I've been mulling and ruminating and thinking and worrying all weekend. I've looked at websites and journal articles and sites that calculate risk and discussion boards. I've looked at everything, tried to weigh the evidence, tried to make a decision. I'm angry at the oncologist for making what seemed initially to be a simple decision, more complicated. I'm angry at her for injecting doubt into the process. I'm angry at myself for being afraid of all the side effects. I'm angry that I have to deal with this at all.
So this is where I am right now: I feel like the evidence points at the fact that stopping the function of the ovaries in a pre-menopausal woman (like me) is helpful in preventing recurrence of breast cancer. It may even be equivalent to chemotherapy in its utility. So my thought is to go into one of the trials that gives you an injection each month, to stop your ovaries from working (and essentially puts you into menopause), and then randomizes you into one of two medications: Tamoxifen or an Aromatase Inhibitor (AI), both of which have also been shown already to reduce recurrence. Even without chemo, I'll have plenty of side effects to contend with: the side effects of early menopause (hot flashes, night sweats, etc. etc.) as well as the side effects of Tamixifen (similar to menopause) or the AI (joint pain).
Sounds lovely, doesn't it?
We meet with the onc on Tuesday, and will try to make sense of all this.