Saturday, February 27, 2016

Better off NED 3.0

Today is 3 years since I finished treatment. 3 years. Holy crap.

I decided to wait to throw my party until I was declared NED at the end of March. I found last year, while I had a great time partying, having to go through multiple rounds of testing I really wanted to celebrate when I was all done. So I'll wait.

But...I couldn't wait to bake. Made a yellow cake with fluffy milk chocolate ganache. And I piped my scar on it.

I mean I still needed to celebrate. And I'm not going to lie, my belly hurts. I may have eaten a little too much cake. For dinner. But I'm celebrating.

I also ate a ham and cheese sandwich today. They were my savoir during chemo, one of the only foods that tasted correct, and one of my main sources of protein. And it was delicious. I think ham and cheese will forever be comfort food for me.

And my parents are taking me to brunch and I may have bought my entire stitch fix (delivery service of new clothes). Because, things need to be celebrated.

Madonna was right. If we took a holiday. Took some time to celebrate. Just one day out of life. It would be, it would be so great.

February 27th will always be NED day for me.

Saturday, February 20, 2016

Cognitively Better than I thought

I feel like my brain doesn't function as well as it did pre-chemotherapy and I wondered if my continued cognitive difficulties-particularly word finding when fatigued, could in fact be blamed on chemo/tamoxifen. Well, apparently I am not the only person who wondered this as a team of researchers enrolled 170 women in the Los Angeles area in a 1 year study. Ganz et al recently published the study "Impact of Adjuvant Endocrine Therapy on Quality of Life and Symptoms: Observational Data over 12 Months form the Mind-Body Study" in the Journal of Clinical Oncology. This observational study followed woman in 3 groups: No Endocrine therapy, Tamoxifen and Aromitase Inhibitor (AI). There was a significant difference in the age of the woman in the AI group over the tamoxifen group, as expected. AI is used in postmenopausal patients.

The authors looked at patients after primary treatment (enrollment), 6 months into endocrine therapy, and 1 year into endocrine therapy. The study found during enrollment and one year later that all breast cancer patients had significantly worse quality of life (QOL) scores than a control group of concurrent healthy woman. Well that is a little bit depressing. But regardless of type of endocrine therapy it was noted that even one year after the completion of primary treatment (being surgery, chemo, radiation or any combination) continued to have sleep disturbances, fatigue and cognitive issues. Those are some pretty big items that are going to affect your QOL one year out.  I think the most important finding of this study is best described by the authors as follows:
Adjuvant chemotherapy contributes significantly to greater symptoms in the year after primary treatment, and combined with ET (endocrine therapy), is likely responsible for the failure of some chemotherapy related symptoms to resolve. 
Yikes. I hope that this is the first of many publications from the authors and that they continue to study if endocrine therapy continues to affect folks for the duration of their endocrine therapy. But, you know people are only on these treatments for 10 years.

The statistically significant results that this study found was that both the AI and tamoxifen group had significantly more cognitive problems than the no ET group, with AI patients report significantly more cognitive problems. Interestingly, the tamoxifen group after a year reported significantly more bladder issues than both groups. I won't go into further detail, but I will say that I can attest to that. Both ET groups had a higher rate of hot flashes than the non-ET group and the AI group was statistically greater than the tamoxifen group. The AI group also had a significantly high rate of musculoskeletal problems than either group.

So, it is scientifically proven that at least in my first year after treatment my brain didn't work as well as it used to. We'll see if that can be extrapolated out over the years of treatment. However, in my own independent study with a sample size of one, I would say my cognitive function might be doing better than I thought. I took a certification examination in November for which I studied by reading 11 textbooks (2 of which I had previously read) and just found out that I passed and earned a couple more letters after my name.

Perhaps the cognitive difficulties decrease after the first year? I'll keep my independent study going because I will have to take at least 2 more national exams for certification during the remainder of my time on tamoxifen. Hopefully, I will continue to have positive outcomes.

 Source: Ganz, PA, Peterson L, Bower JE and Crespi CM. Impact of Adjuvant Edocrine Therapy on Quality of Life and Symptoms: Observational Data Over 12 Months from the Mind-Body Study. J Clin Oncol 34. DOI: 10.1200/JCO.2015.64.3866. 

Monday, February 8, 2016

Sucralose, downgraded to avoid!

I distinctly remember when Splenda (Sucralose) came out. My mother bought a lot of it. I baked a pecan pie with it. Then I did some research into it. Sucralose replaces a couple of hydroxyl groups with chlorine molecules. Chlorine. Like the stuff you put into your pool. But, that wasn't enough to get us to stop drinking beverages with it. It was enough to get me to stop baking with it.

Then in 2013 the Center for Science and Public Interest (CSPI) in their monthly publication Nutrition Action Newsletter released that an Italian institute, Ramazzini Institute, evaluated the additive and it has been linked to leukemia and blood cancers in male mice. Yes, mice are not humans, but that was enough evidence for my mother and I to completely cut it out.

Now, the Ramazzini Institute has finally published their study in a peer reviewed journal that details out how exposure over time can lead to increased risk.

Although CSPI states that the risk of over consumption of sugar (obesity, heart disease, diabetes) is greater than the cancer risk from sugar substitutes, I think I'll continue to avoid it. I'll add in  those on the CSPI chemical cuisine avoid list too.

Now, if I could just cut down on the sugar....(the battle continues)