What do you think (about radiation)?

seof

I want to hear some of your thoughts on my situation. The pathology report from my double mastectomy came back. The only cancer cells they found were in one of the 20 nodes that were removed, and a few in the location of the original tumor on the right side, none on the left (left mastectomy was prophylactic...never was cancer suspected there). We did chemo before surgery which was very effective in shrinking the tumor with few negative side effects. From the beginning the Oncologist planned radiation after surgery, then chemotherapy, then reconstruction. The radiation was to be done on the right breast to get rid of any cancer that might still remain in that tissue. Since the pathology report seems to indicate there is no cancer remaining, it seems to me the risks of radiation and the probable side effects are not worth the potential benefit of getting rid of cancer cells, especially since the chemo will most likely do it without the side effects. I have appointments to talk to the various Doctors involved in the next 2 weeks, but I wanted to hear some of your opinions.

Thanks, seof

Susan956

Hope you had a good holiday. For me the radiation was so much easier than the Chemo that it seemed like no real big deal. For me the Chemo was really tough and since I only did a lumpectomy I really had not choice. But all in all I found that the radiation was very easy to tolerate. I do have some soreness in the muscles in my shoulder... but other than that no ill effects.

Take care... God Bless....

Susan

3cbrca

Hi Seof

I think that you really need to talk with your doctors about the data on neoadjuvant (chemo before surgery) treatments. Because its a relatively new approach there is very little data, but it is definitive. As I understand it if you have a Pathological complete response from your chemo (no evidence of tumor or nodes remaining at the time of surgery) outcomes are somewhat better than if there is tumor or nodes remaining. Given that you had some tumor and a positive node (albiet only one) if it were me I would strongly consider RT. If you do decide to go with RT it is so much easier than any of the surgery or chemo. I didn't have a choice - I had a complete path response to the primary tumors but still had 22 positive nodes. The only real problem with the RT is the exhaustion. When you add it to the chemo and the surgery towards the end of RT it is like being hit in the head with a brick-the exhaustion just takes over.
Like every other decision we have to make, ask your doctor, then another, then another. If you're interested in looking at the "state of the science" for Neoadjuvant treatment, there is a page on the NCI website from a conference held on Neoadjuvant tx in April or May which I can send you. Also ask your doc to sign into Neoadjuvant Online to tell you what your statistics are for following the different treatment plans.
Best of luck in your decision- don't you just wish that there were a magic ball that could tell you the answers?
Take care, Sheilah

Unknown

seof, you will most definitely want to get as many professional opinions as you feel comfortable with and then weigh your options accordingly.
I can only tell you my experience and how things went with me.
In '86 I lost my right breast to cancer with 3 nodes involved. I underwent 10 months of chemo with no radiation. Less than two years later (in '88) I lost my left breast with 3 nodes involved. This was followed by 10 months of chemo and then 25 radiation treatments, and finally 7 years of tamoxifin.
Now, would I have had the second breast cancer if I had undergone radiation the first time? I have no idea...
I can add, however, that radiation to the chest area on the left side was not a major event for me. The only effects were some fatigue and a bad 'sunburn'. Once rads were over and the skin had healed, I was good to go.
God bless hun. I know you will make the right decision.

cabbott

Radiation and chemo target cancer in different ways. Surgery is the most effective at ridding the body of a concentrated patch of cancer. Radiation is good for targeted areas that need something just a little less than surgery. The tissues around a positive node might benefit from radiation. Chemo is a body wide diffuse program to target cancer. It targets cancer at a particular stage of cancer development. Different chemos attack cancer at different stages of development, so it is not a replacement for surgery. You will have to decide if surgery removed all the tissue with cancer in it. Many doctors feel that treating the area with radiation where some nodes were positive can reduce the risk of cancer reoccurance and spread and extend your life. Advances in the last few years have made radiation much safer than it used to be. They can target radiation better now so that your lungs and heart stay healthy. However, it might be wise to ask how today's radiation will affect your skin and possibly affect the choices of reconstruction that you have in mind. I'm sure you will make the decision that is right for you.

toninasky

Hi Seof,
I had a lumpectomy with 1 node involvement, and I had chemo and 38 radiation treatments. I would strongly suggest you go ahead with the radiation. It is not bad, and it takes seconds to do each day during the week. It is worth it I think. I had no side effects except for the breast being off color now, and very hard in the beginning. That seems to be getting better. I had my last treatment of radiation in March os 2007. Good Luck. Remember it is your body and you have the right to choose what you do with it.
Toni