I’m a bit late writing this, but this year is a big one for me—my 10-year cancerversary. I was diagnosed with Stage II breast cancer (invasive ductal carcinoma, to be exact) on July 11, 2016. If you’d told me that day that I would be here now writing this post, I’m not sure I would have believed you. The absolute terror I felt the moment I learned I had cancer felt overwhelming and all-encompassing—I just knew it was a death sentence.

But with treatment, lots of therapy and the grace of God, here I am. I’m happy, mostly healthy and so damn grateful for every single day I get in this life. That said, survivorship is a hell of a ride, and there have been a few recent bumps in that road.

A few years ago, I began a pancreatic cancer screening program based on my family history and BRCA2 gene mutation, both of which put me at a higher risk for this form of the disease. I’m still relatively young—I’ll be 48 next month—but I want to be as proactive as possible considering how insidious and deadly pancreatic cancer can be. As part of that protocol, I got an MRI last fall to ensure there aren’t any abnormalities in my pancreas. When the results came in, I was stunned—my pancreas looked fine, but my liver did not.

Cue the stomach drop, I have mets, OMG I’M GOING TO DIE, panic. Thankfully, it’s not that serious, but it’s not great, either. The MRI discovered I have non-alcoholic fatty liver disease, as well as a blood clot on one of the vessels that feeds my liver. While I’ve gained some weight over the past decade (thanks, menopause!), I didn’t think I was so overweight that I’d have fatty liver disease, much less a blood clot (I have zero history of any sort of cardiovascular issue). Turns out, the culprit was something I’ve been depending on for the last nearly 10 years: tamoxifen.

Tamoxifen, the little wonder drug that blocks my body from turning estrogen into tumors (my cancer was ER/PR+), also has the capability to cause fatty liver disease and blood clots. I had no idea! And I’d still have no idea had I not been in this pancreatic cancer screening program.

My oncologist immediately took me off tamoxifen and switched me to letrozole, an aromatase inhibitor that essentially does the same thing tamoxifen did, without the liver damage. I’ve been on it since January, and it has been fine, so far. I still have joint pain and other side effects that I had with tamoxifen, but hopefully my liver is under less stress. I wrote more about the situation in this essay for BezzyBC.

This scare also pushed me to mostly cut alcohol out of my life. I was never a big drinker, but I’m even less so now, only occasionally having a drink or two. I feel much better without alcohol, and I truly don’t miss it that much.

So, what happens next? Honestly, I’m not sure. I have my annual visit with my oncologist next week, so I’ll discuss any additional next steps with her. I also want to chat with my GI doctor, who oversees the pancreatic cancer screening, to find out if I’ll have another MRI this fall (I don’t get them as often as is actually prescribed because they are hella expensive).

For now, I’m staying the course—taking my meds and trying to do what I can to be as healthy as possible. Cancer doesn’t end the day you receive the “no evidence of disease” diagnosis, a lesson I keep learning as I navigate this winding road of survivorship.