The Story of the Eggs

During chemotherapy, I received Zoladex shots once a month and quickly learned what it possibly feels like to go through menopause, i.e. not fun! Zoladex shuts down your reproductive system. Its purpose for me was to help protect my ovaries and eggs from the harsh cocktail of chemo poisons I was receiving on a weekly basis. The most common type of cancer associated with BRCA1 mutation carriers is triple negative. Triple negative means the cancer tumor has no hormone receptors. This is the type of cancer both my Mom and I had, so shutting down my ovaries to help protect them was its sole purpose. Other types of breast cancer tumors with hormone receptors, Zoladex is used as a form of treatment to shut down hormone communication within the body in order to inhibit reproductive functionality, and prevent further tumor growth.

Unfortunately shutting down my reproductive system invited many unwanted menopausal systems such as major hot flashes and vaginal dryness. I never knew how debilitating a hot flash could be until I was on Zoladex. I’m sure many of my BRCA sisters who have gone through this can relate to the wave of anxiety that would hit right before a hot flash took effect. And once you knew it was coming, there was no way to stop it until it reached its peak and started to subside. My entire face, neck and chest would turn bright red. My skin felt like it was on fire from the inside out! If I was home, I would rush to the freezer and literally stick my head in the freezer door until it passed. And these hot flashes would hit at any time, day or night, with no rhyme or reason. They would wake me in the middle of the night. I’d throw the covers off and lift my shirt until the internal blaze passed! I know it’s not a pretty picture, but for those who’ve had to take Zoladex like myself, it’s nice to know that enduring months of uncomfortable red, sweaty hot flashes, was not an exercise of futility! These shots might’ve worked!

I recently had some blood work done that checks hormone levels at a specific time within the menstrual cycle. These levels indicate egg viability, and to my pleasant surprise, my numbers were strong, which means there’s a very good chance that Zoladex did in fact help protect my ovaries and eggs against the wrath of chemotherapy!! 🙌🏻

It is becoming more & more common for BRCA mutation carriers to freeze their eggs as women decide to take further prophylactic measures to ensure they don’t get ovarian cancer, which is significantly harder to detect vs. breast cancer. Screening techniques for breast cancer are more advanced. The only screening technique for ovarian cancer is a transvaginal ultrasound. I’ve been getting those since I found out I was a mutation carrier at 25. I’m sure MRI’s are used as well, but ultrasounds are the most common. They’re not, however, a great screening tool for early detection and ovarian cancer typically does not show many early symptoms of tumor growth, which makes it a dangerous type of cancer to have.

There’s also a blood test that may help indicate ovarian cancer, called a CA 125, but it is not as accurate as one would like CA 125 – Mayo Clinic.

Really, the best measure against preventing ovarian cancer is removing your ovaries. For many BRCA mutation carriers, recommended age is 40, though some studies suggest women with very high risk, BRCA mutation carriers with a strong family history of ovarian cancer, should consider oophorectomies by 35. In my case, being that there’s no family history of ovarian cancer besides being a BRCA1 mutation carrier, my Oncologist recommends oophorectomy by 40. I am currently 38.

Thankfully we have a beautiful healthy boy, now a little over 2 yrs old. We are considering adding to our family. I turn 39 this August, so when you think about how long it may take to conceive, plus the 9 months you’re pregnant, 40 is really just around the corner! My husband & I don’t want to risk anything being that I am already a breast cancer survivor. Once you have cancer, your risk for any type of cancer increases. We decided to meet with a fertility Dr to discuss our options. We were considering artificial insemination. After speaking with the Dr, we’re now considering IVF, which has the highest % of conception, 80%, which is ironically the same chance of breast cancer with a BRCA1 mutation. With IVF, we would also have the opportunity to screen embryos for the BRCA mutation. Considering embryonic genetic screening is fairly expensive, it’s possible insurance may cover it being that I am a cancer survivor (something to look into fellow survivors).

So now some decisions need to be made. Whether or not we have another child, my ovaries need to go by 40. Which leads me to the next topic, my BRCA sisters, regarding medically induced menopause at a younger age. There are multiple health factors to consider when dealing with early menopause. Topics such as hormone replacement therapy, osteoporosis, heart disease and even dementia, need to be discussed, as all are increased risk factors when deciding to pursue an oophorectomy at a younger age.

So much more to discuss! Until next time my BRCA sisters… As always, please feel free to share!!!

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