Sunday, December 14, 2014

My Decision on the Oophorectomy

Some of you who are friends with me on Facebook may have seen the news that I will not be having surgery on Monday.  For those who didn't see the news and for detailed follow up on the reasoning behind my decision, I thought a follow-up blog post was in order.  So, here is a taste of what was going on in my brain late last week.

The SOFT trial yielded the following results so far, announced Thursday morning:
  • Among those who underwent prior chemotherapy (mean age, 40 years), researchers observed a 22% (HR=0.78; 95% CI, 0.6-1.2) reduction in relative risk for recurrence among those who received tamoxifen plus ovarian suppression compared with those who received tamoxifen alone. The decrease — which was not statistically significant — equated to four or five fewer patients out of 100 developing recurrence within 5 years.
  • Researchers observed a 35% (HR=0.65; 95% CI, 0.49-0.87) reduction in risk for recurrence among those who received ovarian suppression plus exemestane compared with those who received tamoxifen alone. The decrease translated to seven or eight fewer patients out of 100 developing recurrence within 5 years.
Drew and I spent a long time discussing this data, as well as my potential quality of life for the rest of my life due to having my ovaries removed.  The way we looked at it, if I had my ovaries removed and I began taking exemestane (or another aromatase inhibitor), statistics based on this study would show I may have a 7-8% better chance of not having a recurrence (moving me to stage 4 cancer).   I am considered "High Risk", due to the size of my cancer and being considered "advanced stage" (stage 3c).   Thus, the study showed patients like me benefited most from ovary suppression/removal.  However, in the back of my mind, I kept wondering, is this really what God wants me to do?  I am most interested in what the "Great Physician" and healer wants me to do.  He gave me these ovaries and He can take away--but is that what He wanted?   I still wasn't sure--but 8% didn't seem like a significant number to warrant me going to get my ovaries out in just a few days.   If I have my ovaries removed, there is a 100% chance I will suffer side effects that could harm me long-term.  At my pre-op appointment with the surgeon on Thursday morning (before the data was released), I explained to her that I wasn't feeling at complete peace about the surgery.  She told me that I shouldn't have the surgery if I don't completely feel at peace about it.  But, I needed to let her know that afternoon whether I was canceling the surgery.  She did say that the goal of doing this was to be able to "make it" to menopause age.  Yes, I may suffer many nasty side effects due to going through full-blown menopause at my young age.   But, at least it could potentially give me a better chance to live longer.  Plus, Dec. 15 really was an ideal time for the surgery---Drew had time off to help since I would have restrictions for 2 weeks.  We had met our large deductible for the year.  I figured, if I was going to eventually have my ovaries out, may as well have them out now.  But, Tamoxifen wasn't giving me the problems it was previously.  Would I ever have those problems again?   I am "supposed" to be on Tamoxifen for 10 years total.  Arrrrgggghhh.  What to do, what to do?

Next, I pulled out the Bible--it has so many answers--could it have an answer to this question, "Should Heather get her ovaries taken out?", it doesn't have the literal answer to that question.  But, I just wasn't getting an answer or peace either decision (to have or not to have them removed).  So, I prayed again for God to make it clear to me and then I just opened the Bible.  Here is what I read immediately upon randomly opening the Bible:  "Do not trust in nobles, in man, who cannot save.  When his breath leaves him, he returns to the ground; on that day his plans die.  Happy is the one whose help is the God of Jacob, whose hope is in the Lord his God, the Maker of heaven and earth, the sea and everything in them.  He remains faithful forever." (Psalm 146: 1-6).  I could definitely take this to mean, "Don't trust in the statistics that man came up with as a result of this trial--God is in control of all things. He is your maker and knows YOUR body best."  Was He telling me that He would let me know without a doubt when/if He wanted me to remove a body part that He gave me?   Well, after also speaking to parents and talking through it all with Drew, I began to receive affirmation that this just wasn't the right time for the surgery.  In fact, I am not sure if it will ever be the right decision.  

So, I cancelled my surgery.   I am still not 100% certain that the right decision won't be for me to have my ovaries removed someday.  But, for now, they are staying in.  Now, if Tamoxifen starts rearing its ugly side effects head again, it may be my only option.  But, until that day comes, I am going to appreciate and enjoy the extra estrogen.     :-)  

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