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Options for Treatment and Prevention of Recurrence

8 Sep

The Breast Blog #16

Drugs, Good Food and/or Other Options for Treatment/Prevention

September 4, 5 and 8, 2011

So…  it’s been five days since I got the good news – a pathology report saying I was clear of cancer – and I find I’m still kind of having trouble believing it.  After that first day of relief and gratitude and mild euphoria, I have had more several days in which I doubted the news.  Did they really find everything?  Is it really true?  Dare I believe it?  Can I go back to living a full-throttle life?

I feel a bit crazy for asking these questions.  I feel like my doubt is dishonoring the gift.  But I just want to be honest that those feelings are there.  A large part of this doubt is, once again, because of dreams I’ve had which indicated that something serious was going on.  I acknowledge, of course, that the dreams were probably pointing to this early cancer that was found and treated.  But the imagery was so disturbing sometimes that I felt like they were pointing out something more serious.

These dreams included things like: hundreds of rats pouring out from under a sheet on the floor, and really ugly rats bobbing in the ocean, and three large black spiders the size of my hand, and streams of red ants crisscrossing the countryside – too many to do anything about, and lots of baby tarantulas pouring out from the sleeve of my shirt.

I acknowledge that these dreams could have been this intense because they knew they needed to get my attention before my situation did become more serious.  However, until I have some dreams with really healing imagery, I’m afraid it could take a while for these doubts to totally fade.

Today I went to a spiritual gathering called A Circle of Miracles.  At the end we always form a circle and we share miracles.  I knew I had to verbalize my good news in order to help make it more real.  And before I could even speak the words, I had to struggle with emotions that had welled to the surface.  In spite of the excess of “free time” I’ve had in recent months, I seem to have kept myself sufficiently busy to avoid feeling this deep well of emotion that was obviously still under the surface of my outward calm.  Even now, two hours later, I feel emotionally fragile.

I guess speaking the words aloud really makes the whole thing – all of it – feel more real.  And I think the tears were an expression of the fear I had felt and the relief that maybe things really are going to be okay.

I imagine I am not alone in being leery of celebrating too soon.  I’ll have to do some research and ask other cancer survivors about their experience.

Speaking of cancer survivors, as I share my story with others, I hear about more and more women who have had either breast cancer or biopsies.  It really has begun to feel like an epidemic.  I’ve been keeping track of only the people I personally know.  I’m not writing down friends of friends or sisters of friends, I’m just writing down the names of people I know.  And there are now over 20 who have had breast cancer.  The good news is that the vast majority have survived.  I am learning that breast cancer is most definitely a treatable disease – especially when it is caught early and the woman chooses appropriate treatments and/or lifestyle changes.  (Of the three I know who succumbed from the disease, one had refused any conventional treatment and another refused any lifestyle changes – continuing to smoke, eat poorly, etc.  My humble guess is that the third, whom I once knew well, had unresolved emotional/psychosocial issues which may have compounded her physical issues and contributed to her death.  But that’s just me trying to make sense of her death.)

So, what next?  I had a follow-up appointment with my surgeon last Thursday.  My wounds are apparently healing nicely and she was pleased with my pathology report.   She did recommend 1) that I up my intake of Vitamin D, as that helps prevent cancer, and 2) that I consider taking aromacin (also spelled aromasin.)  She reported that it cuts the incidence of recurrence 60%.  She also said that it can greatly reduce the possibility of cancer arising in my left breast.

Aromacin is one of two drugs recommended for women with estrogen-positive receptors.  (The other is tamoxifen.)  I asked her about the side effects.  I knew there were quite a few with tamoxifen.  She said that aromacin had many fewer side effects.  However I just did some research and am quite concerned.

Some of the side effects include: hot flashes (in 33% of the women), hair thinning/loss (in 15%), debilitating joint and muscular pain, fatigue, insomnia, nausea/abdominal cramping/diarrhea, etchttp://www.livestrong.com/article/224531-aromacin-side-effects/

Okay, I am all for a 60% decrease in the possibility of a future cancer, but these are very unpleasant side effects.  I have experienced hot flashes, thin hair, and abdominal cramping, as well as insomnia, and I’m not a fan of any of these!  I know there are herbs I can take that have counterbalanced some of these symptoms in my past (black cohosh for hot flashes, mint and licorice for abdominal discomfort, and various herbs for better sleep) and I assume these would work even if the symptoms were chemically induced.  However joint and muscle pain that makes it challenging to move/get out of bed is a rather significant factor.  If one cannot move without pain, one become less likely to move, therefore one gains weight – which is not a good thing if you’re fighting breast cancer because estrogen grows in fatty cells, and increased estrogen makes one very susceptible to breast cancer.

Here is more on the drug: Aromacin.

“Aromasin (exemestane) is an anti-estrogen, or estrogen suppressor medication, taken as a 25 mg pill. Aromasin is a steroid. This medication helps lower your risk of breast cancer recurrence, and improves your chance of survival.

The enzyme aromatase is present in fat tissues, such as breast tissue. Aromasin inhibits this aromatase, which converts pre-estrogen to active estrogen. This is how Aromasin suppresses estrogen levels after adjuvant chemotherapy treatment for estrogen receptor-positive breast cancer and in women with advanced (metastatic) disease.

Aromasin is given to female breast cancer patients to lower estrogen levels and prevent recurrence of breast cancer. Patients who take Aromasin must be post-menopausal, have finished primary treatment for estrogen receptor-positive breast cancer, and have already taken two or three years of tamoxifen. This drug is also given to patients with advanced breast cancer, when tamoxifen has not halted the spread of cancer.” http://breastcancer.about.com/od/treatments/p/aromasin.htm

Interesting.  My doctor/surgeon is recommending Aromasin even though I am NOT post-menopausal nor have I taken tamoxifen.

I found quite a few sites where women taking Aromasin complained of debilitating leg, feet, and joint pain.   I am realizing the side effects can be quite awful.   And as I am theoretically clear of breast cancer at the moment, perhaps I can find more natural ways of preventing a recurrence rather than subjecting my body to this heavy-duty drug.  (I have never been one for pharmaceuticals.  Except for an antibiotic a few times in my life, occasional Tylenol, and the pill, I have been basically drug-free my whole life.)

So I find myself thinking, How can I prevent more estrogen in my body without taking one of these drugs?  I know that one of the big answers is to cut out meats and cheeses.  The cattle industry especially, but also most commercial meat operations, add hormones to the feed.

“Why are hormones used in food production? Certain hormones can make young animals gain weight faster. They help reduce the waiting time and the amount of feed eaten by an animal before slaughter in meat industries. In dairy cows, hormones can be used to increase milk production. Thus, hormones can increase the profitability of the meat and dairy industries.

Why are consumers concerned about hormones in foods? While a variety of hormones are produced by our bodies and are essential for normal development of healthy tissues, synthetic steroid hormones used as pharmaceutical drugs, have been found to affect cancer risk. For example, diethylstilbestrol (DES), a synthetic estrogen drug used in the 1960s was withdrawn from use after it was found to increase the risk of vaginal cancer in daughters of treated women. Lifetime exposure to natural steroid hormone estrogen is also associated with an increased risk for breast cancer (see BCERF Fact Sheet #09 Estrogen and Breast Cancer Risk: What is the Relationship?). Hence, consumers are concerned about whether they are being exposed to hormones used to treat animals, and whether these hormones affect human health. We try to address this complex issue based on scientific evidence that is currently available.” http://envirocancer.cornell.edu/factsheet/diet/fs37.hormones.cfm

So one thing I can definitely do to decrease my chances of getting breast cancer in the left breast, or getting a recurrence in the right, is to eat a more vegetarian diet.  Those who know me from Facebook know that I have been working hard to change my diet.  I do not intend to be fanatical about it.  I don’t want to become “afraid of food.”  However, if I do feel the need for meat once in a while, I will endeavor to find organic hormone-free meat.  And if I feel the need for cheese, I will choose goat cheese because goats are usually not part of the huge corporate meat industries hellbent on maximizing profits even at the expense of public health and safety.  I do know there is a wonderful local place that sells good healthy chicken and turkey.  (Bolton’s in Sellersville, PA)

When the doctor’s office discovered I did have positive estrogen receptors, they were happy about it actually because it gave me another option in my cancer-fighting tool kit.

But I am very resistant.  I was given the card of a hematology oncologist with whom I’m supposed to make an appointment to talk about Aromacin.  I am not feeling the urge to do that.  I am worried he’s going to aggressively promote this drug and be unsympathetic to my concerns.  (And of course, he won’t ever have tried it himself…..)

Is there anything else I can do to fight this cancer?  YES!  Exercise more and lose weight.  Consider the following:

“Breast cancer survivors whose bodies make the least estrogen have the lowest chance of breast cancer recurrence, a long-term study shows. Estrogen levels — measured soon after initial breast cancer treatment — were twice as high in women whose breast cancer returned as in those whose breast cancer did not come back.

Nearly all the women in the study had already gone through menopause, and most took the estrogen-blocking drug tamoxifen. So where did their estrogen come from? Fat tissue, says study investigator Cheryl Rock, PhD, RD, a professor in the cancer prevention program at the University of California, San Diego.

All this is good news for breast cancer survivors, Rock says. It means that by exercising and losing weight, they can cut their risk of cancer recurrence.”  http://www.webmd.com/breast-cancer/news/20080307/estrogen-brings-breast-cancer-back

Herbalist Susun Weed reports that “Women more than 25 percent over their ideal weight have a 30% higher risk of recurrence.”  (Medical Tribune, October 1992)  She also reminds us that exercise tonifies the immune system and that several clinical trials have shown that regular exercise is strongly linked to heightened immunity and resistance to cancer.  She emphasizes the word “regular” saying that it “is better to walk one mile four times a week for a month than to jog 16 miles once a month.” (Breast Cancer?  Breast Health!  The Wise Woman Way, by Susun S. Weed, p. 89)

There is an interesting recent study just published less than nine months ago, the Nurses’ Health Study, that suggested after a diagnosis of breast cancer, exercise can reduce the risk of recurrence. For women who walk at an average pace three to four hours a week, reduction in deaths from breast cancer were found. It’s encouraging that there may be less recurrence and death from breast cancer by exercising.

The study reviewed here found that women diagnosed with early-stage breast cancer that came back (recurred) had higher blood estrogen levels than women diagnosed with early-stage cancer that didn’t come back. Estrogen can encourage breast cancers to grow, especially cancers that are hormone-receptor positive, so the link between higher estrogen levels and breast cancer recurrence makes sense.  http://www.breastcancer.org

  • Make exercise a part of daily routine. Regular, moderate exercise (brisk walking, for example) has been shown to lower estrogen levels.
  • Eat a diet that’s high in fruits and vegetables and low in saturated fats, and maintain a healthy weight. Having extra body fat may contribute to breast cancer recurrence risk, in part because estrogen can build up in body fat.  http://www.breastcancer.org

By the way, it is now September 6, 2011 and I am feeling better (more hopeful; more on board with the “clear of cancer” report) than I was just a few days ago.  I guess it has to do with feeling proud of myself for the changes I’ve made in my eating habits. Also, I’ve been taking a product which detoxifies the bodies of heavy metals, herbicides and pesticides, etc.  It relieves me that there is something safe out there to detoxify me so that my body has a chance to get well. Everyone of us can surely benefit from that in this day and age, right?

As far as healing from last Monday’s surgery?  The scars at my incision points look really good.  The swelling has gone down and the heat has diminished.  I know there is still healing taking place internally.  When I asked the surgeon to clarify what exactly took place inside my breast, she drew me a diagram showing a slice of pie pointing toward the nipple.  She had cut out a pie slice of tissue in order to get as much of the duct and surrounding tissue as possible, and then she sewed together the sides of that slice.  (That’s my take on what she said, anyway.)  So, there is still healing and mending going on inside.  If I take off my bra, even for a short time, I feel a pulling and tugging and weight that is uncomfortable.  It is true that at this time, the more support I can give my breasts, the better.  Even the sports bra doesn’t feel sturdy enough at times.  But the surgical bra is not that comfortable as it smushes me across the nipples.  I was given a prescription for a custom-made bra – on site at Comprehensive Breast Care Surgeons.  I look forward to having a bra that works for me during this time of healing!

I will be scheduled for another mammogram in December, after my breasts are likely to be fully healed.  (I hope so!  I don’t want to get mashed before they are healed!!!) And then I have a follow-up appointment with Dr. DuPree in March 2012.

So friends, you are now caught up with what is going on for me at this time.  Stay tuned for more information regarding herbs and foods that are particularly helpful in preventing cancer.

Be healthy, y’all.

Rich blessings to each one of you,

Cindy