Wednesday, November 2, 2016

Coke or Pepsi: My Fifth Anniversary of Cancer


Have you ever ordered a Coke and what you get is a Pepsi.  It’s just not the same. Try telling that to your health insurance company.


It has been five years since I was diagnosed with breast cancer.  I was lucky because I caught my cancer early: I found the lump myself.  Because it was not widespread, I had a lumpectomy, not a mastectomy.  Genetic testing made the decision not to have chemo an easy choice.  So once my seven weeks of radiation therapy (which I called “tanning booth sessions”) ended, most people assumed cancer treatment was behind me.


Not so.  Like many women with breast cancer, I was given a drug, tamoxifen, to take for five years.  The side effects, I was told, would include hot flashes, night sweats, and a host of other things that sounded a lot like menopause symptoms.  I was 49 when I was diagnosed, so I suffered these side effects right along many women my age without any history of cancer.  "Is it hot in here?" was my constant refrain.  But it wasn't too bad.


Until this year, over four years after starting tamoxifen, when I began to experience changes in my mood.  I have always been a very happy person.  I had never experienced depression until this year.  And then it hit me.  I was tired, and thought I was over-trained, having trained for an ultra-marathon in 2015.  I took some time off, but it didn’t help.  Objectively my life was wonderful, and I knew that logically.  But I sure didn't feel it.  There were days when I felt sad, and other days when I felt nothing. Nothing.  I slept for 10 hours or more a day.  I stopped my athletic endeavors almost completely.  I ate everything in sight and drank a lot of wine.  I gained over 20 pounds. 


I began to examine everything about my life.  And then I remembered I ordered Coke and got a Pepsi.  Well, what actually happened is that I went to the drug store to get my tamoxifen, and the pharmacist noted that he had filled a different brand. 


“It’s the same active ingredients as the other tamoxifen.  Just a new brand.  Your insurance company has required us to change it,” he explained. 


“So it’s like Coke versus Pepsi?” I recall asking.  I should have realized then that this could be a problem.


It’s not that one brand is cheaper than the other, it’s just that insurance companies negotiate volume discounts.  And it is not that Coke is better than Pepsi, or vice versa.  Some women have worse side effects on one type of tamoxifen, and others react the opposite way.  Clearly, the switch was a terrible idea for me.  I spoke with my doctor, and dropped tamoxifen altogether, just a few months before my five years was up. He assured me that the drug had already done its work in protecting me.  And I could not keep living the way I was living.


So now, the good news is that I am cancer-free, drug-free, and once again happy.   I have lost more than 10 pounds that I gained earlier this year, and have a plan to lose the rest.  I am back to training, and am eyeing what races I might do in 2017.   I am celebrating that I have passed that five year mark, which means that it is much less likely that my cancer will recur.  It’s a wonderful world!

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