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The Messy Choices of Breast Cancer

With breast cancer you are never done. I was reminded of this reality with the anniversary of my five-year remission from early stage invasive breast this year. While I was deeply thankful for the attaining this recovery milestone, I was also confronted with a new medical dilemma. Which of two treatment paths would I choose in my battle to sustain my remission? Like I said, with cancer you’re never done.

The first path was all about survival numbers. To get the “best” numerical outcome, I would have to change my post-treatment medication from the tried and true Tamoxifen to an aromatase inhibitor. It was a change I dreaded and for good reason.

Five years ago following surgery and radiation for my newly diagnosed breast cancer, I suffered through six months of aromatase inhibitor treatment. When I say suffer, I mean the drug transformed me from a fit 50 something women into a fragile, arthritic riddled, depressed women who felt and moved like I was 80 years old. The cost of using this medication again in pursuit of the best survival numbers would be a severe downgrade in my quality of life.

The second path was all about a better quality of life. The survival numbers were still good but not the best, and tamoxifen wasn’t without its own problems. It clearly depressed my estrogen levels, which accelerated arthritis and aging. And that turns out to be a big issue for me because I come from a long family line of arthritis that inflicted painful joints on my aging mother and grandmother. And now tamoxifen was pushing me in that same direction. But compared to the aromatase inhibitors, it was a gentle shove versus falling off a cliff.

So, which path should I take? Do I forgo the best survival numbers and wind up guilty and fearful about metastatic breast cancer down the road? Or am I more fearful of the disastrous impact that the best outcome drug will have on my quality of life? It’s not enough that the diagnosis of breast cancer steals your hope about a healthy future in the initial treatment ordeal. Now I have to deal with yet another messy set of choices regarding the next five years of my life. Ironically, I will never really know if I made the right decision or not. Like I said, cancer is all about messy choices.

Here is what I do know. Following my initial treatment for breast cancer, my job has been to give my immune system its best shot to fight back against a recurrence. And without a doubt, I can’t do that with crippling joint pain and deep depression. For the sake of my immune system and my long term sanity, I have to choose a lifestyle that allows me to feel good, ride my horse Lady, and bike with my husband David. That’s why I am choosing to continue tamoxifen along with eating healthy food, exercising daily, engaging in meaningful activities, nurturing important friendships, cultivating the habit of gratitude and giving back to those less fortunate.

I am opting for the best quality life over suffering for the best numbers, a choice that includes letting go of my guilt about second guessing myself. Though I have lost a lot with cancer, I’ve never lost the right to live my life on my own terms. And that on so many levels has made all the difference…

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