Ashe Elton Parker

A Writer of LGBTQ+ Characters in Speculative Fiction

Tag: hormone suppressant therapy

Oncology Check-In

This entry is part 38 of 44 in the series Breast Cancer Posts

This past Friday, I had another Oncology visit. This time, instead of getting my Neulasta injection after the appointment with my Oncologist, I picked it up prior to the appointment. This is so I wouldn’t be stuck waiting at the hospital to have it injected; a nurse has to do it, and the medication is refrigerated to keep it fresh because it is a powder-gel combination so it works over a long period of time. There are three-month and six-month doses, and I have the three-month dose.

Nothing’s changed with regards to my medication regimen. My doc said what I’m on now is better than the Tamoxifen, though I forgot to ask precisely how. Before my appointment with her, I went for blood draw, for tests for both her and my primary care doc, but the hormone results take 24-48 hours to return. I think the VA either has to send the tests out to another lab, or it just might be because something about the test requires more time. Next time I go to the lab and see I’m getting a hormone test done, I’ll ask the process it goes through and why it takes so long.

I may contact my Oncologist tomorrow to see if she’s had the results in, and if I do, I’ll try to remember to update this post with the news.

One thing my Oncologist did say was that if this medication regimen isn’t suppressing my hormones adequately, we may have to look into surgery to remove my ovaries. I’m sort of half-hoping it has to be done, and half-hoping it doesn’t, and the latter is because it won’t be a full hysterectomy, and I don’t really fancy going in for the remainder of the procedure at a later date. Still, if it’s required, I’ll do it. The last thing I want is to put myself at risk for more cancer.

ETA:

During my Oncology visit, I also received a breast exam, which I’m apparently to have done every six months now. I wanted to mention this in particular because I learned a couple things which are troubling to me. One thing, which I’ve noticed in my breast self-exams, is that it’s impossible to press deep enough to the front of my chest wall. This is desirable because it enables the examiner, whether it be the woman herself or her physician, to feel through the entire breast. The main issue preventing this complete examination is the density of my breasts, which my doc places at a level of three or four on a scale docs apparently use to indicate difficulty/ease of breast examination.

When I asked if this was bad, she said that breast density—the denser the breast is—was an indication of the propensity of cancer (higher density = higher likelihood of breast cancer). My Oncologist went on to add that right now, there are no decided recommendations on how else to examine breasts. What I got from her explanation is that though there are possible other methods, besides mammograms (which she noted may not work as well because of my breasts’ density), which may work for discovering breast tumors, there’s a great deal of uncertainty about whether or not they’re actually even as helpful as a mammogram, never mind any more helpful.

Also:

My Estrodiol is apparently suppressed to a level which pleases my Oncologist, so it looks like my current medication regimen is working. Yay.

Oncology Checkup

This entry is part 36 of 44 in the series Breast Cancer Posts

Last Friday, I had an Oncology checkup. This is part of routine post-cancer care for breast cancer. I believe I mentioned here previously my Oncologist called to briefly discuss the possibility of putting me on Tamoxifen instead. Well, this visit was sort of a follow-up on that call.

Like usual, I first saw an intern who was working with my doc. She and I went over the past few months regarding my experiences with the medication regimen I’d been originally placed on, and I mentioned to her my hands had begun intermittently itching. She checked my heart and listened to my lungs, ensured I didn’t have edema in the legs, and went to give her report to my Oncologist. I remember her first name was Amy (’cause it’s very familiar to me), but not her last name.

When she returned, she had my Oncologist, Dr. Colonna with her. My lungs and heart were checked again, then Dr. Colonna sat and we got into the main topic of my visit: what medications would be best for my post-cancer care.

We once again went over the benefits and side effects of Tamoxifen and my Anastrazole-Leuprolide regimen. My main concern with the Tamoxifen is the possible stroke side effect. I know thousands of women have been on Tamoxifen for years without such a side effect, but it’s a main worry for me. I’m concerned about the osteoporosis which the Anastrazole-Leuprolide regimen can cause, but not as much as I am about the stroke issue.

Dr. Colonna wasn’t strongly determined I should switch to the Tamoxifen, and she listened to my concerns about the side effects issues, then suggested I remain on my current regimen for about five years and possibly stop all hormone suppressants. I disliked that idea, mainly because I know that at 45, my body will still be producing hormones; my mother’s menopause didn’t end until she was in her fifties, and I told Dr. Colonna I was expecting my natural menopause to last that long—so I thought I should be on some sort of hormone suppressant therapy until at least my fifties.

She agreed with this, and we eventually worked out I’d remain on the Anastrazole-Leuprolide therapy for five years, then I’d switch to Tamoxifen. I’m to go in annually for DEXA scans of my bones to ensure I’m not losing too much density in them. I suspect if I do, I’ll be switched to the Tamoxifen sooner, but Dr. Colonna said my initial scan showed I had excellent bone density, so she felt confident I could remain on my current regimen for at least five years.

I told her about the itching in my hands, how it’s intermittent, and she explained it may have something to do with the early menopause my body is going through. So, it’s hormones and nothing can be done about it. LOL It’s not that bothersome, so I was just glad to have an answer for why it started up.

I also told Dr. Colonna I’m trans. I probably should have long ago, but I didn’t want Mom present to try to downplay it. It is important for all my caregivers to know, even if I’m not going to be able to do much—if anything—toward transitioning anytime soon.

While I was up at the VA (actually, during the waiting period for my medication refills, including the Leuprolide injection which needs to be administered by a nurse), I made an appointment with my primary care doc to have a regular checkup. My last one was a female exam, and I need to tell Dr. Milne (pron. mil-nee) I’m trans and what my projected plans are. Now that I’m finished with the intensive cancer care, I can better focus on my trans issues, and I’m looking forward to doing so.

Hormone Suppressant Therapy

This entry is part 33 of 44 in the series Breast Cancer Posts

On the 18th of this month, I began the last (and longest) phase of breast cancer treatment: hormone suppressant therapy.

This required a visit to the VA Hosp to see my head oncologist, Dr. Colonna. They actually called me just as I was heading out the door to go, and I answered the phone to a request I come to my appointment early. This I was more than happy to do of course, and I had a relatively short waiting time when I was finally shown to a room.

Now, the rooms where I’ve been seeing my VA Oncologists are standard hospital rooms. They have a bed (usually raised for some reason), a computer stand on wheels, and a short exam bed. I think they use the rooms for sleep tests of some sort, ’cause there are signs posted on the walls about having to be out by a certain time in the mornings.

First I saw a resident working with Dr. Colonna, and she and I went over my cancer care up to this point and possible hormone suppressant therapies I may consider. I’ve forgotten her name. She departed, then returned with Dr. Colonna and Nyna, one of the oncology nurses.

Dr. Colonna reviewed everything with me again, then gave me a more detailed explanation of the possible hormone suppressant therapies I could use. There were really only two: the standard Tamoxifen and a combination therapy using a pill with an injection. Considering the possible side effects of Tamoxifen—one I disliked a great deal was the risk of blood clots—I opted for the other program, which was the one Dr. Colonna really preferred to use with me.

We also chatted about the possibility of me having a partial hysterectomy because I have PCOS. Dr. Colonna promised to arrange an appointment with the women’s clinic’s surgeon to discuss the possibility.

After our discussion, she gave me a brief breast exam, and we discussed my upcoming (in Aug) mammogram. She said, considering the density of my breast tissue, she thought it might help to do an MRI of my breasts regularly and promised to consider it. That ended our visit, and Nyna took over.

I like the Oncology department. They’ve given me easy to read printouts of all the information regarding the drugs they’ve given me since the beginning. I wish the other departments did this. At first, Nyna gave me the Tamoxifen paperwork, saying this was what Oncology’s pharmacist had seen was prescribed for me, but that was corrected later.

My hormone suppressant therapy regimen:

1. Anastrozole – this is the pill. I get 1MG of it once a day, and I take it with my night meds.

2. Leuprolide injection – this must be administered by nurse every three or six months; I chose the three-month option because it’s easier for me to remember to make appointments every three months because I can do it on my way out of Oncology. It’s also a little involved. Half of it is powder, which is the medication, and the rest is a suspension system of gel. They must be mixed prior to administration, and my first dose was injected in my abdomen (near my belly button) well below the skin (I have a lot of fat there). The gel dissolves slowly as a time-release function for the medication.

After receiving the paperwork, I went down to pick up my medications. Getting the leuprolide injection took a little time because it hadn’t been entered into the computer for the pharmacist to discuss with me. Once that was done, I went to wait on my meds, then took the injection back upstairs. After a twenty or so minute wait (for the gel to get room temperature from being chilled) I had the injection. The nurse said it was supposed to sting as the needle came out, but mine didn’t start stinging until after I’d fastened my jeans shut. Even now, after the weekend, the spot still stings, but it’s not constant. Most of the time, I feel nothing, in fact, and the stinging has gotten weaker as the days pass.

Then, appointment for my next injection made, I was free to go!

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