Survivorship

The AYA community (Adolescents and Young Adults) cancer community doesn’t like the term “battle cancer,” because it implies that somehow someone didn’t do enough if they “lose their battle” to cancer. While I completely understand and respect this, I can also understand how the whole “battle” idea came into play, especially when it comes to survivorship.

For the last year, there was a war inside my body against cancer. I hit it with major artillery and atomic bombs to get rid of the bad guy. Now I’m in the immediate-after, looking around at the rubble. I’m very shell shocked. I take a moment to just witness the destruction around me, inside me. I’m in awe that I’m still here, still standing. I mourn the loss of the life I knew. The life I was learning to love. I can’t look around too long or I’ll be paralyzed with fear and sorrow. Part of me wants to just collapse with the extreme weight of grief I’m carrying.

I start to survey the damage. There are surprises like: some of the rubble is smoldering and needs additional resources thrown at it to keep me safe; some of the rubble is going to be thrown out. Other than that, I’ll attempt to rebuild.

I vow to rebuild. To do better this time around. To come back stronger, or at least come back in general.

New Meds

This week, I started two new medications. “Maintenance meds.” To maintain my “no evidence of disease” status. They don’t feel very maitancy to me though. They feel extreme. They are extreme. It makes me so sad to have to do this to my body but at the same time I’m happy there are options to improve my long term survival odds.

First up is Letrozole. It is what is called an AI or aromataze inhibitor. It works by reducing the amount of estrogen in my body. Since the cancer I had really thrived and grew off of estrogen, the thought is get rid of what the cancer likes and it won’t come back or grow.

Second up is the PARP inhibitor Lynparza. It targets a specific enzyme, poly adenosine diphosphate-ribose polymerase (or PARP). PARP helps repair cancer cells so they can replicate. Lynparza messes with PARP, so the cancer cells can’t replicate. A bit of a “two birds with one stone.” Don’t allow replication and kill the cancer cell that isn’t allowed to replicate.

I wasn’t worried about this drug. Sure, it’s newer. Sure, it has only just been approved to treat BRCA2 mutation-positive breast cancer this summer. But whatever. It’s a fancy new drug and I’m on the forefront of medicine! Then I was required to do 3 separate education sessions on this medication. It was coming from a special pharmacy. I got a bit suspect. Why is everyone treating this drug with so much caution?

And then the truth comes out! Dr. Wells and Stacey were real cute in calling it a PARP inhibitor this whole time and not what it truly is…. an oral chemo!!! Honestly though, calling it a PARP inhibitor made it less scary. Hearing it called an oral chemo and having it arrive in a yellow hazardous bag makes me realize how serious I need to take this next chapter—survivorship. It reminded me that there are things I can do to set myself up for success, just like I did with IV chemo. If I don’t listen to my body, care and nurture it, I will suffer the consequences and side effects.

Now What

I’ve had a handful of doses of both medications. It makes me a bit nauseous. Water tastes funny again. Food isn’t super appealing in general. There may be more frequent bathroom trips. But its all easier than it was on IV chemo. These things are annoying but manageable so far with over the counter medication and pre-planning.

So, like everything else in cancer land, I move forward, into the unknow learning from those before me. Trying different hacks and trying to take the best care of myself. Scientifically, magically, and joyously living life.

Sources

• AYA Community: https://fwaya.org/adolescent-and-young-adult-oncology/
• Letrozole: https://medlineplus.gov/druginfo/meds/a698004.html
• Aromataze Inhibitor: https://www.breastcancer.org/treatment/hormonal/aromatase_inhibitors
• Estrogen-Dependent Cancers: https://my.clevelandclinic.org/health/diseases/10312-estrogen-dependent-cancers
• Lynparza: https://www.astrazeneca.com/media-centre/press-releases/2021/lynparza-granted-fda-priority-review-for-olympia.html
• What is a PARP Inhibitors?: https://en.wikipedia.org/wiki/Poly_(ADP-ribose)_polymerase