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Monday, October 1, 2012

Risky Business

Remember when life was simple? Sure, maybe you were exhausted from taking care of the kids, or from working. Maybe your biggest worry was how to get rid of those extra 15 pounds that just wouldn't budge. Ahh, those were the days. Now we have to worry about weighing the risk factors of almost everything. Do I dare buy those non-organic berries even though the organic ones are 3x as expensive? How many supplements should I be taking to prevent a recurrence, and..... the mother of ALL worries - how do I determine whether the side effects of the medication are worse than the risk of not taking it?

Now I'm not talking about chemotherapy, because at this moment in time, the benefits far outweigh the side effects in the long run.  Those are the real statistics, folks. I'm talking about the other medications that so many of us are taking as follow-up prevention. Whether it's Tamoxifen, Tykerb (that's mine), Herceptin, Arimidex, Zometa (also mine) and a whole bunch more that I don't even know the names of, they ALL have side effects. By now you know that I'm the queen of talking about side effects.  Sure, my hair has completely grown back  - Hallelujah! - but all these drugs are powerful and they ALL have side effects.  Some of them slam you right from the start, some of them creep up on you over time, but read your package inserts people! They don't make that stuff up. It all comes from somebody somewhere reporting those symptoms.

So what do you do when your doctor says she thinks maybe you should stop taking DIHBIHM (DrugIHateButIsHelpingMe)? Perhaps it's time to consider the risks.  I hate considering risks. First of all, I don't have a good history with them. I had extremely low risk factors for having breast cancer, and we all know how that turned out.  Risk factors are statistics and I hate statistics. My husband loves them. He takes comfort in them and understands them.  Personally, I just see the small numbers and assume they have my name on them. What's a little heart trouble compared to going through chemo again? What's a little bladder spasm or horrific muscle pain among friends?

The good news is that you and your doctor really can make informed decisions that weigh the real risks of your side effects versus potential benefits. The information is out there and your oncologist knows the numbers and can help you navigate your choices.


1. Discuss exactly how debilitating your side effects are with your doctor. Don't sugarcoat it because you're afraid to stop taking the drug. Be honest.

2. Talk with your doctor about the real risks associated with stopping. Make sure you are comfortable that you've been given ALL the information.  Perhaps schedule a separate appointment where you can focus just on this so you're not feeling rushed.

3. Discuss your fears openly with your doctor.

4. Ask about alternative drugs. Sometimes there's an effective, but perhaps more expensive, alternative to what you're currently taking.

5. Don't assume that if you stop taking the drug, the cancer will come back.  You may be able to stop for a while and then go back on it, or maybe you've taken enough to get the majority of the benefits already. Once you've made the decision, don't be afraid to change your mind and revisit the question later. You're a woman - it's your prerogative to change your mind.

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