Recurrence: Taking Tamoxifen May Not Be Enough Protection.

Patient Expert

Breast cancer is a powerful punch to the gut, an emotional slap upside the head. Cancer is the big gorilla sitting in the corner; while you're going through treatment, it's an overwhelming fact of life that's impossible to shove out of your mind.

But as time goes by, the memories fade. You never forget cancer entirely, of course; it's a life-changing experience that stays with you forever, much like having a baby (only without the joyful outcome). Still, its presence in your day-to-day life diminishes, and after awhile taking that tamoxifen pill or that daily dose of Arimidex is no more disturbing or evocative than the handful of vitamins and supplements you swallow with your morning glass of OJ. Cancer stays with you, but its terror fades to fear, or disquiet, or maybe even disappears entirely, leaving in its place an acceptance of fate.

That's where I am now. Cancer doesn't scare me anymore. Maybe because I'm a full six years past treatment, with no signs of recurrence. Oh sure, the physical reminders are there, and will probably never disappear: the sore shoulder from mastectomy issues, the tingling and itching from chemo, the decreasing bone density and risk of fractures from continuing hormone therapy.

But emotionally, I'm fine. I look at the legions of women being diagnosed, going through treatment, and coming out the other side and think, wow, thank God for the medical community, for the doctors, nurses, and researchers who work so hard to make so many of us well again. I sorrow for those who draw a short straw, whose random encounter with this vicious disease ends in death. But I'm overjoyed that the majority of us DO make it, and go on to live our lives as survivors.

Even though I'm well past the scary part of cancer, I like to stay in touch with advances in research. Is there a cure lurking on the horizon? A preventive vaccine? Is there anything I should be doing to keep breast cancer at bay-or, anything I should STOP doing? Do I need a lifestyle change?

Well, maybe. Perhaps a lot of us do. A recent study published in a journal of the American Association for Cancer Research offers this information: breast cancer survivors with high levels of estrogen in their blood are much more likely to see a recurrence than those with lower levels of this hormone.

The study compared breast cancer survivors who'd remained cancer-free with those who'd seen a recurrence. And, after factoring in the variables, the study showed that women whose cancer had come back had estrogen levels twice as high as those who dodged the recurrence bullet. And this despite the fact that the majority of women were taking tamoxifen, a hormone therapy drug that blocks estrogen's ability to feed cancer cells.

What's the takeaway here? If you're a breast cancer survivor, you'll want to do everything you can to keep your estrogen levels low. How? First, if you're taking tamoxifen or an aromatase inhibitor, don't slack off. Renew your prescription on time, and be sure to take it every day.

Second, exercise. Physical activity lowers estrogen levels in your body naturally. And third, maintain your ideal body weight, which is within 10% of what you weighed as a healthy 18- to 20-year-old. Estrogen is produced in fat cells; the more fat cells, the higher your level of estrogen.

Exercise and lose weight easy to say, SO hard to do But even minimal efforts toward those goals are worthwhile. Because you don't want to join the current treatment crowd, and go down that cancer path again.