“Nobody said it was easy, it's such a shame for us to part. Nobody said it was easy. No one ever said it would be this hard. Oh, take me back to the start.”
-Coldplay “The Scientist”
Outpatient or minor surgeries tend to be no brainers. Getting that weird mole removed from your back, easing the pain of carpal tunnel syndrome in your wrists, ridding the headaches that come with impacted wisdom teeth - you get where I’m going with this. Little things that are expected and need to be done at some point as we age ever so gracefully. Then there are the big or major surgeries that are often necessary, lifesaving, and more than a little scary; open heart surgery, double mastectomies, brain surgery, etcetera.
Since November 2012, I have had five surgical procedures done, four minor and one massive. Now, I find myself weighing the pros and cons of another surgery. It’s considered outpatient and therefore minor. It is also elective. But for me, it’s major, and I’ve been more than a little freaked out. After many long and thoughtful conversations with both my oncologist and my gynecologist I’ve elected to have a complete hysterectomy.
In 2007 my tumor was estrogen negative and as long as I tested BRCA negative as well, they felt there was no reason to remove my ovaries or any other plumbing. This time it’s different. This time, my tumor was estrogen positive and this time I’m taking Tamoxifen.
Tamoxifen is used to prevent estrogen positive cancers from taking up residence in another part of the body just like Herceptin is used to prevent HER2+ cancers from relocating elsewhere. I got the double whammy - I’m taking both.
I really thought I was done with the surgeries for a while…. but “just when I think I’m out... they pull me back in.” I’ve adjusted quite well to life as a Tamoxi-babe. And I plan on being a Tamoxi-babe for the next five years as suggested by my doctor. I’ve been managing the side effects of hot flashes with vitamins and diet. I wasn’t overly concerned about the risk of blood clots because I am fairly active and know the warning signs. But after an evening of a little too much Internet research, there is one side effect that I just couldn’t come to terms with; Tamoxifen can cause rare types of ovarian, endometrial, and uterine cancers. Cancers that often do not have any side effects until they have progressed to stage III or beyond.
This past spring, when I met with my gynecologist for a routine exam, he looked at me, dropped the f-bomb, and said he just couldn’t believe I was battling breast cancer again. Being the Tamoxi-babe that I am, I had a million questions to go over with him regarding the long-term effects of taking Tamoxifen. I knew that many women do in fact stop taking Tamoxifen because of the very real fear of reproductive cancers. His thoughts were, and I quote, “Hmmm, let's see, you’re BRCA negative with no family history of the disease yet you got breast cancer. Twice. Let’s do a complete hysterectomy and not leave anything to chance. Jeez, with those odds, can’t you win the Powerball or something good?”
So..buh-bye lady parts, staying alive has become a full time job.
He explained the procedure would be laparoscopic and fairly quick, typically completed in an hour or two. Barring any complications, I would be able to go home the same day and be back at work after a short time off my feet.
I’m having a hard time with this though, after all I’ve been through, logically I know it is the right decision; emotionally, it hurts a little. My boys are both in high school and nearly grown. Having more children has been off the table for several years now. But those parts of my body allowed me to create two of the most amazing human beings I have ever met. I made them. It’s like a huge chapter of my life – being a giver of life – is now closed.
So I tried to think like a scientist, and rationalize while “no one ever said it would be this hard,” it’s a choice and I’ve chosen. I’ve chosen to remain a Tamoxi-babe for the recommended course of treatment. I’ve chosen to take the pre-emptive strike against any potential new cancers I could be at risk for. I’ve chosen to have a complete hysterectomy. I’ve chosen to do whatever is within my power to stay here.
Thankfully, the surgery was a success. No more than a few days off my feet while indulging in the lovely narcotics that were prescribed to get me over the hump. I went right back to my daily routine and back to work in less than a week. What I will also share with you, my readers, is what was explained to me four days post-op in a phone call from my surgeon. In reviewing my pathology report they found that yes, in fact I already had a pre-cancerous lesion in the endometrial lining of my uterus typical of the types of pre-cancerous lesions caused by Tamoxifen. Yes, pre-cancerous. Yes, after only a few months on Tamoxifen. Yes, I am still trying to wrap my brain around this. I’m lucky I had the surgery when I did. I’m fortunate that I was armed with the information I needed to make an educated decision allowing me to be proactive about my health. I dodged the bullet. I made the right choice.
So each day since that call, I wake up and I think of my favorite quote by the most eloquent author, A.A. Milne, “you’re braver than you believe, stronger than you seem, and smarter than you think.”