And yet, there has been a shift in thinking, so significant that it is being heralded on the front page of the New York Times. The national guidelines that call for giving chemotherapy to almost all of the 200,000 women diagnosed with breast cancer each year is now being questioned and debated by leading researchers. According to the new thinking, chemotherapy should be used for only about 30 percent of those women, the ones whose breast cancer is not fueled by estrogen. For the other 70 percent, the lifesaving treatment seems to be the hormonal treatment, such as tamoxifen or aromatase inhibitors.
This still leaves many patients, and their doctors, in a quandary: Who, exactly should forego the chemotherapy? The facts are not yet all in, and breast cancer can be fatal. Isn’t it wiser to take the most aggressive treatment, including the chemotherapy, just in case it turns out to be what saves your life? This is not a situation where you want to err on the side of doing too little.
Ten years ago, no one suggested I could skip the chemotherapy. The only question was how much of it I needed. Even though my breast cancer was highly estrogen-positive, I had two tumors, and lymph node involvement. I was also 41, with two small children. I would have done almost anything to save my life. And after surgery, aggressive chemotherapy, five years of tamoxifen, four years and counting of an aromatase inhibitor, I’ve reached the ten year mark (knock on wood) without a recurrence. Given what I know now, I would opt for the chemotherapy again, even though it was hell.
But when I hear about vaccines for cervical cancer, and breakthroughs for other diseases, my first thought is always about breast cancer, and how much longer it will be until there is a cure, or at least better treatment. Yes, we’ve come a long way in ten years, but not long enough.
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