Chemo or radiation?

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cahjah75
cahjah75 Member Posts: 2,631
edited March 2014 in Breast Cancer #1
I will be having bilateral mastectomies on the 22nd. Which treatment will come first, chemo or radiation???

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  • Christine Louise
    Christine Louise Member Posts: 426 Member
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    Give us more info, please
    No "one size fits all" answer to that. Do you already know you need both?
  • cahjah75
    cahjah75 Member Posts: 2,631
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    Give us more info, please
    No "one size fits all" answer to that. Do you already know you need both?

    chemo or radiation?
    my bilateral mastectomies will happen in 10 days. Which treatment is first, chemo or radiation?
  • Christine Louise
    Christine Louise Member Posts: 426 Member
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    My experience
    Because I had bilateral, I didn't need radiation. My understanding is that radiation is done to ensure that the margins around a removed lump are cancer free. Since bilaterals take "all" the breast tissue, there are no margins to irradiate. I say "all" in quotation marks because even bilaterals can't remove every single molecule of breast tissue. Still, unlike a lumpectomy, there is no margin.

    I hope other survivors will post and correct me if this is not the whole picture.
  • cahjah75
    cahjah75 Member Posts: 2,631
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    My experience
    Because I had bilateral, I didn't need radiation. My understanding is that radiation is done to ensure that the margins around a removed lump are cancer free. Since bilaterals take "all" the breast tissue, there are no margins to irradiate. I say "all" in quotation marks because even bilaterals can't remove every single molecule of breast tissue. Still, unlike a lumpectomy, there is no margin.

    I hope other survivors will post and correct me if this is not the whole picture.

    I may be wrong but I thought
    I may be wrong but I thought my surgeon explained to me that I should wait to have reconstruction because I needed both radiation and chemo.
  • Christine Louise
    Christine Louise Member Posts: 426 Member
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    cahjah75 said:

    I may be wrong but I thought
    I may be wrong but I thought my surgeon explained to me that I should wait to have reconstruction because I needed both radiation and chemo.

    Sorry, I guess I don't know
    Surely someone else will post with more info for you.

    I would have thought that you don't have enough info yet to know if you need chemo or rads. Without knowing if your lymph nodes are clear and other specifics of your cancerous tissue (which will be tested after surgery), I don't understand how your doctor knows yet.

    Obviously, I'm the one who doesn't know. Hope I haven't just confused you.

    You could call your doctor's office Monday and clarify this. I've had great answers from my docs' nurses when I leave a voice mail and they call back later. Best of luck!
  • Rague
    Rague Member Posts: 3,653 Member
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    My experience
    Because I had bilateral, I didn't need radiation. My understanding is that radiation is done to ensure that the margins around a removed lump are cancer free. Since bilaterals take "all" the breast tissue, there are no margins to irradiate. I say "all" in quotation marks because even bilaterals can't remove every single molecule of breast tissue. Still, unlike a lumpectomy, there is no margin.

    I hope other survivors will post and correct me if this is not the whole picture.

    Margins do apply with mastectomies too!
    Getting good margins in mastectomies is important.

    My surgeon refused to discuss doing surgery before chemo was done to try to shrink and get clean/good margins. Chemo (A/C) worked and we did get a good bit of shrinkage and had clean margins when I had my mod. rad. mastectomy. I had more chemo after followed by rads.

    Remeber that not all forms of BC (or any other C) are the same and all do not have the same treatment protocol.
  • Rague
    Rague Member Posts: 3,653 Member
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    cahjah75 said:

    I may be wrong but I thought
    I may be wrong but I thought my surgeon explained to me that I should wait to have reconstruction because I needed both radiation and chemo.

    I was told by all my Drs.
    I was told by all my Drs. (PA, Surgeon, Chemo, Rads) that we would not discuss reconstruction for at least 9 months and probably a year post surgery. I'm IBC, which is a VERY aggressive form. I knew from the 'git-go' that I'd have Chemo before surgery and Chemo and Rads after surgery.

    I see where there are those who have recon before rads but for me I'm so glad that I didn't - I burned very BAD from it and I really would not like to think haw bad the healing/taking care of the burns would have been had recon been involved.

    It's great to ask for personal experiences but remember that they are personal and not your diagnosis or situtation. Talk to your Drs. they are the ones who know your particular needs.
  • Christine Louise
    Christine Louise Member Posts: 426 Member
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    Rague said:

    Margins do apply with mastectomies too!
    Getting good margins in mastectomies is important.

    My surgeon refused to discuss doing surgery before chemo was done to try to shrink and get clean/good margins. Chemo (A/C) worked and we did get a good bit of shrinkage and had clean margins when I had my mod. rad. mastectomy. I had more chemo after followed by rads.

    Remeber that not all forms of BC (or any other C) are the same and all do not have the same treatment protocol.

    Thanks, Rague
    Yes, I've done some online "research" since posting. Thanks for correcting my info, Rague. I will be more careful about posting in the future.

    From BreastCancer.org:
    Radiation may be recommended after mastectomy if:

    the tumor is larger than 5 centimeters
    the tissue removed during mastectomy does not have clear margins
    cancer cells are found in 4 or more lymph nodes
    the cancer occurred in a number of locations within the breast
  • cahjah75
    cahjah75 Member Posts: 2,631
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    Thanks, Rague
    Yes, I've done some online "research" since posting. Thanks for correcting my info, Rague. I will be more careful about posting in the future.

    From BreastCancer.org:
    Radiation may be recommended after mastectomy if:

    the tumor is larger than 5 centimeters
    the tissue removed during mastectomy does not have clear margins
    cancer cells are found in 4 or more lymph nodes
    the cancer occurred in a number of locations within the breast

    My tumor
    My cancer tumor is 6.8cm and that is why my oncology surgeon said I would have both radiation and chemo following the mastectomy. Because the tumor in my other breast is precancerous I have opted for the double mastectomy with reconstruction down the road. My surgeon said that radiation could affect the skin. It's all so confusing and I sometimes think I ask too many questions....
  • Christine Louise
    Christine Louise Member Posts: 426 Member
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    cahjah75 said:

    My tumor
    My cancer tumor is 6.8cm and that is why my oncology surgeon said I would have both radiation and chemo following the mastectomy. Because the tumor in my other breast is precancerous I have opted for the double mastectomy with reconstruction down the road. My surgeon said that radiation could affect the skin. It's all so confusing and I sometimes think I ask too many questions....

    NOT too many questions
    You absolutely deserve to know what is happening and what is going to happen with your treatment. I hope you call the doctor tomorrow and insist on all the answers you need. The whole situation is scary enough, and being confused just adds to the anxiety. All the best to you!
  • Rague
    Rague Member Posts: 3,653 Member
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    cahjah75 said:

    My tumor
    My cancer tumor is 6.8cm and that is why my oncology surgeon said I would have both radiation and chemo following the mastectomy. Because the tumor in my other breast is precancerous I have opted for the double mastectomy with reconstruction down the road. My surgeon said that radiation could affect the skin. It's all so confusing and I sometimes think I ask too many questions....

    The skin will be affected.
    The skin will be affected. Everybody is different as to the amount of reaction to the radiation but all will get at least some 'tanning' and some may get a bad burn but most fall somewhere between the extremes. For me, I only got some tanning and freckling and dry skin until the last 3 doses. After the last dose it was like a mild sunburn but by the next morning most of the area was blistered and continued to get worse for quite a while. Thankfully the areas that were burned the deepest (took 6 weeks for the last scab to come off) were in the area that no longer has feeling in it from the surgery so I didn't feel the worst of the pain and oxycodon and Vicodin took care of the other somewhat less burned areas. I'm not trying to scare you by telling you of my burns - not to be expected at all but bad burns are a possibility just as you might only get some 'tanniing'.

    Another question to ask your Rads Dr is will you be getting booster doses after the initial radiation. Some do, some don't. I didn't (again thankfully) because as my Rads Dr told me because the area that was involved with the IBC and the number of lymphnodes also involved it would impossible as the area was just too large and the boosters are anarrow directed 'shot' at the exact sight of the tumors if they were small enough. At least that's how he explained it to me.

    Susan
  • BethInAz
    BethInAz Member Posts: 203 Member
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    Treatments plans
    Dear one,
    Treatment plans are as individual as you are. I had bilat mast last October and had chemo but not rads. When I asked my oncologist about this at my 3 month checkup, he said that the doctors in my team discuss each individual case and depending on lymph node involvement, size of tumor, location of tumor, etc., the decision is made as to whether rads are necessary for the individual patient. In my case, they determined rads were not necessary. Thank goodness, I said to myself! I did the chemotherapy - 4 rounds spaced 3 weeks apart - and it was entirely doable. I'm happy that I'm on the other side of the whole journey and I know as you find out more information, you will be able to make good decisions and find peace in the journey.
    Blessings to you!
    Beth
  • MAJW
    MAJW Member Posts: 2,510 Member
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    IF..........
    Your doctor has told you you WILL be having both, after surgery, chemo comes before radiation......I am triple negative.....had lumpectomy last May......then chemo from June-Aug and 33 radiation treatments with the last 7 being boosters...my tumor was 2.2 cm......had clean, clear margins, NO lymph node involvement....I tolerated the chemo fairly well......no day at the beach BUT FOR ME, it wasn't as bad as I had expected.....no vomiting, not the first wave of nausea.....my physicians are VERY aggressive with anti nausea medications....I did lose my taste buds for about 6 days following each infusion.....became very tired after the second....the effects are cumulative....I didn't do well with the first Nuelasta injection, but was fine with the next 3. Radiation, again, for me, was very tolerable........never burned, but I do tan fairly easy, that's a plus I was told.......didn't even turn pink til the 4th week, then the next two weeks, I became more so......the boosters did cause a bright red "spot".......I never burned...but I used the creams they gave me religiously! Radiation fatigue set in about the 4th week......it is a weary feeling.....like I could never get enough sleep. Radiation effects are also cumulative...

    I wish you well and Peace be with you
  • cahjah75
    cahjah75 Member Posts: 2,631
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    MAJW said:

    IF..........
    Your doctor has told you you WILL be having both, after surgery, chemo comes before radiation......I am triple negative.....had lumpectomy last May......then chemo from June-Aug and 33 radiation treatments with the last 7 being boosters...my tumor was 2.2 cm......had clean, clear margins, NO lymph node involvement....I tolerated the chemo fairly well......no day at the beach BUT FOR ME, it wasn't as bad as I had expected.....no vomiting, not the first wave of nausea.....my physicians are VERY aggressive with anti nausea medications....I did lose my taste buds for about 6 days following each infusion.....became very tired after the second....the effects are cumulative....I didn't do well with the first Nuelasta injection, but was fine with the next 3. Radiation, again, for me, was very tolerable........never burned, but I do tan fairly easy, that's a plus I was told.......didn't even turn pink til the 4th week, then the next two weeks, I became more so......the boosters did cause a bright red "spot".......I never burned...but I used the creams they gave me religiously! Radiation fatigue set in about the 4th week......it is a weary feeling.....like I could never get enough sleep. Radiation effects are also cumulative...

    I wish you well and Peace be with you

    thanks
    thanks for all the comments. I spoke with my surgeon's nurse this morning and she said I will meet with oncology radiologist and oncologist for chemo together to decide what treatment will be. I may be overloading myself with info but I want to be informed as to what might happen.
  • jnl
    jnl Member Posts: 3,869 Member
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    cahjah75 said:

    I may be wrong but I thought
    I may be wrong but I thought my surgeon explained to me that I should wait to have reconstruction because I needed both radiation and chemo.

    It seems that most have
    It seems that most have chemo before rads.