Tuesday, October 20, 2009

Prepping For Tomorrow's Appointment

Tomorrow I meet with my oncologist. This will be the last time I see this particular oncologist because he's moving to Arkansas next week. I'm glad he stuck around until my chemo was done. That was mighty good of him, don't you think?

Tomorrow we're to talk about Tamoxifen, the estrogen-blocker I'm to take for the next 5 years ... one pill a day. My tumour, like most breast cancers, was estrogen fed so the idea behind Tamoxifen is that it will reduce the chance of a recurrence by blocking estrogen. My research, though, is recommending that aromatase inhibitors are, perhaps, better than Tamoxifen so I have some questions about them. They also counter estrogen but in a different way and they supposedly have fewer side effects. The catch is that the aromatase inhibitors are only good for post-menopausal women and that's where I'm confused because I think I'm in that grey area where I'm not sure if I'm pre or post. Would someone just tell me already! I also wonder if the aromatase inhibitors haven't been previously mentioned because, perhaps, they're not covered by Sask Health. I'm not sure about that but I wonder. The aromatase inhibitors are considerably more expensive than Tamoxifen but if they have better results and fewer side effects and are appropriate for my stage of life, I definitely want to know about them.

This distrust of the medical system is warranted. If something isn't in our protocols here, they typically aren't even mentioned even if you might benefit from them. When I read about women from other countries and their breast cancer treatments, they often mention PET scans as standard testing. I asked my surgeon about PET scans and he said they're not part of our protocol here, though he thinks they are the way to go "in the future" ... and I'm sure they're not now part of our protocols simply because we don't have a PET scan in Saskatchewan and because to get one out of province is very expensive. The thing is "the future" is now in other places. Why shouldn't the future be NOW for Saskatchewan patients, too? The only reason I knew about PET scans was because I had to research them for a legal file a few years ago. Not a single medical profession has mentioned PET scans to me.
From PetScan Vancouver ...
Positron Emission Tomography or PET is the most advanced medical diagnostic imaging technology available today for the early and accurate detection of cancer and its recurrence.

A whole-body PET scan provides information about the body’s chemistry and cell function (metabolism) rather than pictures of the body’s anatomy or structure as shown by X-ray, ultrasound, CT scans, or MRI. As a result, PET scans may reveal abnormalities or tumours that would otherwise go undetected. In more situations than with any other imaging modality, a PET scan is key to the early detection and accurate treatment of cancer.

  • Detects tumours early and accurately.
  • Assesses tumour aggressiveness and monitors success of therapy.
  • Determines whether a suspicious site is benign or malignant.
  • Scans the whole body for detecting spread of cancer (metastasis).
What I find annoying is that there are drugs and tests out there that might really be to your benefit but you're not even told they exist. I find that disconcerting. It really means you have to do your own research, ask questions, and sometimes really push, trust your gut, and even pursue things independently. You essentially become your own doctor without the training. Something's wrong with that.

Anyway, tomorrow ... oncologist and bloodwork. I hope he gives me something for this edema. It's worse today. Just call me elephant ankles!

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