If planning a holiday is a clear sign of recovery…

The point at which you can look forward to and plan a holiday after you’ve finished cancer treatment is regarded as a clear sign of recovery. I must be doing OK as I am in fact planning – and very much looking forward to – not one but several trips.

The reason planning ahead is seen as such a positive step is that for all the months you’ve been undergoing treatment, your time horizon has been limited to the next treatment or appointment. It really is very difficult to see further than that. In fact sometimes – immediately after surgery, for instance – you’re taking things a day, never mind weeks, at a time. I need to refer here to a really thoughtful essay entitled After the Treatment Finishes – Then What? by Peter Harvey, a now retired UK consultant clinical psychologist. For people who’ve finished treatment, he says, planning too far ahead brings its own worries and fears and to switch suddenly to planning for events months in the future is a step too far. That was indeed the case with me for a while but I seem to have “moved on” on that front – at least enough to plan some holidays.

So Andy and I are off to Madrid soon for a few days, to spend some time with some really good friends of 30 – yes, 30! – years, whom we met when we lived there in the 1980s. Then we’re off to Croatia with the boys for two weeks at the end of July.

I’ve also booked flights for that annual long weekend/short week of skiing that I go on with friends every January (Stopping the downward spiral). Flights are very reasonable when you book them ten months in advance (!), but this trip was hard to book. I guess that’s partly because I was still in that “scared to plan” period when the flights became available a month ago. Also, it was on my mind that I had to cancel this year’s trip because I was in the middle of treatment (I love Glasgow, but it’s not Geneva).  And next January really is a long way off. Planning for something next month or even in the summer is very different from planning for something next year. Not only that, by the time that trip comes round I’ll have had my first mammogram since my diagnosis. That’s due in December, a year after my surgery. Anyway, the trip’s booked, as are the other two. There will be uncertainty and worry along the way but for the moment it seems I’m firmly on that road to recovery.

 

 

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.