The Importance of Health

Immediately after health authorities announced that we would be affected by the COVID-19 pandemic, my mother was diagnosed with breast cancer. 

Less than two months prior, she had mentioned a hardened area in her right breast. Honestly, I did not pay much attention since she regularly brings up non-existent health conditions. In addition, I was working so much that I made myself believe, “It is nothing. My mother is too healthy to have breast cancer.” When I finally felt her breast, she had a hard surface that measured about six by four centimeters. The moment I felt it, I knew something was wrong. Within one month, my mother had a definitive breast cancer diagnosis, had undergone surgery, and received her first round of chemo. We moved very fast to achieve the best health outcome possible. In less than two months, life had taught me a fundamental lesson. No matter what, health is our most important asset.

To disclose a little bit of my mother’s health information (with her permission), she has lived a very healthy lifestyle all her life. She has tried to eat healthily, never drank alcohol or smoked tobacco, and always avoided the sun. About six months prior, my dog (her favorite living thing) rambunctiously hit her in her right breast while welcoming her to the house. At the time, we did not make a big deal out of the hit. The impact of his giant paw on her petite frame must have caused some damage. Breast cancer symptoms can be a pain, discomfort, changes in skin color or skin appearance, or nipple discharge or retraction, but most commonly women can feel a lump or a mass on the breast or underarm. Yes, an injury to the breast can be a cause of cancer.

When I logged in to the Mount Sinai electronic medical record system and read the diagnosis, I felt my life was ending. One of the people I loved the most would be taken away from me. My mother has been my example for years. Her strength and perseverance have guided almost every decision in my life. She left Cuba at age 55 with only the clothes on her back in search of a brighter future for us. I am thankful for that choice.

Although the breast cancer she had was not the fastest spreading, the oncologist decided to create an aggressive treatment plan to cure and prevent cancer from returning or spreading. Metastatic breast cancer can be serious and more difficult to treat, we were lucky that hers was caught very early. The side effects of chemo led to nausea, vomiting, diarrhea, and fatigue, but the worst came after the treatment was over. She started to lose her strength, her memory started to fail, and her bone density diminished to the point where even a gentle fall could lead to a bone fracture. Her quality of life was reduced to the point that I could hardly recognize my own mother.

While researching possible treatment options for her, I came across anti-aging and age management and the possible safe interventions she could try. When her oncologist declared her cancer free, I started her on testosterone replacement therapy. She felt a difference within two weeks. She also started progesterone one hour before bed and took high doses of certain supplements to act as anti-inflammatories. Inflammation is one of the worst consequences of diseases like cancer, diabetes, and obesity. Her labs were a mess after chemo; her markers of inflammation were through the roof. Two months after I started her on hormone replacement treatment, her values normalized, and her symptoms disappeared. She was no longer tired, her memory returned, and her will to live was vibrant.

What effects did the testosterone have on her? Six weeks after testosterone therapy initiation, she reported that her libido was back “I feel like I am 30 again” she was able to go upstairs by herself, something she had not done since being on chemo. She started to cook and to tell her old stories one more time, some that she had forgotten months before. Her hair grew stronger, as did her nails. She was back to being herself.

Progesterone restored her sleep. It also boosted her energy and memory. For years she had depended on prescribed medications to go to sleep. After she started progesterone, she reduced that dose from 2 mg a night to 0.25 mg. She is still taking it because of the placebo effect it provides. She knows that she does not need it but is afraid not to be able to sleep without it. One of the reasons we develop insomnia is the decline in essential hormones like estrogen, progesterone, and melatonin. We fall to sleep when those levels are optimal.

A combination of old age, no prior hormone replacement, and the side effects of chemo and adjuvant therapies had decreased my mom’s hormones to undetectable levels. She had already experienced severe menopause symptoms for many years. Her estrogen is still undetectable since she is on an estrogen blocker, a five-year therapy to prevent cancer from returning. What good is being cancer-free if you feel tired, fatigued, and miserable every day? What happens when we have no quality of life? It is our job to try to achieve balance, improve our patient’s quality of life, and give them some enjoyment. Life is supposed to be joyful. That is why health is so important. Without health, what good is life?

Even after a breast cancer diagnosis (you should be in remission), certain hormones can be used to improve quality of life. Testosterone is essential for women’s health. As women age, their testosterone levels decline tremendously—the same with progesterone. After menopause, the concentration of testosterone plummets, causing all kinds of undesired symptoms. Estrogen is a key player in a female’s health. This hormone influences almost EVERY function. Keeping its levels as optimal as possible, even before menopause, is key to age as healthily and gracefully as possible. The experience of my mother’s cancer made me realize that health is our most important asset; however, to live our best life, we need to be able to live joyfully. By responsibly optimizing hormones, we can help suitable patients rediscover the joy in their life. By doing so, we can give a person their life back, with the ability to enjoy it to the fullest; as a doctor, one of my goals is to help my patients achieve optimal health and joyfulness.

– Dr. Luis A. Pérez