The Toughest Lesson So Far

I started taking bioidentical hormones in 2009 to treat anxiety and depression. The information available at the time about the safety of hormone replacement therapy was just as useless as it is today: a mish-mash of research to show that yes, women can experience huge relief from hot flashes and mood issues and, oh yeah, they might also get cancer.

At the time my doctor recommended that I take the progesterone and estrogen (because I was still menstruating) but only for a few years, to be on the safe side. And at the time, to my great regret, I thought that was a fine idea. If it’ll help alleviate the anxiety that I just couldn’t shake any other way, I was up for it.

So I took progesterone tablets and rubbed estrogen gel on my skin every day. And I was less anxious. After three years I weaned myself off of it. So far, so good.

You know what happens next. In just the same way that I can’t be sure it was the hormones that reduced my anxiety, I can’t be positive that they gave me cancer. But I did get cancer and it was the hormone-fed variety. Even if the hormones didn’t cause the cancer, it certainly helped it grow. It’s possible, I suppose, that my body might have been able to address the cancer cells and flush them away had it not been for the hormones I was taking daily.

My breasts were very dense so I was going in for mammograms every six months. I had that last mammogram (I’ll never get another one) the day after we had dropped our older daughter off at college. It was September 2016. The doctor recommended a biopsy to look at an area that could have been fibrous breast tissue but could also have been cancer. 

I got the phone call later that week. I’ll never forget sitting with Chris in my doctor’s office while she drew a chain of milk ducts on the examination table paper. Some of my cancer was DCIS, in the milk ducts, but there were also stage 2 tumors. Chris says I was crying too hard to hear the doctor say that it looked like they’d caught it early. But I doremember saying, “It was the hormones!” And I remember her quietly saying that the hormones might have helped the cancer grow but probably didn’t create it.

Thanks.

The hardest part was all of the other tests that followed to find the full extent of the tumors. It seemed to take forever, waiting for results and then for my surgeon to decide whether she wanted to know more. It wasn’t long before I decided to have a double mastectomy. My feeling was that I didn’t want to have any repeats (in the breasts anyway). I just wanted all the breast tissue gone. Also, my breasts were huge and I didn’t exactly love them. (A silver lining to all of this that I’d discover was being able to take up running again. No more big boob pain!)

Then Trump was elected. The world skidded into a hell pit.

It wasn’t until December that I had my surgery. It went well and I spent long, drugged-out days napping and watching Mozart in the Jungle. Chris was my nurse and our cat was his assistant. I healed well because I slept a lot. 

After that, radiation for six weeks, which sucked. It was like getting a bad sunburn, coming home, liberally applying aloe vera, and then heading back to the beach the next day. And the next. And the next. For a long time.

I didn’t need chemotherapy but I am taking tamoxifen. Ironically, tamoxifen works by preventing any aberrant cancer cells in my body from bonding with the hormones I still create. A hormone blocker. Sort of the opposite of taking hormones.

It’s hard but also helpful to write about this. I regret using hormones. I believe that I might have found some other way to address my anxiety (which was not minor). But what’s done is done. 

To anyone out there who’s considering hormone replacement therapy for whatever reason I say, think long and hard about other options. Acupuncture. Herbs. Therapy. Anti-depressants. Cannabis. Hysterectomy (seriously). A shocking number of doctors recommend hormones for women just to keep their post-menopausal vaginas nice and moist. That right there is bullshit. Our bodies change. We should strive to embrace the changes because there’s no magic pill that will keep any of us young. It’s just not worth it. I’m not sure what this means for trans women, but I worry about them too. One thing I’ve learned: don’t mess with hormones.

All of this happened against the backdrop of an extended peri-menopause. My body changed a lot when I had the mastectomy, but there have been other, less dramatic, changes too. My skin is less elastic, I’m not as horny, I get hot flashes (though thankfully not terrible ones). 

After radiation, we headed to Kauai.

Interestingly I am also less moody and feel far more focused. As I write this I have to say I’ve never been happier. Post cancer, I’ve learned how to live more easily with uncertainty. I’ve learned how to avoid worrying about things that probably won’t happen (which is most bad stuff). Like comic Tig Notaro, I’m super happy to be here. It feels good to hear someone who's had cancer make jokes about it. Here's mine: My breasts were luscious, but then I found out they were trying to kill me.

Next post: The silver lining no one wants you to know about menopause.