Saturday, July 05, 2008 rogz asks

Q: Rethinking my treatment plan.

My cancer was diagnosed in March. IDC, stage 1, 0/2 nodes, 1 cm, ER+/PR +, HER-. Surgeon thought I was perfect candidate for lumpectomy w/ radiation due to size of tumor. We also discussed the possibility of hormone therapy. Chemo was probably not needed. Very little was discussed about side-effects and length of radiation therapy. Met with oncologist after lumpectomy. He suggested that inaddition to radiation therapy and hormone therapy that I consider chemo due to my age (48) and family history (mother died of breast cancer at age 54). I agreed and am currently finishing 4 cycles of Cytoxin and Taxatere. My next step is radiation therapy and I'm having second thoughts. My cancer was in the left breast so I'm concerned about possible heart problems as a result of radiation treatments. Also, I have smoked on and off for over 20 years and am concerned about developing lung cancer as a result of the treatments. Now I'm thinking that I should reconsider my surgical choice and have a masectomy instead of radiation therapy. Would this make sense in my case?

Edited to add that my margins were clear.

Answers (2)

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PJ Hamel

7/ 5/08 10:32am

Rogz, my understanding is that radiation is so sophisticated and focused (literally) now, that the chance for heart/lung problems just isn't what it used to be. My advice: Talk with the radiation oncologist,and tell him/her your concerns, sparing no details of your history, your fears, etc. Have a discussion; don't let yourself be lectured to. And then make your decision. A mastectomy, of course, is much more difficult than a lumpectomy. It can involve long-term shoulder issues, pain, tingling, numbness... and then there's the decision to get reconstruction, have an implant, a prosthesis, or just go without. It's just complicated, and if you could avoid it, I would.

On the other hand - yes, if you're VERY fearful about radiation, consider a mastectomy seriously. But I'd still advise talking to the radiation oncologist first.

Good luck - PJH

Angi

7/ 5/08 4:15pm

Rogz, I can totally relate to your fears as I'm in radiation mow and have had a mastectomy in the past. I should also mention that 3 years after having a mastectomy due to invasive ductal carcinoma stage IIa, and going through 4 rounds of AC chemo, then following up with Femara that my cancer returned. I did not have radiation the first time and my medication failed to prevent the estrogen from binding with the cancer cells. My doctors beleive that one tiny little cell was left behind to grow over the last 3 years. Had I had radiation the first time around this probably would have been prevented, as radiation is a localized treatment and chemo is a systematic treatment. Now I am sitting thru 35 sessions of radiation that will be followed up with another dose of chemo then a different type of medication.

Only you can truly decide what treatment is best for you - but as PJ said, radiation has come a long way, and while it there can be possible side effects, most are rare and they have to tell you every little thing that may or may not occur. But still, in order to fight the cancer and become a survivor you must be willing to do everything in your power to ensure your future health, right? Talk to your doctor, gather the facts, educate yourself then make an informed decision that you feel is best for you. No one can tell you what to do, you have to decide for yourself. But radiation is really not that bad, though I have only done 10 sessions thus far. I'm sure that if you've made it through all this, you can make it through radiation as well. Be strong, stay positive and best of luck to you!

Angi

Q: Rethinking my treatment plan.

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