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AlaskaAngel · 01-14-2009, 05:24 PM

As of today, no change has been made online in this link:

http://www.oncolink.org/experts/arti...&ss=22&id=1780

Quoted in full to preserve accuracy of content for the purposes of this thread:

Dear OncoLink "Ask The Experts,"

I have been diagnosed with invasive, stage T1c N1 M0, high-grade breast cancer. I've had lumpectomy and axillary node dissection with 3 positive nodes. My receptors are positive as well as the HER2/neu positive. I am 7 weeks post surgery and have not yet started chemo as I am not totally convinced that I want to have it. The doctor said that chemo should be started 3-6 weeks post surgery. I figure it will be about 2 more weeks before I'm done researching alternative possibilities (I just started) to see if I can avoid the chemo and RT. My question is, what negative consequences am I facing by delaying chemo until I am confident that it is the only way out?? I have not been able to find info on this subject, and I feel that I have the right to explore other options without accepting the first thing that is offered to me. Please explain.

Kevin R. Fox, MD, Assistant Director, Clinical Affairs and Associate Professor of Hematology/Oncology at the Abramson Cancer Center of the University of Pennsylvania, responds:

In general, chemotherapy should be started within 12 weeks of the diagnosis. There is probably little harm in waiting a couple of additional weeks, but it must be understood that nothing except chemotherapy and tamoxifen, together, have been researched well enough to be considered "adequate" alternatives.

Chemotherapy and tamoxifen remain the standard and unwavering recommendations for this patient. Also, after a lumpectomy, the addition of radiation therapy is considered the standard of care. Without radiation, the risk of a local recurrence is very high and the addition of radiation therapy decreases the chance of a recurrence significantly.

01-14-2009, 05:24 PM	#26
AlaskaAngel Senior Member Join Date: Sep 2005 Location: Alaska Posts: 2,018	Status quo report As of today, no change has been made online in this link: http://www.oncolink.org/experts/arti...&ss=22&id=1780 Quoted in full to preserve accuracy of content for the purposes of this thread: Dear OncoLink "Ask The Experts," I have been diagnosed with invasive, stage T1c N1 M0, high-grade breast cancer. I've had lumpectomy and axillary node dissection with 3 positive nodes. My receptors are positive as well as the HER2/neu positive. I am 7 weeks post surgery and have not yet started chemo as I am not totally convinced that I want to have it. The doctor said that chemo should be started 3-6 weeks post surgery. I figure it will be about 2 more weeks before I'm done researching alternative possibilities (I just started) to see if I can avoid the chemo and RT. My question is, what negative consequences am I facing by delaying chemo until I am confident that it is the only way out?? I have not been able to find info on this subject, and I feel that I have the right to explore other options without accepting the first thing that is offered to me. Please explain. Kevin R. Fox, MD, Assistant Director, Clinical Affairs and Associate Professor of Hematology/Oncology at the Abramson Cancer Center of the University of Pennsylvania, responds: In general, chemotherapy should be started within 12 weeks of the diagnosis. There is probably little harm in waiting a couple of additional weeks, but it must be understood that nothing except chemotherapy and tamoxifen, together, have been researched well enough to be considered "adequate" alternatives. Chemotherapy and tamoxifen remain the standard and unwavering recommendations for this patient. Also, after a lumpectomy, the addition of radiation therapy is considered the standard of care. Without radiation, the risk of a local recurrence is very high and the addition of radiation therapy decreases the chance of a recurrence significantly.