One down, just 3,652 to go

Yesterday I took the first of the 3,653 tablets I’m due to take over the next ten years as part of my long-term hormone treatment plan.

The oncologist said in her letter to the breast surgeon before my last chemo session in November last year that I should start hormone therapy as soon as I was recovered from my operation of 19 December and “if up and about”. I’m not exactly sure what recovered means – fully? partially? – but I’m up and about at least some of time so I decided that rather than start taking the tablets on some random, grey, nondescript day later in the month, I’d start on 1 January, the first day of the new year. So on every Hogmanay (or New Year’s Eve for the non-Scots among you) for the next nine years, I’ll tick off another year and on Hogmanay in 2025 I’ll have a massive celebration to mark my finally having finished treatment for something that happened more than a decade earlier.

That is, of course, assuming that the cancer doesn’t come back in the meantime or that some accident or other unforeseen event doesn’t cause me to shuffle off this mortal coil before then. There are no guarantees but I’m generally a glass half-full kind of gal so let’s look on the bright side ;-). And let’s face it, there are no guarantees for anyone in this life, it’s just that most of us never think about it and do just fine.

So just to recap, the breast cancer I have (had?) needs oestrogens to grow (Understanding your chemo regimen &  Breast cancer does indeed “come with baggage”). Every day for the next five years, I’ve to take one tablet of a drug called letrozole. Letrozole is one of a group of medicines called aromatase inhibitors. Aromatase inhibitors lower oestrogen levels in the body by blocking aromatase, an enzyme that converts other hormones into oestrogen. As a consequence, any slow-growing or dormant cancer cells that may have survived chemotherapy (and/or radiotherapy) are starved of the oestrogen they need to grow and so they slow or stop growing and/or spreading to other parts of the body.

Hormone treatment is now recommended for some women – I’m one of them – for ten years. Once the five years of letrozole are up, I’ve to take one tablet a day of another drug, tamoxifen, also for five years. That’s where the figure of 3,653 comes from – one tablet a day of either letrozole or tamoxifen for the next decade, and the decade includes three leap years.

The side effects of aromatase inhibitors can be severe and many women stop taking these medicines as a consequence. One of the reasons the oncologist emphasised recovery and being up and about is that exercise can help alleviate “the likely side effects [of letrozole] including bone ache and joint stiffness”. I’m not exactly super mobile at the moment but my daily walks on Tooting Bec Common must count as some form of exercise. Another reason for starting now is that I’m hoping that if I do get these side effects, I won’t notice them so much among all the other aches and pains I have at the moment following my operation and the chemo. I’m only half joking there.

Anyway, fingers crossed. Happy New Year everyone, and here’s to 31 December 2025.