Treatment for an 87 year old mom
 

Hi everyone,

The 87 year old mom of a friend of mine was recently diagnosed with breast cancer for the first time. My friend, Barb, is having difficulty registering on this site so I am asking questions for her. Here is the pathology info that I have received:

Breast, right, partial mastectomy - poorly differentiated (grade III/III)
Invasive ductal carcinoma, 3.3 cm in greatest dimension, with all surgical margins free of tumor (T1NXMX, histologic stage IIA)

The surgeon recommended a lumpectomy since Bette has a history of strokes when being under full anesthesia. At first the family thought that Bette would only be receiving Herceptin and Tamoxifen (she has osteoporosis). Now there is confusion as to whether she will need radiation.

1. What are the dangers of radiation for a woman of her age?

2. Is radiation really necessary?

3. Does it make sense for her to receive only Herceptin, without chemo?

4. Does anyone know of someone with a similar age/diagnosis...what have they done?

5. Bette lives in South Dakota and is seeing an oncologist in Rapid City. Does anyone have any experience with doctors in that area?

6. If radiation is recommended, would it be a good idea to get a second opinion?

That is all for now. I know from past experience with my own cancer that the men and women on this forum are brilliant and oh so helpful.

Thank you in advance!!

Alice
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Re: Treatment for an 87 year old mom
 

Alice,

I saw your questions and while I can't answer all of them from personal experience I will throw out there what I can and hopefully others will join the conversation. (Disclaimer: when I say you or you're I mean it in a general sense, I did catch that you were asking for a friend. :) )

The reason radiation would be important is because she is having a lumpectomy. When I was diagnosed I was told that with a mastectomy I may or may not need radiation but with a lumpectomy the risk of recurrence goes up significantly without radiation so my takeaway from that was that it's a critical part of treatment if you have a lumpectomy.

Herceptin is a targeted drug for HER2 cancers and while everyone is different, my understanding is that herceptin alone is more likely to have a positive result than chemo alone. There may be a reason the doctor is not recommending chemo and it never hurts to ask that question, just so you know what's going on. Doctors handle these situations every day and I think they sometimes forget we don't have the educational background they do so if you're unsure about something they're telling you, you should ask. If they have a problem with that then I would consider getting a different doctor to be in charge of my medical team.

I hope that helps some.

Re: Treatment for an 87 year old mom
 

Regarding radiation. There are new machines that are less hard on us. I have a friend in a "minor" metropolitan area who had radiation via this new method. If that is available in Rapid City, there should be no problem.

The whole line of treatments will be tiring as it is for someone that age. (Look what it did to us!) But sounds like they are trying to do the minimum and give a good standard of treatment.

Re: Treatment for an 87 year old mom
 

I checked google ( topic- radiation for an 87 year old woman with cancer) and got results.
It seems radiation is beneficial and tolerable. One group of mixed patients (male and female)
total number 177 patients, received radiation, some palliative some for curative purposes.
80% of the patients took the full course of radiation. About 36% had the full course but had to take therapy breaks. The overall impression I got was that radiation was beneficial
in holding back the disease.

Paul

Re: Treatment for an 87 year old mom
 

Lucy, Steph & Paul,

Thank you so much for your responses. I have passed them along to Barb.

Lucy, I thought the radiation was added because of Bette’s lumpectomy. Thanks for confirming that!

Steph, do you have a specific name for the new radiation treatment? It sounds interesting.

Paul, thank you for doing that research. It is good to know that Bette could take a break from her treatment if necessary.

Alice