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Just Diagnosed with Cancer? Chat with Experts

Friday, September 19, 2008 biscuit, Community Member, asks

Q: is chemotherapy always necessary

I just had a lumpectomy which removed a 3 cm tumor. The surrounding area and sentinel lymph nodes were clear - no cancer spreading.  I'm going to have to make a decision on my treatment to follow. Is chemo always necessary and decided based on size of tumor?  will chemo be beneficial?

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Answers (5)
Laurie Kingston, Health Guide
9/19/08 10:23am

Hi there,

If your lymph nodes were clear, then it is possible that your doctor will not recommend chemotherapy for you (I know many women who just had surgery or surgery and radiation). Every cancer is different and the prescriptions for each of us need to be different, too. In advising you, your doctor willl take into account the size of your tumour but also how agressive it was (this is why it's a good sign that it hadn't spread) as well as other factors.

Good luck and stay in touch-

Laurie

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laura, Community Member
9/19/08 3:32am

hello,

sometimes chemo is not necessary, ask your doctor about certain test that can help determine your recurrance rate and chemo benefit.

good luck laura

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Angi, Community Member
9/19/08 11:35am

I find myself asking the same question - as I've had chemo the first time around yet still had a recurrence and I do not want it again but am told I need it, and since I've already had a recurrence that I am more at risk for having another recurrence down the road.  So it's a tough choice to make.

 

The test that Laura is referring to is the Oncotype DX - but if you've already had it removed, and gotten back your pathology - well then I'm afraid it's too late unless the doctor ordered it when he sent the tumor in to be tested (labs rarily hold samples.) The Oncotype DX test is one in which it maps out whether or not chemo will likely benefit you and reduce your risk of recurrence.  So if you did not get this test (which you likely did not get as most insurers don't cover it yet and it's a $3000+ test) your doctor will go off of the results of your pathology report like what grade your tumor was (how aggressive) and hormone factors.

 

My adive would be to get a copy of your path report and educate yourself on what tests where done and what the results where, so that you can ask your medical oncologist all the right questions.

 

hope that helps!

Angi

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PJ Hamel, Health Guide
9/19/08 11:55am

Biscuit, if your cancer is ER/PR-receptive, ask for the Oncotype DX test that Angi mentions. It's a very good predictor of whether or not chemo will help you. This early in the process, the pathology lab should still have preseved samples of your tumor. It costs about $3500; Medicare and some insurors cover it; others don't. The company that markets the test, Genomic Health, also has started the Genomic Access Program to assist you with verifying insurance coverage and obtaining reimbursement, so you might access them, too, should you find yourself in a position to benefit by the test.  Good luck - PJH

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lia, Community Member
9/19/08 7:25pm

If you are estrogen/progest positive..and you are within your 8 week window from surgery..ask for an oncotype Dx..they still have your breast tissue.  Genomic testing will call you to tell you if it is covered... mine was, by insurance..all of it.  It is worth the try.. request now since it takes 7 to 14 days for results..and they like you to stay in that 8 week window..good luck!!!

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By biscuit, Community Member— Last Modified: 06/20/13, First Published: 09/19/08