I saw my oncologist last week. She doesn’t want me to take any other aromatase inhibitors. She believes the whole class of drugs would trigger my depression as the letrozole did. She wants me to take tamoxifen. Tamoxifen works differently from the AIs. She thinks I may tolerate it. I would have to take it for ten years instead of five. I balked at that until I realized if I tolerated it, ten years wouldn’t be an issue.
My risk of breast cancer recurrence in other parts of my body is about 3.5% if I take tamoxifen. If I take nothing, risk rises to 7%. Granted, neither number is high, but I like 3.5 better. My oncologist says she has no problem with me taking nothing. I would be watched more carefully if I chose that route. I feel ambivalent about watching and waiting until they find something. I’d rather prevent something from growing in the first place.
Until this morning, I had decided to start taking tamoxifen when I returned from my trip in June. I thought I’d see how it goes. Why not?
This morning, I saw my prescribing psychiatrist. He said that tamoxifen would affect my anti-depressants, and vice-versa, in a big way. Were I to take tamoxifen, I’d have to change my psych med regimen fairly radically.
Some of you may know that I was hospitalized last summer for a severe medication issue. It was a nightmare for my family and me. Fortunately, after that awful event, I found a great, experienced psychiatrist (& covered by Obamacare!) He painstakingly guided me, trying different medication combinations. After months, we hit on the right “cocktail.” I feel like me again. In spite of cancer and my other challenges, I am thankful. Every day, I feel more able and strong. I’ve struggled with depression since my late teens. It’s a gift to feel this well.
Is it worth risking my good, balanced self for a 3.5% better (which actually means 50%, doesn’t it? ) chance against cancer recurrence? I don’t know if it is. My psychiatrist has offered me an alternate course of psych medications and dosages to replace the ones I’d have to give up. The transition from one drug to another can be grueling, with no guarantees that it will work. Should I try a new regimen with the tamoxifen? I don’t know what to do. Quality of life is a huge consideration. I don’t have a good quality of life when I am deeply depressed. Readers input is greatly appreciated.