A Necessary Evil

Scripture of the day:

II Corinthians 1:3-5

Blessed be God, even the Father of our Lord Jesus Christ, the Father of mercies and the God of all comfort; who comforteth us in all our tribulation, that we may comfort them which are in any trouble, by the comfort where with we ourselves are comforted by God. For as the sufferings of Christ abound in us, so our consolation also aboundeth by Christ.

Hair loss with chemotherapy during breast cancer treatment is a given. The following is an article about why we lose our hair when we go through chemotherapy. The link directly to this article will follow.

Why and How Hair Loss Happens

Hair loss occurs because chemotherapy targets all rapidly dividing cells—healthy cells as well as cancer cells. Hair follicles, the structures in the skin filled with tiny blood vessels that make hair, are some of the fastest-growing cells in the body. If you're not in cancer treatment, your hair follicles divide every 23 to 72 hours. But as the chemo does its work against cancer cells, it also destroys hair cells. Within a few weeks of starting chemo, you may lose some or all of your hair.

If you are having chemotherapy, your hair loss may be gradual or dramatic: clumps in your hairbrush, handfuls in the tub drain or on your pillow. Whichever way it happens, it's startling and depressing, and you'll need a lot of support during this time.

Some chemotherapy drugs affect only the hair on your head. Others cause the loss of eyebrows and eyelashes, pubic hair, and hair on your legs, arms, or underarms.

The extent of hair loss depends on which drugs or other treatments are used, and for how long. The various classes of chemotherapy drugs all produce different reactions.

The timing of your treatments will also affect hair loss. Some types of chemotherapy are given weekly and in small doses, and this minimizes hair loss. Other treatments are scheduled every three to four weeks in higher doses, and may be more likely to cause more hair loss.

Chemotherapy drugs

• Adriamycin (the “A” in CAF chemo treatment) causes complete hair loss on the head, usually during the first few weeks of treatment. Some women also lose eyelashes and eyebrows.
• Methotrexate (the “M” in CMF chemo treatment) thins hair in some people but not others. And it's rare to have complete hair loss from methotrexate.
• Cytoxan and 5-fluorouracil cause minimal hair loss in most women, but some may lose a great deal.
• Taxol usually causes complete hair loss, including head, brows, lashes, pubic area, legs, and arms.

Other types of breast cancer treatments may also cause hair loss. For example,

Radiation treatment

Radiation only causes hair loss on the particular part of the body treated. If radiation is used to treat the breast, there is no hair loss on your head. But there might be loss of hair around the nipple, for women who have hair in that location. Radiation to the brain, used to treat metastatic cancer in the brain, usually causes complete hair loss on the head.

Hormonal treatments

Tamoxifen may cause some thinning of your hair, but not baldness.

No matter how forewarned you are and how ready you think you are, it's always a terrible shock when your hair falls out.

Hair, Skin and Nail Loss

If you are making this journey as I am, may God bless you with His healing touch. I know He loves you

Life After Letrozole

Scripture of the Day:

            “Peace I leave with you; my peace I give you. I do not give to you as the world gives. Do not let your hearts be troubled and do not be afraid.

John 14:27

I am curious about what it will be like to go off my Letrozole in August. My doctor has given me the choice. So I started looking at what some people are saying about it. I am so tired of the pain that comes with the medication. I am also curious about weight loss. I have not found anything on that yet. The sites I have looked at say that weight gain is one of the side effects. I can tell you that I went to a Rec Center 5 days a week for 7 months and only lost 8 pounds. So I'm hoping for a change in that area. 

If this is a concern for you there are certainly more than one site with discussions about stopping that medication. I have not, as yet found any medical information about it. 

Going off Letrozole - this is the link for the following conversations. 

Going off Letrozole (Femara) after 5-1/2 years

by artgirl2014 on Wed Nov 12, 2014 10:59 PM

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In 2008 I was diagnosed with breast cancer.  I had a mastectomy and was placed on Femara (Letrozole).  I stayed on it faithfully for 5 + years but decided about 6 months ago to stop.  My oncologist gave me some information on research showing that patients who remain on these AI drugs have a decreased chance of recurrence in 10 years.  Since I am 65, I am very concerned about my bone health and because of the Letrozole, I now have severe osteoporosis.  I also suffered from a considerable amount of joint pain and other less serious side effects.  If you have had a similar experience and chose the same path, how are you doing and are you relieved that you made the decision to stop?  I am busy second-guessing myself right now and would like to hear from others!  Thank you!

RE: Going off Letrozole (Femara) after 5-1/2 years

by ljt33 on Wed Nov 12, 2014 11:41 PM

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I am compelled to write, because I too was diagnosed with BC in 2008, had a mastectomy, chemo, radiation, and then 5 years of tamoxifen.  I am now 53.  In April, I was running 3-4 miles a few times a week, was down around 153, and generally feeling great.  My doctor said that "studies have shown" that after 5 years of tamoxifen, one in my demographic should switch to 5 years of Femara, so I did -- around May of this year.  By mid-June, I had many aches and pains, could barely run around the block, and had gained 10 pounds.  I sought treatment from PT and orthopedic specialists, thinking that it was from too much running.... but secretly, I blamed the Femara.  That was the only change in my life right then!

With my doctor's ok, I went off the Femara at the end of July, and then went 3 months not taking anything.  I'm back to running, albeit I have to build myself back up, but at least it is relatively painfree.

I do not think you are crazy to go off the Femara.  It will be interesting to see if, in a few months, some of your joint pain and other things go away.  If so, it might be worth it just for that.  If you change your mind, I'm sure you could go back on it.  But I would also ask if there were any other drugs with the same/similar effect.  I am back on Tamoxifen, which I find is just fine.  The aches and pains on Femara though were negatively affecting my life!

RE: Going off Letrozole (Femara) after 5-1/2 years

by ljt33 on Wed Nov 12, 2014 11:43 PM

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Ooops - I overlooked your statement that you had already stopped Femara 6 months ago.  Has your joint pain subsided as well?

RE: Going off Letrozole (Femara) after 5-1/2 years

by artgirl2014 on Wed Nov 12, 2014 11:48 PM

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Much better.   Still some pain but so much better than it was!  Thanks so much for responding.  I was a runner, earlier in my life.  It was the one exercise that made any sense to me.  It was very organic in a way --- like I was connecting to all those who ran before me and before all of the health clubs and exercise equipment.

RE: Going off Letrozole (Femara) after 5-1/2 years

by mlbieds on Thu Nov 13, 2014 12:27 AM

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I was diagnosed in November 2007, was lucky to have lumpectomy and radiation, followed by Tamoxifen. Tamoxifen was easy for me, until I broke my leg and then got a blood clot. The docs blamed Tamoxifen for the blood clot, and switched me to Arimidex. I stayed on it about a year and was having so much joint pain my Doc switched me to Femara. I hated it too. There were days I could hardly get out of bed, and the first ten feet or so of walking were excruciating, but got better the longer I walked. After five years (total for all drugs) I decided to go off the Femara. My onco doc wanted me to complete five years on the Femara (in addition to the 2.5 years I was on Tamoxifen and Arimidex). I said no. This was about a year ago. A lot of my joint pain went away, but not all of it. I recently had a physical and found I was very low on Vitamin D. From reading on this forum, I believe it is a side effect of the Femara, and most likely the reason I still have bone/joint pain. I am working now to get my D levels up to where they should be. I am still fatigued, but have some weird blood issues to blame for that (as far as I know, not related to cancer). At the end of the day, I balanced taking the meds with quality of life, and that is something only you know best. Good luck. Mary Lou

If you are making this journey as I am, may God bless you with His healing touch. I know He loves you.

Look how far I've come

Scripture of the Day:

Proverbs 3:8 (NLT)

            Then you will have healing for your body and strength for your bones

February 27, 2012

Tomorrow is the anniversary of my biopsy. As I’ve said before, this is not an anniversary I particularly want to celebrate even though I should. Yesterday, the service at Tabernacle Baptist Church seem to be all about me even though we all know lots of us get the same message for whatever reason. But breast cancer was actually mentioned. I’m not the only one in the congregation that has it. Pastor Baker talked about trusting God and His infinite wisdom and trust that He won’t desert us. One of the hymns was Standing on the Promises of God. This was the first hymn that spoke to me a year ago. What an awesome feeling to know  He was right  there beside me yesterday.

Am I still sad? Yes. Do I feel like celebrating yet?  Not really. But do I feel like I’m in the arms of Jesus and he’s encouraging me? Yes and Amen. Today is the first time in a couple of weeks that I don’t spend a few minutes out in the car crying before I start my day.

There were also things said in the sermon that made me feel right about retiring. I’ve often thought if I’d known then what I know now, I might have picked a different career. Well, I know now that the opportunities are out there and God will put me where He wants me.

I just watched Joel Osteen. It was the same thing – a message for me. It was much the same, except when you think about your problem, look down. It’s under your feet. I liked that phrase. 

June 20, 2014

It's been over 3 years since this time in my life and I still am not thrilled when those anniversaries roll around. But it is neat to read this again and remember what an impact God had in my life then. And He still does. I am never alone and it feels wonderful. 

I have started getting out and exercising at the local gym. I am enjoying that. I'm meeting new friends and working to stay healthy. 

We had cancer insurance that I bought because I used to smoke. I figured I'd get lung cancer. I carried this for almost 20 years before we had to use it. We were discussing policies and whether we should keep them. I am just not secure enough about my recovery to let that one go. My husband, David, was great about it. If it gives me some kind of security, then we keep it. As a cancer patient, I am now uninsurable. I can't get life insurance or elder care insurance or any medical until I've been cancer free for 5 years. I have 2 to go.

April 21, 2016. 
I have had my oncology check up and my breast surgeon check up for April. I will come due again in October. To important things will happen at that time. With my oncologist, I have been given the choice to get off of the Letrozole. I get to choose. I have taken aggressive action with my treatment of my breast cancer. But I'm pretty sure that I will choose to get off of this medication. The side effects are hard to live with. I will have to visit my oncologist once a year forever.  

With my breast surgeon, it should be my last appointment. I will not have to go back there any more. Just look where God has brought me!!

If you are making this journey as I am, may God bless you with His healing touch. I know He loves you.

Take a Break

I will be taking a break from my blog until April 21. If you are a cancer survivor, then you know it's important to get out there and live. That is what I'll be doing with my sister. We're on our way to Germany to visit my daughter and see some sites.

Is Chemo Working?

Scripture of the Day:

Isaiah 58: 8

Then shall thy light break forth as the morning and thy health shall spring for the speedily: and thy righteousness shall go before thee, and the glory of the Lord shall be thy reward. 

How Can We Tell if Chemotherapy is Working?

With the exception of adjuvant chemotherapy, in which there is no apparent cancer present, the effectiveness of chemotherapy on cancer cells is measured in terms of "response."  The techniques to monitor responses can be similar to the tests used to diagnose cancer. 

• A lump or tumor involving some lymph nodes can be felt and measured externally by physical examination
• Some internal cancer tumors will show up on an x-ray or CT scan and can be measured with a ruler
• Blood tests, including those that measure organ function can be performed.
• A tumor marker test can be done for certain cancers

Regardless of the test used - whether blood test, cell count, or tumor marker test, it is repeated at specific intervals so that the results can be compared to earlier tests of the same type.

How is response defined? Response to cancer treatment is defined several ways:

• Complete response - all of the cancer or tumor disappears; there is no evidence of disease.  A tumor marker (if applicable) may fall within the normal range.
• Partial response - the cancer has shrunk by a percentage but disease remains.  A tumor marker (if applicable) may have fallen but evidence of disease remains.
• Stable disease - the cancer has neither grown nor shrunk; the amount of disease has not changed.  A tumor marker (if applicable) has not changed significantly.
• Disease progression - the cancer has grown; there is more disease now than before treatment.  A tumor marker test (if applicable) shows that a tumor marker has risen.

When is response measured? For a newly diagnosed person who has been prescribed chemotherapy for cancer, the number of treatments is set.  For example, an oncologist will prescribe a specific number of chemotherapy cycles based on the treatment protocol.  Responses may be measured during the chemotherapy, but the number of cycles does not generally change unless the cancer grows.  If the cancer grows, the chemotherapy will likely be stopped or changed to different drugs.

For a person who has had a recurrence or has advanced disease, a specific number of cycles may not be prescribed.  Rather, 2-3 cycles are given and then response is evaluated.  If the disease is stable or shrinking, additional chemotherapy may be given as long as responses are maintained, provided the toxicity of the chemotherapy is tolerable.  In general, a minimum of 2-3 cycles of chemotherapy is required in order to measure response.  One cycle of chemotherapy may not be adequate to evaluate its effectiveness.

Is Chemo Working?

If you are making this journey as I am, may God bless you with His healing touch. I know He loves you.