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Chemo after surgery

margeebarnes
Posts: 1
Joined: Oct 2002

I had a infiltrating ductal carcinoma (1.5X1X1 size) removed with a lumpectomy on 10/24/02. The lymp nodes removed and are negitive. It has been suggested that I have having chemo then radiation. Has anyone refused the chemo and chose only radiation?

jmears
Posts: 270
Joined: Jul 2001

Hi, The treatment protocals my Dr explained to me would not call for chemotherapy in what yu have said above. If you are Her2/Neu then chemo may be called for ... I think if I were in your shoes I would pass on the chemo unless they tell you that the cancer was very aggressive. Good luck!! Jamie

jmears
Posts: 270
Joined: Jul 2001

Hi Jamie again. I shouldn't have said I would pass on chemo in your shoes ... that is totally your call and you and your doctors have a lot more info. There seem to be all kinds of reasons chemo is suggested aside from the standard protocal ... maybe age (the younger you are the more aggressive the treatment is), other risk factor .... So I apologize for pushing my opinion ... best of luck on your decision. Jamie

ksfc
Posts: 252
Joined: Apr 2002

Whatever the circumstances, I think it's always a good idea to get at least two opinions about how you should proceed. I went to the doctors locally and then went to a larger cancer center for a second opinion on the pathology of my tumor and what chemo would be advisable. There's a lot to be considered that depends on your pathology besides just whether or not your nodes are negative. They take age into account, how aggressive your particular cancer is, whether it's estrogen or progesterone positive, her-2-neu status, etc. Don't feel rushed - you have time to make careful decisions. Diane

nasa2537
Posts: 317
Joined: Apr 2002

Hi...I didn't refuse it....I was told I didn't need it. My tumor was 1.1cm. But, there are so many factors they use to determine whether you need it. Also, the National Institute of Health published a paper that said it should be offered to all women regardless of stage. My oncologist is on a national tumor board, and she had told me that IF...your tumor is well-differentiated and under 2 cm, they don't recommend it. Also, not recommended if it will not make at least a 3% difference in your chance of survival. So, I would ask about the well-differentiation, and the percentage. One local oncologist did have a point, though. He said if he told a woman that the chemo would only make, say a 2% difference in your chance of survival, if you were one of those 2 in 100 women that the cancer came back in, all the percentages in the world would mean nothing to you. I have a dear friend that just went through 4 rounds of AC, and she did very well. They premedicated her with (not sure of the spelling) Anzimeth for nausea...either a shot or IV (don't remember which), and then she took it in tablet form whether she needed it or not for 3 days after treatment. She said she had a few incidences of queasiness, but never any full-blown nausea. Anyway, your oncologist knows what's best for your type of cancer, but you make the ultimate decision. Best wishes to you, and God bless. Cyndi

inkblot
Posts: 705
Joined: Jul 2001

Hi Margee:

I agree with several of the other ladies on this one.

The absolute first thing you need is to get another opinion. If possible, try to consult with an oncologist at a good sized cancer center. (an appoint. at such a facility usually gets you an automatic "team" consult...medical oncologist, radiation oncologist, surgeon, oncology social worker, and finally, a review of your slides by the pathologist and the rest of the team. It's worth the effort really.

Did you have the Sentinel Lymph Node Dissection at surgery? If so, the type of tests done on your nodes with this procedure are very advanced and yield more indepth information.

Some renowned docs believe that any and all women with bc should undergo at least the standard four cycles of AC chemotherapy. Others may be more conservative or aggressive in their approaches. Thus the need for a second opinion.

Also, you need to thoroughly review your pathology reports with your surgeon, and/or the medical oncologist with whom you have (or will) consult. Insist that they take the time to be certain that you understand, to YOUR satisfaction, what the terminology, etc. means. Otherwise, it's not going to be of much help to you in making a decision.

If you are pre menopausal (as I was), then chemo is typically recommended for us because our tumors tend to be a bit more aggressive and less dependent upon hormones, etc.. Your Her2 status is also important in making treatment decisions but there again, different doctors have different opinions about it.

I'd like to recommend that you vist: wwww.nci.nih.gov This is the website of the nationl institutes of cancer and the info you will find there may be very helpful. It's certainly reliable and solid info. You may choose the professional or the patient
format in order to better understand what things mean.

You must feel confident in the decisions you make now. That requires getting informed
and being an active participant in your care and treatment choices. Don't ever hesitate to ask whatever questions come to mind and fully expect to have them answered by your doctor(s). If that doesn't happen, you're wasting your time with that particular doctor and need to go on a doc shopping spree. You want someone who is going to make you comfortable and someone whom you can trust, to provide your treatment in the way your particular personality requires. If you can get that settled, early on, then you're less likely to find yourself needing to change doctors later on or halfway through treatment.

The anti nausea meds of today really are an amazing addition to the treatemnt process. The Anzamet (which someone else mentioned) really works well. I also took it and my nausea was well controlled.

Chemo is powerful stuff but it can also be life saving. Fear about having it is certainly justified. But the need for good information is even more important for you right now. Sometimes, as we come to understand certain things, our fears are lessened.

Don't feel rushed to make a choice right away. The ideal "window" for beginning chemo is up to 6 weeks, post surgery. So there's no hurry. The only hurry is to begin your information gathering and get an appoint for a 2nd opinion.

Warm hugs to you and please let us know what you ultimately decide to do.

Love, light and laughter,
Inkblot

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