Cancer in the Rear View Mirror: The Overexamined Life

The last part of my breast cancer treatment is a small white tablet, Tamoxifen. I take one a day, and I will take it for five years. The side effects vary. But, for me, they have been minimal. I don't sleep through the night, and my joints are a little stiff every morning. But, it's hard to tell if that's from Tamoxifen or a year of breast cancer treatment.

Tamoxifen is interesting. Here's a little science and the history. Tamoxifen was first developed and tested as a fertility drug as it affects estrogen production. But, it also inhibits cells from receiving estrogen. So it was a failure as a fertility drug, but it is perfect for women with estrogen receptor positive breast cancer. It works as an estrogen blocker. Cancer micro cells are unable to receive the estrogen they need to grow.

So I take it every day, my little white pill of insurance that my estrogen will not feed any lingering cancer micro cells.

Tamoxifen can also cause thickening of the uterine lining (which can lead to uterine cancer) so it it standard to have a baseline uterine sonogram and biopsy after taking Tamoxifen for a few months.

I went to my gynecologist Friday for my first routine, standard uterine sonogram and biopsy. She told me my uterus looked great, the uterine lining looked thin (also great), my copper IUD was in the right place (more good news). And, then she said, "oh, (pause) that's interesting." NOTHING DURING A ROUTINE BIOPSY IS INTERESTING.

"It looks like you have a cyst on your right ovary. Do you get cysts on your ovaries?" NO, I DO NOT AND HAVE NEVER HAD CYSTS ON MY OVARIES.

More probing and sonogramming, and again she said "oh, (pause) and it looks like you also have a cyst on your left ovary." THIS IS NOT WHAT I CAME IN FOR.

She went on to tell me that both cysts were approximately 4 cm and did not look suspicious at all--liquid filled, not surrounded by fluid, yadda, yadda, yadda. But, because of my history, she said, I should follow up with my oncologist and see how she wanted to proceed.

When my radiologist found my breast tumor, she also told me that my tumor did not look suspicious. Deja vu all over again.

I held it together for the rest of the appointment. I got dressed, walked out of the medical building, got into my car and called Jay. And, I just started to cry and cry and cry in that full on "I have had enough cancer, cancer talk, and cancer scans cry."

I have put in my time and been optimistic for a whole year. I am done. I'm tired of looking on the bright side. I'm tired of not worrying until it's time to worry.

I'm not an optimist by nature. I've been working hard at it all year. Healthy attitudes yielding greater life expectancy and all that. Blah, blah, blah.

Some people are Tiggers, some are Eeyores. I am a Rabbit. I am a full on worrier. To the outside world I may look like a relaxed woman with a husband, two kids and a regular yoga practice, but no. My name is Barbara, and I am a worrier.

And, I had really just stopped worrying about a cancer recurrence every day--all the time. I had stopped thinking about how many of Elizabeth's and Andrew's milestones I would be around for. (Elizabeth's bat mitzvah in 2013, definitely. Andrew's bar mitzvah in 2016, no guarantees). That's how I had been walking around for awhile.

In the past few weeks, though, I had really started trying to live my life like a regular person with regular life expectancy.

And, then, BOOM! Ovarian cysts.

I called my oncology nurse when I got home and left a message. When she called back (an hour later) she told me that ovarian cysts are normal in all women, and she was not worried. She was not worried--at all. And, I should not worry.

I am going to Sloan Kettering for a PET scan this Wednesday (scheduled before the ovarian cyst discovery). PET scans find any and all tumors (not micro cells, but full on angry tumors). I will have the results a day or two after the scan.

This is my life now. I am going to be examined and over examined. (Is the unexamined life worth living?) And, doctors are going to find things--cysts, polyps, tumors. And, every time I am going to be on this emotional cancer roller coaster hoping that what they find will be nothing.

So, now, today, I am doing what Kathleen, my oncology nurse, told me to do. I am not worrying.

That's a big fat lie. I am terrified that there is cancer growing in my cancer factory body again and that I will have to meet a new team of experts at Sloan Kettering and start the whole awful cancer treatment ride--again.

That's Rabbit, the worrier, talking.

I'm trying hard to be more like Tigger.