Tamoxifen we may meet again?

I've been dreading this post.  Basically ATLAS trial showed that 10 years of Tamoxifen offers more benefit than 5 years.  This came out at the San Antonio Breast Cancer Symposium in December.  To review, those who are estrogen receptor positive basically means estrogen feeds our cancer and that is why we take hormone inhibitor pills like Tamoxifen, especially if you're premenapausal.  Dr. H already wanted me to be on it for 10 years.  The visit with Dr. Litton was in September and she was fine with me being on it for just 5 years.  I think I will need to email Dr. Litton.  Also this Medscape article interviewed Dr. Ravdin who came up with Adjuvant! He apparently would recommend 10 years for those grade higher than 1 and node positive.  I'm node negative but grade 2 intermediate grade....grrrrr...so I may still see Tamoxifen once again.  If so, I don't think I want to do it until I completely know I am not going to have a child.  Even with Tamoxifen it comes with a price of quality of life.  For me I think the major culprit was sleep.  I see Dr. H again this summer and hoping to email Dr. Litton within the next week or so.

 "The results of ATLAS are most relevant for younger women," said Peter Ravdin, MD, who moderated the press conference. Dr. Ravdin is codirector of the SABCS and director of the Comprehensive Breast Health Clinic at the University of Texas Health Science Center at San Antonio.

Dr. Ravdin plans on telling his premenopausal patients with ER-positive disease that 10 years of tamoxifen has benefit over the standard of 5 years. "I am going to be comfortable doing that," he said. The risk for endometrial cancer with tamoxifen is "very low" in these younger women, he added. "I think this trial will have a major immediate impact on premenopausal women."

However, tamoxifen beyond 5 years is not for every premenopausal woman.

He explained that he would lean toward recommending it to women who are at high risk for late relapse (those with positive nodes and/or bigger tumors). Women with small grade 1 cancers are not good candidates because their risk for recurrence is so low. Taking tamoxifen comes with quality-of-life issues, such as hot flashes and other effects, he reminded reporters. Many women already struggle to complete 5 years of tamoxifen because of the adverse effects, so taking the drug for 10 years will present challenges.

The study was funded by Cancer Research UK, the UK Medical Research Council, AstraZeneca, the United States Army, and EU Biomed. Dr. Gray and coauthors Dr. Ravdin, Dr. Barlow, and Dr. Powles have disclosed no relevant financial relationships.

Lancet. Published online December 5, 2012. Abstract, Comment

35th Annual San Antonio Breast Cancer Symposium (SABCS): Abstract S1-2. Presented December 5, 2012

Lasiks, Gyno and Genetic Case and a New Year

Happy 2013! Lots of things to update so lets get started.

Lasiks:  I’m about a month and a half post Lasiks.  Science is amazing.  My day vision I’m seeing as clearly as if I had my contacts in.  Low lights and my night vision is still iffy.  This is to be expected.  My eye doc said it can take up to 3 months for it to stabilize.  I see halos and there isn’t as much clarity when I try to focus on words  I really don’t have dry eyes besides the morning.  I haven’t really have to use my rewetting drops so dry eyes are not a problem.  The redness of my eyes disappeared several weeks post op I felt some sensitivity when I wash my face and when water gets in my eyes up for a month post op. All surgeries require time to heal.  Halos and low lighting are the biggest culprits so I'm happy overall.  I sometimes still feel as if I should take off my contacts at night and have finally stopped reaching for my glasses in the mornings.

2 weeks post op

Gyno visit:  Third time is the charm.  After two reschedules with my gyno, I finally saw her in early December.  Basically, she scheduled tests that I thought she would schedule.  The good news is that she feels my cycles are normal and frequent enough that my hormones are very active.  (Good news and bad news I guess regarding breast cancer vs ovary production.)  I have to time the tests with my cycle so I couldn't get that test done until later in December. Overall great news!  Looks as if I'm close to where I should be for a 36 year old!  One test showed that I was .05 lower than someone my age but that was to be expected for the chemo I was on!  I'm all about knowing and mentally preparing myself for the future so I'm glad I know where I'm at and I'm very happy.

Gene Patenting Case:  Friday we were told that the Supreme Court will take on whether or not human genes will be patentable so fabulous news!  Hopefully we will have a decision by the spring of next year.  It’s pretty crazy.  We started this process when I was 32 and I’m 36 now.  I really hope we win because this would be monumental in terms of more research, less cost on testing, more availability of testing and possibly more advancement.  My hope of course is that it will help me make a definitive choice as well as hope those behind me.  I’ll update more as things progress.  Some links to check out for more details.  

Supreme Court to decide if human genes patentable

Myriad Stymies Cancer Answers by Impeding Data Sharing

Today is January 1, 2013 so Happy New Year!  Wow, what a year!  I'm going to have to devote another entry on my reflection of 2012.