Now that you've been adequately warned, here's some background. Up until age 41 & 5/12ths, I had been rock-solid and dependable in the menstrual cycle area. The general rule is that if you receive chemotherapy before age 40, your periods may be interrupted and will return after chemotherapy finishes. If you are over age 45, chemotherapy will cause permanent menopause. As usual, I was stuck in the murky middle. Shortly after I got my second dose of chemo, my period got really whacked out and just quit entirely. Time went on and on with no period. After six months, my oncologist said it would likely not come back. After a year she said I can consider my periods to be finished and myself in menopause.
Two weeks later... SURPRISE!... the period came back. Rock solid. 28 days apart, very little variation.
That was October of 2009 when the periods came back and I was 42. My oncologist said that menstruation might be back to where it was pre-cancer, but maybe not. Chemo probably damaged the healthiest eggs and at my age, I was running out of healthy eggs anyway.
(as a side note, I know several people who have struggled tragically with post-cancer fertility. It makes me so sad and I find those people tend to struggle in private. I had not plans to have more children after cancer, so I am in no way even close to experiencing that kind of loss.)
This April, my period was a little strange. A little longer than normal. Notable, but not alarming. In May and June it was mostly on time but a little late and a little light. Since June 15th... nothing.
Fortuitously, my annual PAP smear was scheduled for today, not quite three weeks since I should have had my last period, so I decided to wait for the appointment to pursue it.
Yeah, my Ob/Gyn said it.
"You're too young for Uterine Cancer, but then again, you were too young for breast cancer."
and
"Uterine cancer and breast cancer can be related."
He offered me a few options:
1) Have an ultrasound to check out the lining of the cervix, which thins and deteriorates during menopause. To be safe, he thinks we should do a uterine biopsy at the same time.
WHAT?
2) Take progesterone for a week to see if my period starts.
WHAT?
He asked me if I am allowed to take hormones. I told him I am "extremely unwilling" to take hormones. He said it's only for a week. I said I don't want to do that.
3) Do a blood test to check my FSH (follicle stimulating hormones) levels. If the level is high, that means my wee little brain is trying to make my ovaries do their thing. That would indicate that this is a menopausal issue.
Ok. I'll do that.
I did that.
But I've been feeling panic since that appointment this morning and I won't even get the FSH results for a week.
Does everyone who misses a period for three weeks get threatened with cancer?
I had some more errands to run, but when I got home, I started googling. I'm not sure uterine and breast cancer really are related in the absence of taking tamoxifen. I didn't have a hormone-sensitive breast cancer, so I'm not sure there is any correlation at all. I assume that he's just being overly cautious with me. Other than this blood test, I will not make another move without consulting my oncologist. I have my next appointment scheduled with her on Sept 7.
One concern to me is that this FSH test might be kind of meaningless because hormone levels can change daily.
Let's face it. I'm 44. Menopause at this point may be early, but it's not out of the question, especially considering my recent history.
I'm kind of panicking though. HELLO PTSD! Did my doc really need to bring this up to me? Couldn't we lead with "menopause" and talk about "cancer" later?
So I'm desperately seeking stories here. Anyone else have something similar post-chemo?
And I'm remember what I tell everyone else... when you hear hoof beats, think horses, not zebras. Here's the problem though. Once you find out that you've heard the zebras once, you that sometimes it's zebras.
UPDATE!!!
First off, I am so grateful for how people just jumped in here with wisdom. Slowing down and breathing and not panicking are definitely in order right now. Since I have zilcho impulse control, I called my oncologist. She is out of the office, but I spoke with her NP. She confirmed that the link between the two cancers is tamoxifen, which I did not take. When I told her how he jumped right in with cancer and biopsy talk, she said... oh geeeez. She's going to talk to my oncologist and call me tomorrow. I think I might try to get recommendations from her for docs to see in the future. I think I need doctors who understand the complicated world that birthed me a couple of years ago -- physically, emotionally and spiritually.
14 comments:
take a deep breath.
periods get whacked out post-chemo. i wonder what kind of experience this doc has with these issues? i would definitely contact your oncologist before taking anything, and i would also line up a second opinion.
oy.
Thanks Lani. I was going to wait for tests, but I think I might just call my oncologist.
Katie, first off, slow down. Periods are so wacky at this age. It could totally be menepause related. I know it's automatic to think cancer. I did late last year when my period changed and became very heavy and then an ultrasound showed a thickened lining. I swear the radiologist was thinking uterine cancer, because WHAT ELSE could it possibly be? Turns out it was caused by Tamoxifen, and a uterine biopsy proved benign.
BTW, I was freaked out at the thought of that biopsy, but it was exactly like a pap, that quick only a bit more pressure. Anyway, what I'm saying is try not to think the worst. I don't want to clog your comments with my gory details, but I'm happy to share if you'd like to know more.
Sorry I can't answer the post chemo questions, but you're not alone with period issues. Crazy menopause and stupid cancer really mess things up.
Def call the oncologist. Be aware the progesterone will wack your cycle out, good call not to take it.
FWIW, I was perimenopausal at my late 40s, so it's not as unusual as you think to hit menopause early.
Remember Rule #1: Don't panic.
Hugs.
Agree w/Lani, Katie. The Mack truck in the room is the manner of the physician. One weird period does not a cancer make. Grrrr. Starting with the least invasive testing, and moving to other methods of testing (if necessary) is the way to go.
jms
what chemobabe said. onco n gyno worlds are so far apart.
i've been thru chemopause 3 or 4 times and every time it came back differently. after one bout of chemo, i did have some issues with a thick lining of the uterus that resolved itself. chemo makes your uterus confused n say "dude what the hell?"
you may be too young for menopause but after chemo, all bets are off...so you may very well be entering the dreaded hot flash/night sweats zone. so FSH is a good call. I get mine done regularly to make sure my body isn't getting up to hijinx and trying to be female again.
i would call the onco. as far as the gyno, the U/S and biopsy are really no big deal if it's an in office biopsy. it's just a straw like thing inserted n grabs a small bit of the lining. i had it done with no anesthesia or anything. it feels like an uncomfy pap.
don't panic....those headlights you see don't necessarily mean a mack truck.
Hi Katie,
I'm so sorry you had to have that alarm simply because your gyn was so insensitive. He had no right to even say the C word.
It's good you called your onc. I totally think that is the best thing.
And I would stay off Google. Trust me, as a googler myself, it does more harm than good to do research on the Internet in situations of panic. I've done research when panicking, and it's led to more fear and lots of crying.
I would definitely go with the FSH testing. I did it post-chemo and learned I was in full menopause. No birthing kids in my future (lots of loss), but I adopted my cutie-pie.
Keep us updated. In the meantime, take deep breaths and do nice things for yourself. You deserve it.
Katie, echoing what everyone has said, it's entirely NORMAL at your age for periods to start being erratic. You are allowed to be NORMAL sometimes!!!!
You know, maybe it could be related to your weaning off the meds, too. I definitely got wackiness in my cycle both times I weaned off similar meds. I know they aren't really hormone-related drugs, but it was awfully coincidental and at the time, my doctor said it was common just because you're body is trying toestabalize its systems or some such. At any rate, I went back to normal a couple months after the Wellbutrin and the Paxil. Just something to consider.
Most likely it's just one of those Joys of Womanhood: Hormone Town episodes. But lots of encouragement and good vibes heading your way just for good measure!
Thanks again everyone. Sarah, I hadn't even considered those two things together... thank you.
As many of the comments mentioned, the main symptom of uterine cancer is abnormal bleeding (thickened lining of the uterus), not lack of bleeding. I'm really surprised your GYN would've jumped right to cancer with your symptoms! Talk about insensitive.... Your oncologist's NP was right on with the oh geez, and you're right on with looking for a new GYN who has a bit more understanding.
Oh no..Just what you needed.
I am 53 and hoping the periods I STILL have like clock work will go away during chemo
The only good part of it.
With my luck ...they'll come back like yours.
I am with your oncologist ...Oh geeeez
Why scare you to death jumping with this result so fast.
Hang in there...Hopefully its just menopause coming on
I read your post last week about Rebecca and thought of her when I was out on the boat in our pond as the sun was setting . It was beautiful and I smiled thinking of her.
I went via your link..And read back some on her blog. So sad...but have to save I loved the "I'm outta here" last post.
My thoughts and prayers are with you over the loss of your friend. (((hugs)))
The video was awesome...She would have liked that
Debbi~ http://atoosassygal.blogspot.com/
Katie - odd...I just went through this which is why I am only just now reading this post! I didn't have chemo but I did have an oblation to deal with the side effects of CONSTANT periods from Tamox. An oblation SHOULD result in no periods for 5 years. But here I am 2 years later spotting -- and I stopped Tamox after taking it only one year. At My annual my doc said those magic words "ultrasound" and "biopsy" that are sure to send any cancer patient into hysterics. The ultrasound showed NOTHING (which makes cancer unlikely) and I am still waiting for the test results to come back from the biopsy. Apparently if the biopsy shows nothing they still want to do more invasive tests. And I am thinking...if I don't have cancer I really don't care WHY....cancer has gotten me over WHY - sometimes it just is.
I have had solid menopausal symptoms event though I am only 42 -- but considering what they have done to my body to save it I am sure IT thinks it is much older.
I wrote a piece to go on my blog about how terrifying this was....I will put it up later today.
Good luck to you!!!
Lest you hadn't figured out, Jody seems to be right on the money, I, too share your lack of impulse control, as well as a lack of patience for caregivers/doctors who don't seem to care about what they do.
Fight on.
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