara (letrozole).  The AI’s block the enzyme aromatase so less estrogen is present to stimulate further growth of hormone receptor positive breast cancer cells.

You may have heard of tamoxifen. Premenopausal women’s ovaries are still producing estrogen and aromatase inhibitors will not stop that so they are usually given tamoxifen instead.  Aromatase inhibitors have more benefits and fewer serious known side effects than tamoxifen but they are also not without risks.  The most common side effect is joint pain or joint stiffness.  One week after finishing radiation my oncologist started me on the AI Femara.  Within two days I woke up feeling stiff all over.  I can only describe it as feeling achy like the flu is coming on.  Every joint in my body from my fingers, wrists, elbow, shoulders, neck, knees, etc. ached.  This experience has made me more empathetic to those of you that suffer from arthritis.  I was scheduled to see my doctor and receive my herceptin treatment in only a few days so I hung in there and continued the Femara for three more days hoping my symptoms would improve.

My symptoms did not improve but only worsened.  I walked into my doctor’s office.  One look at me and she said, “What’s the matter? Are you alright?  You looked better than this when you were going through chemo!”  I was on the verge of tears.  I felt physically horrible.  It probably didn’t help that we had just gone through a hurricane the week before (Sandy), losing power for 4 days and nights, were dealing with gas rationing and now commuting to work, and at the moment I was looking out the window at several inches of snow that was falling in the middle of a Nor’easter (Athena) knowing I still had at least another hour at the hospital until my infusion was done before I could attempt to go home! Wahhhh!

Needless to say, I stopped taking the Femora the next morning and could already feel a difference!  It felt so good to start feeling good again.  My doctor gave me a new prescription, this time for Arimidex which I will get filled in a week.  She is hopeful that this one will not affect me in the same way.  Since it’s something I will have to take for five years, yes that’s FIVE years, I am praying that it agrees with me.


It got me to thinking about how something so tiny could have such a big affect on my entire body!  For me, that tiny pill caused symptoms that left me miserable.  A different AI pill will hopefully do the big job of lowering the amount of  estrogen to feed any ER+ cancer cells.  There are many things that are small but can make a huge difference in our lives, for the good or the bad.  A few words of encouragement can make all the difference in someone’s day but so will a few unkind words or a certain facial expression leave an effect in a negative way.  “Worry weighs a person down; an encouraging word cheers a person up.” (Proverbs 12:25 NLT)

several mustard seeds

With hurricane Sandy last week there has been an outpouring of random acts of kindness.  Something so small as an invitation to hang out for a few hours in a house with power made all the difference in making it until things were normal again.  “For we are God’s handiwork, created in Christ Jesus to do good works, which God prepared in advance for us to do.” (Ephesians 2:10 NIV) The biggest thing I can think of is actually one of the smallest, a mustard seed. They are usually one or two millimeters in diameter.   Matthew 17:20 says “If you have faith as small as a mustard seed, you can say to this mountain, ‘Move from here to there,’ and it will move. Nothing will be impossible for you.”(NIV)   “The simple truth is that if you had a mere kernel of faith, a poppy seed, say, you would tell this mountain, ‘Move!’ and it would move. There is nothing you wouldn’t be able to tackle.” (Message) Again, my mustard seed faith has helped me through not only this cancer journey but life.

Enjoy Jason Castro’s “Only a Mountain” music video http://www.youtube.com/watch?v=UxWayfx3p2s

Don’t underestimate the power in small things:

“Be faithful in small things because it is in them that your strength lies.” – Mother Teresa

“They might not need me; but they might. I’ll let my head be just in sight; a smile as small as mine might be precisely their necessity.” – Emily Dickinson

“A small leak can sink a great ship.” – Benjamin Franklin