Sunday, October 25, 2009

Read At Your Own Psychological Risk

I thought for a while before deciding to post the following observations and speculations as they are quite personal and not necessarily something I would talk about with everyone except the closest of confidantes, but because these relate to my breast cancer and treatment experience, I think it's important that I honour my philosophy about this blog and post these thoughts. Maybe they will be helpful to someone else out there. Even if the following information isn't necessarily useful (and I'm sure it's not), it might provide some comfort even if to say to someone "you're not alone". I haven't seen these observations discussed anywhere else, so I'm going to put them out there because they're for real. STOP NOW IF YOU DON'T WISH TO KNOW ME ANY MORE INTIMATELY THAN YOU ALREADY DO!! (As if you could stop now!).

Observation No. 1

I have toe knuckle hairs. Just on my big toes and I have always shaved them off when I shave my legs. Before I had chemo, I mean. I haven't had a hair on my legs since I lost my hair during that first chemo treatment. I even lost the hair on my toe knuckles. But, interesting to note (to me anyway), is that my toe knuckle hairs have grown back while I've been on taxotere (the chemo drug for my last 3 of 6 chemo treatments). Hair didn't grow back anywhere else. Legs and arms are still completely bare, so I wonder if it didn't grow back on my toes because of wearing the ice boots? Since I don't have hairy hand knuckles (honest, I don't), I can't say if the ice gloves would have had a similar effect.

I'm going to assume that confessing to toe knuckle hair is no big deal. I'm going to assume that many other people have toe knuckle hair but that's it's just something we don't typically talk about. Right? Don't worry, I'm not asking you to fess up. I'm confident that I'm right about this. No need to out yourself, too.

The hair on my head IS starting to grow back, by the way. Fine little ones that stand up when I run a washcloth over my head. I think some are long enough that they're starting to curl a little ... just curving a little at the tip. Some might be about 3/4 of an inch long ... some dark, some light. How exciting! I'm a little nervous, though, because there's a patch at the front of my head, right in the middle, where nothing has started to grow yet. Not good but I'm not alarmed ... yet. I haven't dared to look at the back of my head. Generally, I still find looking at my baldness upsetting ... especially if I linger.

Observation No. 2

First a confession, which holds some relevance in terms of timing, though not as personal as confessing to toe knuckle hair. Yesterday, I stayed in my pajamas ALL day. I did NOT have a bath. The closest I got to the sink was hand washing and teeth brushing. That means I don't know if the following happened only today or whether it was yesterday.

This morning I gave myself the spa bath treatment. It felt great! When I was toweling off, I noticed with some surprise that my right breast was suddenly slumping! Two days ago it wasn't like that. I would have noticed because it wasn't something gradual. The slump is rather dramatic compared to what it looked like previously. Not only has it slumped, but now it's all squishy and soft instead of solid and firm. A very marked change.

It raises some questions for which I have no answers. Curiosities more than anything.

Once I learned that my tumour was estrogen fed and that it had low levels of progesterone, I learned about "estrogen dominance". My understanding (and I'm no clinical researcher or doctor so don't quote me on my understanding) is that estrogen dominance can cause or contribute to breast density. I confess to having been rather proud that while at 50 years old, my breasts, which had grown considerably since my early 40's, hadn't drooped. They sat quite high and round on my chest. I had never had cleavage in my life until my mid-40's and that they were "perky" was a bonus. I could still go bra-less and not look silly.

In my research I read that women who have perky breasts in their 40's and beyond should be aware that this could be a sign of high breast density and that, after age, high breast density is the 2nd leading risk factor for breast cancer. That was news to me. Both "breast density" and it being a "risk factor" were news. And, in fact, my surgeon told me that my breasts were very dense. Now, I can't say for sure WHY breast density is a risk factor. Is it because it signals estrogen dominance (estrogen not being balanced by progesterone and/or other hormones and with estrogen fed breast tumours being, by far, the most common) or is it because it's harder to detect lumps in dense breasts? I'm not sure. Maybe it's both.

Now, back to my suddenly droopy boob. Why is it suddenly so droopy? I've only been taking Arimidex (the estrogen blocking drug I take for the next 5 years) for 3 days. Could that have already blocked enough estrogen to make my breast slump? I just find it very curious! If anyone knows anything about this, I'd be most interested to know. I haven't done any thorough research on the topic but I will do a little digging.

Oh, and if you're wondering why it's just the right knacker I'm talking about, it's because what's left of my mutilated left breast is already smaller and has it's own directional course due to the incision, scar tissue and such. It's not much of a gauge.

This really is more information that I would normally share but these are things I don't understand and they're actually happening. It seems to me there should be reasons.

Sorry if I've scarred you for life. Join the club!

Note: I just did a quick Google search ("breast density" droop) and found this article, Drop in breast density means tamoxifen is working (Dec 12, 2008). Some quotes from the article:
In women at high risk for developing breast cancer who take tamoxifen to help prevent the disease, a reduction in breast density as seen on mammography is a strong indicator that the drug is working ...

"Our findings suggest that the impact of tamoxifen on risk reduction is predictable by the changes it induces in breast density after 12 to 18 months of treatment ..."

"The women who had a 10 percent or more reduction in breast density -- and that was a substantial number, over 40 percent -- they had almost a two-thirds reduction in breast cancer."
That sounds like very positive news about my now droopy boob. But could that really happen within three days of taking an estrogen blocker? That sounds a little unlikely, don't you think? The study used a timeline of between 12 and 18 months. But how else to account for my droop?

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