Hello again! Yes, it’s time for my annual ‘don’t worry it hasn’t come back’ update.
So, today I had my annual check up with Dr SmileyBloke the surgeon, who was his usual jovial self. He congratulated me on making it to three years clear and confirmed that because all seems well they will now discharge me from the surgical clinic. This just means I won’t need to have these annual check ups – I’ll still have the yearly mammogram and he reassured me that if I have any worries need of them I only have to call.
After our usual chat about diet, exercise, etc. (I’ve lost a stone since I was last there – he hasn’t Ha!) we moved on to whether or not I should move over from Tamoxifen to an aromatose inhibitor – Letrozole. He explained that ordinarily after five years of Tamoxifen I would then be moved on to Letrozole for another five years (something I don’t think I’d been told before). However, I could move on to it now because – after three years of Tamoxifen and at the grand old age of 51 – he’s pretty certain I will now be post-menopausal. Tamoxifen isn’t as effective when you’re post-menopause, apparently, and there are strong benefits to moving on to Letrozole – not least that it’s supposedly as effective at zapping cancer as six months of chemotherapy but without the hideous side effects. He said that Letrozole does have some potential side effects, the worse being joint pain, but that they tend to wear off after a few months. The pros seemingly outweighed the cons, and although I was disappointed I couldn’t just stop the Tamoxifen altogether, we decided I would move on to Letrozole, and he wrote me a prescription and said he’d see me again in six months to see how I was getting on.
And then, as I sat in the pharmacy waiting for the prescription, I made the mistake of reading the accompanying leaflet which filled me with horror, then Googling ‘Letrozole side effects’ which just about finished me off. I very nearly told the pharmacist not to bother, but being typically British and meek I didn’t. I just took the tablets and left.
I’ve spent the rest of the day not knowing what to do for the best. Most of the potential side-effects are very similar to the ones that I had when I first started taking Tamoxifen. I’ve no idea whether I’d get them all over again, given I’ve been on Tamoxifen for 3 years, but I’d hate to go back to the worst of the menopausal symptoms, fatigue, etc. – it’s only been this year that I’ve felt like I’ve started to get over them. But it’s the joint pain that really worries me. I’ve read a lot of accounts of women online who are suffering the most horrendous pain alongside other side effects. And there’s a risk of osteoporosis which Dr SmileyBloke never even mentioned. I think I could move back to Tamoxifen if I found the side effects too overwhelming – but in all honesty right now I don’t even want to contemplate putting myself through them. My mental health’s not been brilliant in recent months and I feel at the moment like more physical issues might just be a bit too much to deal with.
Ideally, I’d like to talk to someone else about the risks and benefits of Letrozole before I move on to them. But I don’t really know anyone who’d be more expert than Dr SmileyBloke and there doesn’t seem a lot of point in talking to him again as he’ll doubtless repeat what he’s told me today. Plus, he’s a busy man and I doubt I could just pick up the phone and talk to him! I might just see if my GP can offer any insights. In the meantime, I’ll stick with the Tamoxifen and keep the Letrozole in a drawer to come back to later. “Better the devil you know” and all that!