Anyhow -- as I get to the five year mark of this particular phase of treatment, I am faced with a fun decision. Do I continue this treatment, which is an aggressive choice? Now that I've done the five years the science shows is beneficial, there is no data to show it is more (or less) effective than other options. It probably is? We think maybe? This is a feel good for reducing cancer risk but comes with an increased risk of heart disease and osteoporosis, because the early menopause does that.
Do I instead take one of those other options (stopping the current treatment and hoping for the end of menopause, while still taking different medications)? This is a possibly less aggressive choice, they don't know for sure, but it comes with less risk of heart disease and osteoporosis...if my ovaries kick back in as hoped.
Do I go with what is behind door number three, of getting the ovaries out and committing to irreversible menopause? Finality and the most aggressive option. But I am 42. I don't know if I am ready to be 100% committed to that.
I'd like my old brain, and my old body, back. I would. But I would not like the cancer back. Oh no I wouldn't. I definitely would like to not die while I have young kids, and would also prefer to not die until I have grandchildren. And then some. But man.... wouldn't it be nice to feel 42 instead of 62, or whatever this is comparable to.
No data. Big decisions, no data. Gut feelings and anxiety to base your big decisions on. Look at your kids' faces and choose the aggressive treatment, then look at your own face in the mirror and think how it might feel to get a bit of yourself back from cancer. There are no good ways to make these decisions. I have a few months to ponder this. I am probably going to go with option two and a half: stop the awful Lupron shots (which force the menopause) and wait and see how my body's estrogen levels change over a couple of years. Maybe they don't. Then we know my ovaries are kaput and the decision is made (they come out, because kaput or not I have an elevated risk of ovarian cancer with them in, given my history). If they do turn on, then I've postponed the decision, and I won't feel like I decided to sacrifice a return to before-ness that was a mirage in the first place.
"It really isn't fair, the kinds of decisions we have to make." -- my First Descents cancer sister. Amen.