FEC Chemotherapy for Breast Cancer

When I was diagnosed with breast cancer, apart from being completely taken aback that something like this could happen to me, I got detailed advice from the oncologist about the type of treatment I would need.

fecI was told that after surgery to remove the tumours, the oncologist told me that I would receive chemotherapy and then  radiotherapy. The chemotherapy I received was called FEC. This is a combination of three chemotherapy drugs 5 fluorouracil, epirubican and cyclophosphamide. FEC takes its name from the initial of these three drugs.It is normally used to treat people with primary breast cancer that has not spread to other parts of the body. Chemotherapy destroys cancer cells by interfering with their ability to divide and grow.

All cells in our bodies continually divide and grow. This enables growth and repair of body tissue. Cancer cells are different because they grow by dividing in a disorderly and uncontrolled way. Different chemotherapy drugs work in different ways and attack the cancer cells at different stages of their growth. This is why a combination of drugs is often more effective than just one drug.

I was given my FEC intravenously. I had a Hickman line fitted because the veins in my hands did not allow easy acces for the cancer nurses.  All my medication was given through my Hickman line. I did not like having it, but it was useful. I was given the FEC as an out patient, every three weeks for 18 weeks. This meant I could go home on the same day after treatment, that was nice, but the days were long and tiring. The time involved is not just that required to give the drugs, but also waiting time, blood tests and time for the drugs to be prepared.fec tired

I suffered side effects with FEC. The common side effects include bone marrow suppression.Bone marrow suppression or myelotoxicity is the decrease in production of cells responsible for providing immunity, carrying oxygen and those responsible for normal blood clotting. Bone marrow suppression is a serious side effect of chemotherapy. The decrease in blood cell counts does not occur right at the start of chemotherapy because the drugs do not destroy the cells already in the bloodstream. However, the drugs affect new blood cells that are being made by the bone marrow. The suppression of bone marrow activity causes a deficiency of blood cells. This condition can rapidly lead to life-threatening infection, as the body cannot respond to invading bacteria and viruses.It can also leading to anaemia due to a lack of red blood cells and spontaneous severe bleeding due to deficiency of platelets. This resulted in me suffering from severe tiredness and exhaustion. It is difficult to describe the depth of the feelings of exhaustion. I also had several spontaneous nose bleeds.

Other side effects include nausea and vomiting. The hospital supplied medication to minimise this. I was instructed to take the medication at specified times after my treatment. However, the most visual side effect of chemotherapy is hair loss. I did try an ice-cap to reduce that, but to no avail. It did not work.

fec baldWhen people think of hair loss, they, and women in particular think of the loss of hair on their head. Certainly that does go. The result is a cold head in winter! However, all of the hair on my body was lost. This included the hair on my limbs and inside my nose. The good news was that I did not need to shave my legs for a year, the bad news is that it meant there were no hairs to stop my nose from running. Always carry a handkerchief!

I was not going to bother buying a wig. However, my cancer nurse advised that I should. This was partly because it might make the sight of me during my illness less difficult for my children and my elderly mother. She also pointed out that it would keep my head warmer, especially in winter. She was right on both counts.

Cancer affects not just the person who is diagnosed, but all the people who love them: their friends and family. I hope you never suffer such a diagnosis, but if you do, bear in mind the agony of those around you.

Valerie Penny

 

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Breast Cancer and Herceptin (Trastuzumab)

During my treatment for breast cancer, I was part of a medical trial in relation to the effecacy of the drug Herceotin (Trastuzumab). Herceptin is a drug that belongs to the group of drug treatments called targetted or biological therapies. It stops specific ways that breat cancer cells divide and grow. I was treated with Herceptin because my cancer cells were found to have a higher than normal level of the protein Human Epidermal growth factor receptor 2 (HER2) on their surfaces. That stimulates the cancer cells to breast-cancer-s10-photo-of-her-2-genegrow. Herceptin works by attaching itself to the HER2 receptors so that the cancer cells no longer grow. it also stimulates the body’s immune system to fight the cancer cells.

I am one of the 20% of breast cancer patients to benefit from Herceptin as my tumours were the fast growing ones that are HER2 positive. I was given the Herceptin along with chemotherapy after my surgery in order to reduce the chance of the tumours spreading or returning. If your breast cancer is not HER2 positive or, indeed, HER2 negative, Herceptin will not be effective to you.

The Herceptin treatment I was given for my breast cancer was given to me intravenously through my Hickman line on the same days as my other chemotherapy. I was treated every three weeks as an out patient. However, the days were long, as the Herceptin was given over 90 minutes with additional time taken to give me saline solutions and my chemotherapy. I had to stay in hospital for several hours in case I was allergic to the treatment. Luckily I was not. However, like all drugs, Herceptin has side effects.

The common side effects of Herceptin include: feeling like you have flu, nausea and diarrhoea. I had all of these. I felt pain in my muscles and joints and often felt breast-cancer-s2-breast-cancer-illustrationlike I had a temperature so I swung between feeling hot and cold. I also had to have treatment with anit-sickness drugs for the servere nausea I suffered. I also got medecine from the hospital to counter the diarrhoea that I suffered.

The trial I was part of was looking into reducing the period of time that women are treated with herceptin, to see if it makes a difference to the efficacy. The usual period for getting Herceptin is about a year. I was treated with it for 9 weeks. I found the hospital visits and the side effects very draining, so, although I had initially felt diappointed that I was only receiving the treatment for a shorter period, in the end I was quite glad to get to the end of the course of Herceptin.

Valerie Penny

 

 

Information about Taxotere (Docetaxel)and Breast Cancer

During my treatment for breast cancer, one of the drugs that I was treated with was Taxotere. It is also known as Docetaxel. It was used for me to treat primary breast cancer that had not spread to other parts of the body. It was used in combination with other drugs in combined chemotherapy. Docetaxel is also sometimes used to treat breast cancer that has come back after treatment or spread, for example, into the lymph nodes.

It works by interfering with the development and growth of cancer cells. Docetaxel blockshickman line.jpg part of the cancer cells before they divide and grow. This makes the cancer cells die off at an early stage.

When I was given Docetaxel, it was gven to me intravenously through my hickman line. I had three weeks between each round of chemotherapy. So, just about the time I was feeling normal again, another dose of the drugs was given.

Docetaxel has side effects. All drugs have side effects. Some people are more suseptible to them than others.Amongst the common side effects of Docetaxel are: bone marrow suppression, hair loss and nausea.

The bone marrow supression was the side effect that worried me most, because this means that I had an increased risk of getting infections when my white blood cell count was low. As a result of this, I was unable to go out and mingle with friends or relatives after my treatment. It made me feel isolated and lonely. My resistance was lowest around 5-10 days after I had had my dose of Docetaxel. So for about one week in every three, I had to be particularly careful to avoid infection. I was warned that, if I did feel unwell during this time, or if my temperature ever did go up over 38C then I was to get medical help or go to the hospital.

I managed to avoid having to go into hospital, but I did find that I bruised more easily and had nose bleeds that were difficult to stop and did suffer from anemia.I did not need any blood transfusions, but I did take iron tablets to boost my red blood cells.

Nausea was a problem for me, however, I was given medication to control this. The anti-sickness tablets were very effective and I was grateful for that. I also noticed that the taste of many foods changed while I was on chemotherapy. Much tasted like tin. However, I am glad to say that my sense of taste has returned to normal since my chemotherapy cancer-101-s8-tnm-stagingtreatment has finished. I was told that I might suffer from diarrhoea, however, my body reacted differently and I suffered more from constipation than diarrhoea.

The other side effects I suffered when being treated with Docetaxel tiredness, fatigue and pain in my muscles and joints. I still suffer from these over a year after termination of my treatment. When the pain is severe, I take pain relief or anti-inflammatories, but I try to avoid them as far as possible. Common practice says that gentle exercise improves the fatigue. I find it merely replaces it with exhaustion!

All in all I found chemotherapy difficult, but it is miles better than the alternative: no treatment: no recovery.

Valerie Penny

Symptoms of Breast Cancer.

Breast_Cancer_1Breast cancer affects both men and women. However, breast cancer has been the most common cancer in the UK since 1997, but is rare in men. It is by far the most common cancer among women in the UK (2011), accounting for 30% of all new cases of cancer in females. In 2011, there were 50,285 new cases of breast cancer in the UK: 49,936 (99%) in women and 349 (less than 1%) in men. Female breast cancer incidence is strongly related to age, with the highest incidence rates found in older women. This supports a link with hormonal status. In the UK between 2009 and 2011, an average of 80% of breast cancer cases were diagnosed in women over 50. Indeed, around a quarter (24%) were diagnosed in women aged 75 and over. I therefore find it very frightening that many older women ignore the risks of contracting breast cancer and are ignorant of the symptoms of the disease, with the exception of finding a lump. Finding a lump may be the most common sympton of breast cancer, however, in many cases finding a lump will be one of the last symptoms to become obvious, especially if the tumour is seated deep in the breast tissue. This is important because the earlier the disease is treated,the more successful that treatment is likely to be.

Some of the signs and symptoms of breast cancer include:

1) a lump in the breast
A lump in the breast is the most common symptom of breast cancer. Most breast lumps are not cancerous. They are usually fluid-filled lumps,cysts or a fibroadenoma, which is made up of fibrous and glandular tissue. But it is important to get a lump checked by a doctor straight away. If a lump or other symptoms is caused by breast cancer, the earlier treatment is received the more successful it is likely to be.

2) a change in the size or shape of the breast
The warning signs of breast cancer are not the same for all women. One of the common signs are a change in the look or feel or size of the breast. Breast enlargement alone is not necessarily a sign of inflammatory breast cancer. I see a lot of women who are worried about a change in breast size, and inflammatory cancer is rarebreast size

3) dimpling of the skin or thickening in the breast tissue
You may become aware of dimpling or tethering of the skin of the breast during a self-exam. It is an important part of the self exam to look in the mirror and look for a dimple. The breast should be outwardly round—it should curve outward and not pull in. If you have had breast surgery before and you have some scars, you might find that the breast will pull in around a scar. Of course, this is a different situation. A dimple is a pulling in of the skin, and it may occur when you raise your arm or lean forward. When you lean forward and raise your arm, the breast should stay outwardly round; it should not pull back in. That may be a sign of cancer, and it should be checked.

4) inverted nipple, a nipple that’s turned in
Every body is different. Some people are born with inverted nipples. That is not a worry or unusual for them. However, if you notice a change in your breasts that result in development of an inverted nipple, so you were not born with one,and the nipple cannot be drawn out, this should be checked by a doctor. it may suggest a lump behind the nipple that is pulling it in.

5) a rash on the breast or the nipple
Although tumors are the most common symptom of breast cancer, they are certainly not the only symptom. Women with a rare form of the disease called inflammatory breast cancer can develop a red, pink, or purple rash across part of their breast. The skin of the breast might also appear puckered, like the skin of an orange. If you notice symptoms like these, have them checked out by a doctor right away. Inflammatory breast cancer can spread quickly.breast cancer rash
6) discharge or bleeding from the nipple
Nipple discharge is a normal part of breast function during pregnancy or breast-feeding. It also may be associated with menstrual hormone changes. It appears spontaneously and involves a single duct. Although the bloody discharge may resolve on its own, this situation requires evaluation with an ultrasound of the area behind the nipple and areola. If the ultrasound shows a lesion, you may need a biopsy to confirm whether it is a papilloma or something more sinister. Although most often, nipple discharge stems from a benign condition. However, breast cancer is a possibility, especially if it is combined with one or more of the following: you have a lump in your breast, only one breast is affected, the discharge contains blood, yhe discharge is spontaneous or the discharge affects only a single duct.
7) swelling or a lump in the armpit
An armpit lump refers to the enlargement of at least one of the lymph nodes under your arm. Lymph nodes are small, oval-shaped glands that are located throughout the body and play an important role in the immune system. Most lumps are harmless and are usually the result of abnormal tissue growth. However, armpit lumps can be related to a more serious underlying health problem. Any unusual lumps should be evaluated by a doctor. Armpit lumps can occur in men and women of all ages. However, finding an armpit lump is most alarming for women because it may indicate breast cancer. Women should perform monthly breast exams and report any lumps to a doctor right away.Note that breasts undergo hormonal changes during the menstrual cycle, and may tend to feel more tender or lumpy during this time. This is completely normal. For the most accurate results, perform breast self-exams about one week after your period starts.

The advice you must consider is this: whether man or woman, old or young, if you become aware of a change in the area of your breasts seek medical attention sooner rather than later. Time is valuable: time is life.

Valerie Penny

Life on Letrozole After Breast Cancer

letrozoleAfter completion of my chemotherapy and just as my radiotherapy started I required to start taking letrozole: just one 2.5mg tablet per day. A 2.5mg tablet each day for 5 years. This is because my breast cancer wasa type that needs the hormone oestrogen to grow. In women who have been through the menopause, the main source of oestrogen is through the change of sex hormones called androgens into oestrogen. An enzyme called ‘aromatase’ is needed for this change to occur. Letrozole works by inhibiting (or blocking) this enzyme. This reduces the amount of oestrogen in your body, which slows the growth of the cancer cells, should they recur. It is my fervent hope that they will not.

I am ashamed to say that I never read the information given with medication, although I know I should. The manufacturer’s leaflet will give more information about letrozole and a full list of the side effects which may be experienced from taking it. I have to take other tablets daily as well. So I take one 2.5 mg tablet of letrozole each morning with my other medication, although you may take letrozole at whatever time of day you find easiest to remember, but try to take your doses at the same time each day. This will helps to avoid missing any doses. You can take the tablets before or after your meals. If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose. Do not take two doses together to make up for a forgotten dose. I suppose one tablet out of 5 years will not make much difference.

However, along with their useful effects, most medicines can cause unwanted side effects although not everyone breast-cancerexperiences them. If you have read other articles in this blog, you will realise, that my primary mind set is always that these things cannot happen to me. Of course, sometimes they can and they do. That is just life. Also, because I do not read the manufacturers leaflets, I did not know the side effects to expect. However, Letrozole has a raft of side effects and I seem to have been blessed with most of them. The common side effects are as follows:

1) Hot flushes and sweating: yes, I get this one! I thought it was my time of life, but no, I owe this joy to Letrozole so I try to keep cool by wearing light, airy clothes or in winter, I wear layers, so I can take them off as required.
2) Headache, muscle or joint pain: oh wow! I have this one in spades. You can ask your doctor or pharmacist to recommend a suitable painkiller but I do not like to take any more tablets than I have to, so I try to manage the pain with rest, hot water bottles or ignoring it before I give in to the painkillers. The dull ache of the joint and pain is a persistent, nagging pain that drains the drive and strength out of me. It is inescapable.
3) Feeling tired, weak or dizzy: Oh, you guessed, I find this side effect really, really debilitating. I simply cannot do all that I did before I got ill. Some days I cannot get up, some days I have to take a nap, sometimes I just cannot move. I get so indescribably weary and tired. I get cross with myself and irritated but it does not explain this side effect to say that I get tired. The tiredness makes me bone weary. My limbs feel heavy, my concentration is affected. My eyes cannot stay open. At other times I cannot sleep at night, so that makes me tired too. I do not drive or use tools or machines until I feel fit enough to do that.
4) Feeling or being sick, indigestion, abdominal pain: Hurrah! I do not get this one! I stick to simple meals, generally avoid rich or spicy foods and I am very careful about my diet.
5) Constipation: I occasionally suffer from this one but I try to eat a well-balanced diet and drink several glasses of water each day.I also drink copious amounts of tea, mostly English Breakfast tea, sometimes Earl Grey.
6) Diarrhoea: Nope, I do not get this one: if you do, remember to drink plenty of water to replace the lost fluids.
7) Appetite changes, weight changes, feeling depressed, hair loss, skin rash, swollen legs or feet, vaginal bleeding: I am blessed with some of these, the most immediately obvious is that my hair has become very thin. Sometimes I wear a hat because my head gets cold, my hairdresser is a magician and always makes me look and feel like a million dollars. The other one of these side effects that I have to cope with is depression. I have suffered depressionfrom depression for many years any way and now it is reasonably well controlled. It is just difficult having another potential source of that mental health problem.
8) High blood levels of cholesterol or high blood pressure. I do not suffer from either of these. I am lucky in that my blood pressure sits fairly low anyway and my doctor also arranges for me to regular have tests to check that these side effects are not rearing their ugly heads.

As I suffer with so many side effects of Letrozole, I have been offered the opportunity to change to another tablet. However, I have declined to do so. I know what the side effects of Letrozole are and I can cope with them, more importantly my long suffering husband knows what they are and he can also cope with them. So for the remainder of the 5 year period, I will cope and I will be grateful that I am being successfully treated for breast cancer. I am a lucky woman.

Valerie Penny

Risk of Recurrence of Breast Cancer

herceptin_drugMy body has endured surgery, chemotherapy and radiotherapy. As a result of this I have lost my hair and my energy. Still, that tumour the size of a baked bean is perceived as a threat. Its return must be further discouraged. My oncologist therefore insists on mammograms every six months and prescribes Letrozole. I must take one 2.5mg tablet each day for 5 years.

Breast cancer is often discussed as a general condition, but there are several different types that require different treatments. One way to distinguish breast cancer cells is through your genes. When you are diagnosed with breast cancer, your doctor will test the cancerous cells to determine their genetic makeup. My tumour had more of the HER2 protein in it than it should have had. HER2 is a protein that stimulates the growth of breast cancer cells. It can be found in your blood and urine. Sometimes it is referred to as a tumour marker. Tumor markers like HER2 cannot be used for cancer diagnosis, but they can provide other important information and the presence of HER2 helps the doctor predict how likely the breast cancer is to respond to treatment.

It is estimated that about 20 percent of breast cancers are HER2-positive. Younger women are more likely to be her_2_geneHER2-positive than older women. HER2-positive breast cancer tends to be more aggressive and to spread more quickly than other cancers. That is why it is important to find out if the cancer cells in your body contain this protein. If your breast cancer is HER2-positive, you have a much better chance of successful treatment with methods that target the HER2 protein specifically. Results show that those who tested positive for HER2 at an early stage of the condition (with tumours 1 centimeter or smaller) had a higher risk of recurrence. Researchers have also found that HER2-positive patients had a 77.1 percent five-year survival rate, with no recurrence. However, they also are
around five times more likely to suffer recurrence than those who were HER-2 negative and have close to three times the risk of recurrence of those who tested negative for HER2. So I am absolutely sure I want to discourage recurrence.

Tumours that are HER2-positive are more often associated with factors that increase recurrence rates. For example, HER2 tumours are more likely to occur in younger women and have higher nuclear grade. Generally, the higher the nuclear grade, the more aggressive the tumour. HER2 tumours are also more likely to show positive margins during breast surgery. Positive margins occur when cancer cells extend beyond the edge of tissue that is removed. HER2 tumours also have a higher likelihood of residual disease being found when additional tissue is removed. Up to 70 percent of patients with HER2-positive breast cancer respond to treatment. However, total remission for the condition occurs only in around 7 to 8 percent of patients. Targeted treatments (medicines that target the HER2 protein, like the Herceptin I was treated with) have improved the prognosis for HER2-positive patients. Remissions can also be lengthy, offering another bright spot in prognosis and reports show that remission can last more than 15 years for some patients.

tabletI was diagnosed HER2-positive and this brings special challenges in my recovery from breast cancer. The HER2 protein can make the breast cancer more aggressive. It can also make it harder to treat with hormone treatments used for other types of breast cancer. However, drugs like trastuzumab (Herceptin) target HER2 directly and effectively. This drug, when used in combination with other drugs, shows some very promising results for improving prognosis and survival rates for patients with HER2 cancer. However, there is a small but real risk of heart damage and possible lung damage. Scientists are still studying how long women should take Herceptin for the greatest benefit. I am not ashamed to tell you that I hope their studies are successfully concluded soonest. I have a vested interest in this, as my tumour was HER-2 positive.

All in all, having made the decision to stay alive long enough to thoroughly embarrass my children, when the oncologist tells me that I must take one 2.5mg tablet of Letrozole each day for the next five years, I will do just that. Letrozole has side effects but I have decided that whatever they are, they have to be better than allowing the tumour to return.

Valerie Penny

After Radiotherapy

It is hard to imagine a treatment that only lasts a few seconds, minutes if you count the set up time, causing after effects.  Believe me when I tell you that it does.  There are side effects of any medical treatments, of course.  With radiotherapy these can be quite frightening.  There is some concern that after treating the brain (particularly if combined with chemotherapy) the patient may develop memory problems.

Radiation therapy works by damaging the DNA (genes) of tumour cells.  DNA damage stops tumour cells from dividing, growing and spreading.  Radiotherapy is a useful tool for treating cancer because cancer cells grow and divide more rapidly than most normal cells around them.  Although some normal cells are affected by radiation, most normal cells appear to recover more fully from the effects of radiation than do cancer cells. Radiation oncologists carefully limit the intensity of treatments and the area being treated so that the cancer will be affected more than the normal tissues.  This is why the set up for the treatment often lasts longer than the treatment itself.

Modern radiotherapy has advanced dramatically over the recent years.  It is now possible to focus radiotherapy with extreme precision. This allows the radiation dose to be targeted to the areas of tumour while sparing most adjacent normal tissues even in seemingly complicated and difficult parts of the body.

brain_lateral_adam

Radiotherapy affects different people to greater or lesser extents.  My friend Ismay, who is a real inspiration to me, is facing terminal cancer with and bravery that is awe-inspiring.  She found the radiotherapy to her head (to shrink a brain tumour) really difficult.  She was left with burns to her scalp.  Her hair that had grown back after chemotherapy, was lost again and the burns to her head made it impossible to wear her wig for weeks.  The pain and distress were hard to bear: but bear it she did. along with some forgetfulness, with her relentless courage and humour.

My treatment was to my right breast.  It was targeted to the area from which my tumour had been removed.  I had been told the radiotherapy would make me feel tired.  I had also been told the effect was cumulative. Unsurprisingly, me being me, when I felt no particular effects after the first dose or so, I felt I had beaten the system.  I had been told the cumulative effects would also include burning to my skin.  Again, initially, I deduced my skin was different to everybody else’s.  It is    not.  However, the effects do not kick in immediately, but do last a long time after the treatment has finished.  Radiation_breast

I have found the after effects of the radiotherapy quite depressing.  The burning under my breast was soothed by aqueous cream but the skin burnt and peeled the way it might with sunburn.  I am now six moths out after radiotherapy has finished.  The burns are healed but my breast still looks tanned compared to the other and I still find I get tired far faster than I expected this far on.  I still cannot walk as far as I used to.  One of my favourite hobbies is dancing, but I cannot dance for as long or as energetically as I did before my treatment.

I continue to find it difficult to concentrate for prolonged periods and the exhaustion is debilitating.  I was becoming increasingly upset about this and was speaking to my friend Margaret.  Margaret survived breast cancer and got her all clear about eighteen months ago.  She has been immensely supportive during my cancer journey.  The wonderful Margaret told me that, even yet, she gets bone tired sometimes.  It is not like the tiredness you feel after a busy day or a late night.  It is a wave of weariness that is all encompassing.  The big problem is it can arrive, unannounced, at any time.  So I have no confidence that, if I start a long or complicated task, I will have the energy to finish it.  This is what I find most exasperating.

However, the side effect that I had feared most was depression.  When the radiotherapy comes to an end, you come off the treatment merry-go-round.  All the attention stops and this can cause the depression the doctors and nurses warned me about.  I suppose when you have been using all your energies to defeat this disease, when it comes to an end so suddenly, it can result in an emotional vacuum.  I have mental health problems anyway and I really feared this problem.  I was lucky, it did not happen to me.  Other friends were not so lucky.  They did feel the sudden stop of treatment and attention left a void that led to depression.

Now I am at the stage where I get check up appointments with the consultant approximately every three months. Before I see the consultant I go to the hospital for an echo scan.  It is also called an echo-cardiogram is an ultrasound scan of the heart. It is sometimes just called an ‘ECHO’. Ultrasound is a very high-frequency sound that you cannot hear, but it can be emitted and detected by special machines. The scan can give accurate pictures of the heart muscle, the heart chambers, and structures within the heart such as the valves.  An ECHO can be carried out for many different reasons.   I have it done to check how well your heart is working after the radiotherapy and to look at how well the valves are moving inside the heart.   An ECHO can also help to see any fluid that may have collected around the heart.  So far my heart is holding up well.

I need to undress to the waist and lie on the couch. A probe is placed on my chest (it is a bit like a very thick blunt pen).   Also, lubricating jelly is put on the probe so it makes good contact with the skin.   The probe is connected by a wire to the ultrasound machine and monitor.   Pulses of ultrasound are sent from the probe through the skin towards your heart. The ultrasound waves then echo (‘bounce back’) from the heart and various structures in the heart.  They make a sort of swooshing noise.

featured-breast-cancer

The consultant also arranges for my blood to be checked to make sure my calcium and haemoglobin levels are high enough.  So far, so good.  This is especially important because for the next five years I require to take a medication known as letrozole.   Amongst the more common side effects of letrozole are hot flushes, hair loss, joint and bonepain, muscle pain, tiredness, unusual sweating, nausea, diarrhea, dizziness, and trouble sleeping.  I have certainly suffered the tiredness as well as the joint, bone and muscle pain.   I was told by other patients it should lessen after 8-10 months.  The doctors have not confirmed this!

So I have complained about my difficulties and honestly reported my progress.  I am aware that I am very lucky. The disease was diagnosed early after a mammogram.  The necessary surgery was carried out quickly.  I am to get another mammogram later this month to confirm that I continue to survive breast cancer now.

Valerie Penny

 

 

 

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