Though my oncologist was not thrilled with me quitting
tamoxifen, she did give me her blessing. “Take a break and see how you feel.
Just promise me that you’ll consider starting up again.”
I stopped taking the pills and within a few weeks noticed an
improvement in my energy level. My hot flashes were less frequent, weight management
a bit easier. Running, my favorite leisure activity, stopped feeling like a chore.
I couldn’t quite ratchet my pace back up to pre-cancer levels, but I could
finally hold my own with my running buddies again.
I harbored a small hope that stopping the medicine would put
me back into my previous ovaries-still-in-action hormonal state of being.
Sadly, aside from one scant period right after I abandoned the drug, my body
stayed stubbornly stuck in menopause.
My symptoms weren’t nearly as bad as they’d been on
tamoxifen, but they were still there, mocking me. I started to have doubts
about my decision. The drumbeat of, “What if?” reverberated in my mind.
I thought about the future—a lot—and wondered how long I’d
have one. Yes, the side effects of tamoxifen were awful, but the thought of
another bout of cancer was worse.
I kept remembering how my oncologist had described hormone
therapy as the third prong in the fork of treatment—every bit as important as
chemo and radiation in keeping me cancer-free—and worried that I was hurting my
chances of survival by leaving it.
The ghost of decisions past began to haunt my dreams. Seven
years earlier, right after my mastectomy, my surgeon had badgered me to take
tamoxifen and I’d refused. At that point, the oncologist had sided with me,
agreeing that, as a thirty-five-year-old mom who hoped to have another baby, I
qualified for a free pass to avoid it.
Obviously, I’d ridden that fateful choice right into a
recurrence. And while I knew that I’d made the best decision I could have made with
the information available to me at that moment in time, I also knew that if my
cancer returned again, I would want to punch myself in the face if I hadn’t
done everything in my power to prevent it.
So I purchased a pill-cutter and split the remainder of the
tamoxifen tablets—I’d held onto them just in case— in two. Every day, I gulped
down a half-pill, meticulously monitoring for negative effects, which were
quick to return. I wouldn’t call them mild, but they somehow felt a bit more
manageable.
Much to my doctor's delight, I’ve remained on this reduced dose for
nearly two years, almost as long as I swallowed the recommended full dose. I’ve learned to
live with the side effects which, as before, have doubled in size and weight in their cumulative consequence.
I’ve learned to watch the scale closely and cut back on
carbs when I notice my weight creeping up. Much as it pains me to renounce my
rank as a runner, I have officially become a run-walker, going the distance at
a modified pace and intensity that allow me to continue to soldier on.
There’s not much I can do about the hot flashes, save for
accepting their hourly visits as part of my new normal. I often carry a towel to
sop up the sweat, but I still haven’t found anything that can ease my
embarrassment.
When well-meaning women—who have never undergone cancer treatment—tell
me that my aches and pains and hot flashes are normal for mid-life, I refrain
from retorting that tamoxifen is so effective at ferreting out estrogen that it
gave my grandmother hot flashes at the age of eighty, well past the prime of her menopausal
mid-life.
I don’t point out that it was not by choice that I was thrust into
the body of a sixty-year-old at the age of forty-two, or that tamoxifen is
something that I tolerate as a necessary evil. I’ve grudgingly come to accept pain
and perspiration as the short-term price I pay for long-term survival.
At my last office visit, my oncologist respectfully
requested that I extend my time on tamoxifen by a few years to make up for reduced
dosage. I promised to complete the full course of treatment.
Tamoxifen had better make it worth my while.