Question about number of chemos

Bev1969
Bev1969 Member Posts: 48
edited March 2014 in Breast Cancer #1
I just got home from my fifth chemo treatment of cytoxin/Taxotere. At the first meeting with my oncologist, he had told me that I had to have at least four treatments but he would like me to have six if I could take them. I am stage IIb - tumor size was 4 cent. and I had one lymph node involved. I had a mastectomy in May and started chemo June 22. When I went in for my treatment today, he told me that they don't have any data comparing 4 treatments with 6 treatments. He said there is a clinical trial going on to determine if having six treatments is better, but right now they just don't know. So, he told me I could leave and go home if I didn't want any more. I was already there and the treatments really haven't been too bad, so I went ahead and took it today, but he told me I could think about treatment #6. He is leaving it up to me whether to get it or not.

Also, originally when he talked about radiation he said that there are arguments for and against it for women with only one lymph node involved so he would let the radiologist make the call and wouldn't influence me. When I talked to the radiaologist, he said they used to believe only women with more than 3 lymph nodes involved needed radiation but recent data shows that radiation benefits even women with only one lymph node involved and he thought I would benefit getting it. So, he is recommending 6 1/2 weeks of radiation after I'm done with chemo. Today the oncologist pretty much said I don't need radiation since I only have one lymph node involved.

So, I have some decisions to make in the next couple weeks. Just wondered if any of you have any thoughts on this. For women who had cancer similar to mine, how many chemo treatments did you have? Did you have radiation also? I'm thinking I should do everything I can now to avoid it coming back. I don't want to go through this again!

Thanks,

Beverly

Comments

  • TraciInLA
    TraciInLA Member Posts: 1,994 Member
    #2
    A little input
    Hi, Beverly -

    My cancer is not very similar to yours (stage I, smaller tumors, lumpectomies); however, I had *no* lymph nodes involved, and I'm doing chemo (4 rounds of Cytoxan/Taxotere) and will do radiation afterwards. The chemo was optional for me, but radiation is a definite.

    I'm not sure how old you are -- one of the reasons my oncologist and I decided together to be more aggressive with my treatment is that I'm only 40, and my cancer is ER+ -- so I probably have a lot of estrogen-filled years ahead of me before I get to menopause.

    But a bigger reason for me is exactly what you said in your last sentence: I wanted to do everything I possibly could to never have to go through this again. That has been the bottom line for me in every decision I've made on this journey.

    Hope that helps a little,

    Traci
  • Moopy23
    Moopy23 Member Posts: 1,751 Member
    #3
    Beverly, I would have the
    Beverly, I would have the radiation, without hesitation. I had 26 treatments, I believe. Some redness, burning, and itching, but my greatest side effect so far has been fatigue. There are also possible "late side effects." Your radiologist can go over in detail the possible and likely side effects. That might help you decide.
  • e_hope
    e_hope Member Posts: 370
    #4
    same stage
    Bev... I too am stage 2b with 2 nodes involved tumor size 3.5cm grade 3 cells... I had bilateral mastectomy. I had 4 treatments of AC and 4 treatments of taxotere. I start radiation tomorrow and will have 30 treatments...so 6 weeks

    My radiation oncologist told me she does radiation on most patients if there is any lymph node involvement. that is what my rad. oncologist told me that the old data they are finding to be wrong with only doing rad if 3 or more lymph nodes removed.

    How many total lymph nodes did you have taken out? That was the only other thing she did state that if you had 20+ lymphnodes removed and only 1 affected then she would consider not doing rad. I was 2 out of 8 removed.

    I am a believer do everything possible now.. you don't want regrets later if it comes back.. heck where in treatment at this point what is a few more weeks added on...
  • Bev1969
    Bev1969 Member Posts: 48
    #5
    e_hope said:

    same stage
    Bev... I too am stage 2b with 2 nodes involved tumor size 3.5cm grade 3 cells... I had bilateral mastectomy. I had 4 treatments of AC and 4 treatments of taxotere. I start radiation tomorrow and will have 30 treatments...so 6 weeks

    My radiation oncologist told me she does radiation on most patients if there is any lymph node involvement. that is what my rad. oncologist told me that the old data they are finding to be wrong with only doing rad if 3 or more lymph nodes removed.

    How many total lymph nodes did you have taken out? That was the only other thing she did state that if you had 20+ lymphnodes removed and only 1 affected then she would consider not doing rad. I was 2 out of 8 removed.

    I am a believer do everything possible now.. you don't want regrets later if it comes back.. heck where in treatment at this point what is a few more weeks added on...

    I had 16 lymph nodes removed
    I had 16 lymph nodes removed and only 1 was positive. Also, in answer to Traci, I am 62 so I am way past menopause! The oncologist said he is going to start me on Arimidex when I am done with chemo.
  • MAJW
    MAJW Member Posts: 2,510 Member
    #6
    4 Chemo infusions
    I was dx with Invasive Ductual Carcinoma......had lumpectomy in May, 2.2 cm tumor, went from stage I to stage II on the operating table, only due to the size......The surgeon got good, clean, clear margins, I had NO lymphnode involvement......I just finished chemo(taxotere and cytoxan) 4 weeks ago, and will start radiation on Thursday.....Chemo was highly recommended even with NO lymphnode involvement to do everything possible to avoid a recurrence in the breast or anywhere else in the body........Chemo combined with 6 1/2 weeks of radiation lowers the possibility and I'll take all of that I can get! It's ALL a personal decision, made with the advice of our doctors, but I wanted it all.........and followed their advice
    Best wishes and prayers,
    Nancy
  • padee6339
    padee6339 Member Posts: 763
    #7
    My 2 cents
    I had stage 1, no lymph nodes were effected. I did 6 rounds of chemo and 36 radiation treatments. They said they treated it aggressively because of the results of the Oncotype DX testing and the possible percentage of the cancer returning. This was all (Lordy I hate chemo brain - had to stop to remember the word! LOL) AHA - the word is "preventive" treatment because they said they "got it all" durng the lumpectomy.
    Pat
  • jhayslip
    jhayslip Member Posts: 11
    #8
    Number of chemos
    Beverly,

    Great questions. I recently posted a related article that may be helpful: http://ukhealthcare.uky.edu/forums/blogs/cancer-research/archive/2009/09/15/how-much-treatment-for-breast-cancer.aspx

    As you point out, I'm not aware of any clinical trials that have compared 4 cycles of TC versus 6 cycles of TC (although if anyone else is feel free to update us here). In situations like that I really don't know which would be best. I wish we were able to have more trials and that more doctors encouraged patients to seek clinical trials when treatment is needed.

    I try to help make those decisions by looking at the pros and cons. In general, I have encouraged people try to get onto a clinical trial or else to stick with what is proven to be helpful. You may get more clarity if you ask your oncologist what proof there is or isn't that the proposed treatment will give you the best chances of for a life-long cure.

    Regarding your question of radiation, the exact type of surgery and the findings on the pathology are all important. It isn't encouraging that your medical and radiation oncologist disagree about your care. Like I mentioned above, its not always that more is better. Sometimes more is just more side effects and the amount and kind of treatment should be guided by the best available proof. You may want to ask both of your doctors why they disagree and if either has spoken to the other. Ultimately, you may want to consider requesting a second opinion to help learn more about why you are getting different opinions. If practical, you may want to request your second opinion at a non-profit major university cancer treatment center so that you'd feel confident that financial factors aren't affecting anyone's opinion about what treatments would be best for you to receive. Sometimes more is better; sometimes more is just more.

    Best of luck as you gather more info to help you wade through the options for the treatment that seems to fit best for you.

    John
  • Moopy23
    Moopy23 Member Posts: 1,751 Member
    #9
    4? or 5? or 6?
    Bev, I re-read your post re how many chemo treatments to take. I am appalled at your oncologist's indifference and unwillingness to guide you on this rather important point. Stick around if you want to for treatment 5?? Wow.

    I guess it truly is up to you whether to do further research on that last treatment. Me, I would press my oncologist more and get another opinion before I do/do not get the 6th treatment. However, I also am a great believer in hitting the beast with everything you've got. So, without doing any further research, my gut would be to take the 6th one.

    Good luck, either way, and let us know what you decide.

    Best,
    Moopy

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