Let's Talk About Aromatase Inhibitors

Let’s talk about aromatase inhibitors (AIs). Since ridding myself of estrogen-producing ovaries, the next step is to start medication that will wipe out any remaining sources of estrogen. 

AIs are from a family of drugs that are androgen/estrogen antagonists, or hormonal oncologics. The bottle says take 1 per day “for cancer”. It should say “to prevent cancer recurrence” because with all due respect to the pharmacy, I don’t have fucking cancer anymore. 

I will, however, take this drug every day for the next 5 years that I can tolerate it. Its job is to prevent any rogue cancer cells from taking hold and growing, because it blocks the enzyme (aromatase) that converts androgen to estrogen, and without estrogen, my cancer cells can’t grow (so goes the theory). 

Some women have no side effects. Others have crippling bone and joint pain, hair loss, weight gain, night sweats, hot flashes, hyper-cholesterolemia, fractures, and osteoporosis. 

The side effects can be so bad that I enrolled in a study to track my adherence to the medication; they will provide mindfulness and other techniques to help me adhere (see the cool pill bottle with the micro USB port? It knows every time I open the bottle...). 

These side effects are to be weighed against the very terrifying possibility of my cancer coming back, should I decide not to take the drug - they would probably have to be horrific for me not to take it, but I guess we’ll see. I don’t think anything could be as bad as the fear of cancer coming back, but for some the survival benefit isn’t worth a survival of suffering. 

Tonight begins this next chapter of my breast cancer treatment, and the official start of tracking me with the pill bottle. Here’s to five years....