Now that radiation is done, the big question is: Now What? More treatment? Remission? Testing?
The “Now What?” question has three answers (which I will, of course, explain):
1. Hormone Therapy in the form of Tamoxifen
Tamoxifen is an antiestrogen (estrogen suppressor) medication that is a form of hormone therapy. It comes in a pill form. I’ll take it everyday for the next 5 years.
Why take it? Because my breast cancer was/is fueled by estrogen. Tamoxifen works by blocking estrogen receptors in breast tissue, which helps prevent cancer from growing. It is traditionally given after initial treatments (surgery, chemotherapy, radiation) have been completed to prevent the original breast cancer from returning and help prevent new tumors from forming.
- Difficulty breastfeeding (so NOT an issue!)
- Menopausal symptoms (hot flashes, vaginal dryness)
- Irregular menstrual cycle
- Osteoporosis (bone thinning)
- Headache
- Fatigue
- Low libido
2. Regular Check-Ups
I will have blood work and check-ups with my Oncologist every three months.
There are no scans or other tests that will take place. If I have any symptoms, e.g., pain without fluctuation or that worsens without any explanation, then additional tests (such as a bone scan or MRI) would be warranted.
That’s it. Though there is an assumed comfort in testing, over the years, research has demonstrated that such testing doesn’t catch recurrence any earlier that the identification of symptoms.
3. More surgery
When I had my double mastectomy and reconstruction 8+ months ago, I elected to have the two-stage reconstruction or two-stage delayed reconstruction. As I have mentioned here previously, radiation can damage whatever is in its way. I decided that it would be better to have the radiation damage the temporary tissue expanders rather than the long-lasting implants.
This means that for radiation, I left the original tissue expander (which feels like a hard water balloon) under my skin and chest muscle. Fortunately, there was little or no tissue damage (Silver Lining).
I will now wait about 6 months before having implants (not yet sure about whether I’ll have saline or silicone) placed.
My plastic surgeon (it’s still so weird to say “my” in front of plastic surgeon!) said that after radiation therapy, the radiated tissues go through a recovery phase during which scar tissue tightens around the implanted expanders. In fact, scar tissue capsules are known to become tighter and this tightness can sometimes result in discomfort, annoyance, and pain. I’ve definitely been feeling this in the last week.
He also said that when the expanders are removed, the “breast” pocket is surgically enlarged, and new semi-permanent implants placed, almost all patients express a sense of great relief. Yes, I can sure imagine that. And look so forward to it!
So, this is where we are. Over and out from the Booby Report.
Things turn out best for the people who make the best of the way things turn out.
-John Wooden
I stumbled upon your article today in the Huffington Post. I enjoy reading your articles and life experiences. I'm sorry to hear about your FBC. My wife is going through similar treatments. She was diagnosed with Stage IIb FBC last July…had a lumpectomy/lymph node removal, then bi-lateral mastectomies, chemotherapy, radiation, total hysterectomy, and now hyperbaric treatments to prep her for reconstructive surgery (1st stage next week). She was on tamoxifen, but after the hysterectomy switched to aromataze…which blows. She's in good spirits, but for 39, feels like an old woman. I'm hoping that your writings will help inspire her. God Bless!
Hollye – A friend recommended that I split the Tamoxifan in half to take half in the am and half in the pm.
Prior to that I was taking the whole pill at night before I went to bed and it was disrupting my sleep (often times I would wake up soaking wet from sweating). Anyhow I hope that tip helps you…it helped me SOOO much!
Great suggestion! I'm going to try this today…especially after a particularly sweaty night!
Just wanted to point out that osteoporosis is not a side effect of Tamoxifen… It actually is known to strengthen bones! (a SL for sure!) I have just started taking it, and I am looking at the silver linings…. Thank you for your wonderful blog… what you've share about your experience with FBC, as well as the helpful tips (and the updates on your family, the recipes, books, and fashion, which keep it well-rounded) is real treasure. I have needed this dose of positivity!
Thanks so much for making this point, Cheryl. It's a great one!
Thank you also for your feedback. It means so much to me!
I have finished my radiation a few months ago, right before Christmas. However, I been feeling ok, it just that I tends to itch and have bad hot flashes… any pointers for what to do?
Thanks so much for your note, Kimberly. Congratulations on being DONE. Yah! With regard to the itching and hot flashes, I'm right there with you. The itching could be a sign of the development of scar tissue from radiation (I've had it too) and the hot flashes may be coming with an anti-hormone medication. I'd suggest checking with your doctor whenever you have symptoms. However, be prepared for the response to be, "It's normal." Take good care and please stay in touch.