Here’s to remaining forever “entirely unremarkable”

It turns out that being described by your oncologist as “entirely unremarkable” is a good thing.

To be fair, the oncologist didn’t use the term to describe me personally. She used it in the context of the physical examination she did of me one day last month, at the appointment I had with her just before I had my latest round of zoledronic acid. That’s the bone-toughening drug I get a dose of every six months to counteract the bone-weakening effects of letrozole, the hormone therapy drug I take daily to lower the amount of oestrogen in my body and so reduce the chance of my breast cancer coming back.

The oncologist had a feel in various places for lumps or swellings or anything else that might have given cause for concern. Later, in her report to the consultant breast surgeon, she described the examination as “entirely unremarkable” in that there were “no signs of recurrent disease”. Of course, an absence of lumps is only that. All it means is there’s no palpable sign of trouble at this time. There could be lots of other stuff going on that we’re just not aware of (How would you know it’d come back?). But it’s something, and on that front I’ll take whatever reassurance I can get.

As well as having bone-strengthening properties, zoledronic acid has been shown to reduce breast cancer recurrence in post-menopausal women such as myself. It’s given via intravenous infusion (that’s a drip to you and me) over a period of 15 minutes; you’re in and out of the chemo unit in no time but it felt really strange to be back there after six months away.

My next round of the drug is due in March next year. Here’s hoping I’m still entirely unremarkable then and indeed that I stay that way for evermore.

 

What does follow-up look like?

So what happens now? What does follow-up look like now that I’ve largely been signed off by the consultants who’ve been treating me for varying lengths of time since my breast cancer diagnosis one year ago this very week?

At around the one-year anniversary of my surgery, in mid-December, I’ll have a mammogram and an ultrasound scan on the good boob (if you’ve had cancer in one breast you’re at increased risk of getting it in the other) and an ultrasound scan on the reconstruction (there’s no point in having a mammogram as there’s no, or next to no, breast tissue there). The plan is that I’ll have those tests anually for at least five years.

I’ll have my next and third round of the bone hardening drug, zoledronic acid, in September. I’ve changed from having that every three months to every six and the plan is to continue on that basis for the next couple of years. I’m on letrozole, daily hormone therapy. Letrozole lowers oestrogen levels in the body and so increases your risk of developing osteoporosis. The bone hardening drug is to counteract that. It’s also been shown to reduce the risk of the cancer coming back in post-menopausal women like me.

I’ll have a bone density scan once I’ve been taking letrozole for two years to measure the effect letrozole has had on my bones so far. The scan I had before starting hormone therapy showed I had strong bones to start with, which is good.

And that’s it.

Or is it? This follow-up plan only works, of course, as long as there’s no recurrence. If that happens, all bets are off, as you’ll know from posts I’ve already written. In between your formal follow-up scans and whatever other ongoing treatments and/or appointments you have, you need to stay aware of the symptoms of secondary breast cancer, not panic at every ache or pain but get any worrying signs checked… and hope like hell that the concern that led you to go and get checked was misplaced and that you are in fact still cancer free.