radiation advise

momcat · 12-31-2009, 11:10 AM

Wishing all a joyous and blessed New Year. I have been lurking on this site for some time and the sisterhood and information is beyond compare. Many thanks for the support and knowledge given freely here. I want to share my saga because my expereince has been so positive. However, I am seeking advise, moving forward, and value your collective imput. I was diagnosed in March 09 with stage 3, grade 3 IDC. I was fortunate enough to be placed in a Brown University trial using Herceptin, abraxane and carboplatin in a neo-adjuvant setting. I completed the chemo with every side effect known to womankind, my support sisters call me the Chemo poster child. Once that was finished (Oct 09) I had a modified radical mastectomy and lymph node dissection. (26 nodes removed). My post surgery pathology report shows no sign of viable invasive cancer in both the breast tissue and lymph nodes. So here I sit awaiting the surgeon's recomendations for radiation. She said if I was under 50 that they would treat me with radiation, however at the ripe old age of 53 it was a gray area. Part of me wants to continue to be as aggressive as can be~ throw everything at the beast and be done with it. Yet my logical mind says it may be benefical to keep some guns in reserve. And why put my poor body through yet another treatment that will have possibly long term side effects. I wanted to share this promising study with you~ they have not released any results as of yet, but they tell me I am not alone in my positive outcome. I would heartily recommend neo adjuvant chemo to anyone. I can't begin to tell you how freeing the knowledge that the chemo worked is! Any imput on radiation or not is welcome and appreciated.

Becky · 12-31-2009, 01:46 PM

I guess the main questions are:

How close to the chest wall was your tumor?
How many lymph nodes did they think were affected (since the chemo killed everything - that's the greatest news!)

Thankfully the chemo worked great but I think local control needs to be considered especially if the tumor was close to the chest wall and possibly if alot of nodes were affected.

Not much help I realize.

momcat · 12-31-2009, 04:26 PM

Thanks for your reply Becky. any involvement of the chest was always negative. Path report says fascia uninvolved. Lymph nodes...good question. Although all 26 were negative for viable cancer, 2 were found with fibrosis and 1 with focal calcifications (1.2 cm.) All but 1were very small, the largest being 2.9 cm. I did have a lymph node biopsy prior to chemo. The Radiologist had difficulty finding a node to biopsy, finally chose the largest one, which did prove malignant. The surgeon did say there was a formula to "guestimate" the number of involved nodes prior to chemo, but I have not gotten an answer back yet.

tricia keegan · 12-31-2009, 04:35 PM

Momcat, personally I'd go for the radiation as it was such a breeze after chemo and you have the added comfort of knowing you've done all you could.
I found rads to be very tolerable, and as there's always the risk of a stray cell after surgery it did give me peace of mind.
Good luck in your decision

krisvell · 12-31-2009, 04:55 PM

Hi Momcat; Your title caught my attention as I just started radiation this week (3 treatments so far). Compared to Chemo & surgery, Radiation is a walk in the park.
I also noticed your case has similarities to mine (see signature). After neoadjuvant, my path report showed 2 lymph nodes with very small mico mets left after surgery but even if there were none, I would have gone for radiation.
Congratulations on the great results! I wish you all the best.
Kris.....

momcat · 02-02-2010, 09:48 AM

I met with a radiation oncologist yesterday and we decided to go ahead with the radiation. It was pretty much a no -brainer! He felt the treatment would reduce my risk of reoccurence by 15%. My concerns were the long term effects of the rads- heart and lung damage and the inability to radiate the same spot twice. He told me my info was old, with new technology and machines these risks were less than 1%. So off to 6 more weeks of treatment and truth be told I am relieved to be continuing treatment.... I was very surprised at my emotional reaction at the end of treatment ... while under treatment I had a sense of security- without any active treatment every twitch and tingle (post surgery things) was worrisome!!!! Thank you all for your wisdom.