Holiday Health Update

Oh, this is so overdue! I know. I keep thinking about how I need to post an update, and then I don't. It's not because I don't want you all to know what's going on—there just isn't anything going on! Seriously. I just don't know what to say! But for you, I will figure it out.

Zometa update: I got the insurance to pay for it! Yay! Also, this year's studies came back showing it to be just as beneficial as we knew it would be, so my insistence on getting it is totally vindicated!

Um, context, right, sorry—recapping. It's a bone density drug that is also used to treat cancers which have spread to the bone (bone mets). Some preliminary studies also showed it having benefit in recurrence prevention for women with early stage breast cancer (me!). It was still being studied, but I looked at the data and read up and decided I thought it was a good idea for me (my doctor thought so too). But alas! Insurance would not pay, because it wasn't yet definitively shown to help! Woe and worry—it's very expensive! $1500 a treatment! I found some funding, and a some of you were very generous (thank you!) and I started getting the treatments. And now, I can get the treatments paid for (as it should have been all along) and we can all use our money for more fun things. Nothing like scraping and saving to have some really unpleasant poison run into your vein. Yuck.

Anyway, and then just this month more studies came back totally confirming that for people with my type of cancer it can indeed reduce recurrence by 46%, so I'm doing the right thing. Excellent.

This is good because I'm not really doing what I should be with the other drugs.

Hormonal drug treatment update: The standard of care for hormone+ early stage breast cancer (what I have), right now, is to do chemo and/or radiation and surgery followed by 5 years of anti-hormonal treatment. This is one of two types of pharmaceuticals—Aromatase Inhibitors, or Tamoxifen. AIs are currently considered the best, so that's what I was put on first. Alas, I cannot tolerate them because I am a sensitive delicate flower and my body hates drugs of any kind. I tried various different ones, but by the time I gave up I was taking one half a pill every three days and even with that tiny amount, I was having awful side effects.

So we moved onto Tamoxifen. Tamoxifen is special in that 15% of people lack an enzyme that metabolizes it, so if you're one of those people, it just does nothing at all. No point in taking it. I, friends, am one of those special people.

So, now I am taking something called Evista (Raloxifen), which is primarily (again) a bone density drug (I am really not going to have problems with osteoporosis, premature menopause notwithstanding), which is also used for recurrence prevention. It operates on the same mechanism as Tamoxifen, which is to occupy (#occupy?) the estrogen receptors so the bad estrogen can't get in there. The advantages for me of this approach (as opposed to the AIs which just wipe all the estrogen from the body) is that I don't have to suffer the side effects of not having estrogen as much, so that's nice. Though I still have a very low amount.

The disadvantages are that the reason it's not really used anymore is that it doesn't work as well as the others. And, oh yeah, I'm only on a half dose because that's all I can tolerate. So to sum up—the AIs work 15% better than the Tamoxifen. The Tamoxifen works 15% better than the Evista, and I'm only taking a half dose of the Evista. Sigh. On the bright side, though there's no way of knowing, I'm pretty sure my super sensitivity to drugs means a half dose is plenty. I'll be happy enough if I can continue to tolerate this one; it's early days yet, and after this there isn't really anything else. So fingers crossed.

About the Tamoxifen thing: If you aren't a breast cancer patient, you will never get tested for this enzyme that prevents absorption of this drug. What a shame! So interesting! Because it's not just this drug—I looked it up and there's this endless list of other things that we 15% of the population can't metabolize and I just would never have known. There are antibiotics, painkillers, all kinds of stuff on this list. Do opiate painkillers just give you a headache? Maybe it's because, like me, you are incapable of absorption! Fascinating stuff, people. Really. Definitely goes in the “we know so so little” file of medical treatments.

Anyway, that's about that for medical news. How's my life? Uneventful, and pleasant. I am feeling pretty well—so happy to be off those AIs. Ugh. I feel a lot better. I go to the gym and run, a lot, I read books, I spend too much time on the computer, I try to get outside and I cook a lot of vegetables. Seriously, it's one of my main activities. I, uh, I don't know! Things are good, that's all that matters. Hope you all are well too and Happy Holidays! XO

PS-- Am I leaving out anything interesting? Feel free to ask questions. The feedback people give me is that you would like updates, but I just don't know what to tell you... help me out here! Oh, here's one; yes I am in San Francisco. I am trying to get out of town more, but that's still not much--the majority of the time I am right here in my apartment in my city. Which is fine. So come on out and visit!