Radiation Decision

[JoyMiller]

Hi, All! I am new so I hope this works out all right! I was diagnosed in Jan. 2005- Stage IIB- 3 nodes pos- Her2+, ER+, had a bilateral mastectomy in Feb. Have finished AC, and began Taxol w/Herceptin in June. Today I have had my 6th treatment of Herceptin alone and will go on with weekly treatments until the end of June 2006. Originally, before the addition of Herceptin to my therapy, I was to have had radiation treatments after the Taxol was finished. Last week my oncologist and I had a discussion about whether or not to start radiation- he said there are not clear benefits to radiation, so I am thinking not to do it. Does anyone have an opinion on this? Or any experience with a similar decision? Given the downsides of radiation and the pluses of Herceptin, I am not clear about this- I think I will talk to the radiation Drs. just to get all the info., but I wonder what anyone out there may have to say. This is a wonderful site!
Thank you, JoyMiller

[kristen]

Hi Joy,
I was also on the fence with 3 nodes +. My onc. was dead set against me having it. I did however go ahead and have my radiation consult. and we both agreed that I was in good health and though it might not give me some huge benefit but I was of the mindset that since I was going in there and getting Herceptin, what was one month of rads. I already knew that I would be going in for an S-Gap for my reconstruction and not implants. I think that is somthing you may want to figure in your pros and cons list. I don't have fair skin and found it very tolerable. A little fatigue, but no blisters or burns, I was lucky.

For me, my thoughts were to do everything I could to fight it now, for fear of it coming back, knock on wood 2 years out and NED. I wish you the best in your decision.

[Lyn]

Hi, when first diagnosed in 1998 I had what was called a "sandwhich therapy" it was AC rads CMF, it was explained to me that the first round of chemo gets rid of the cancer cells floating in the blood stream, the radiation gets rid of the cells in the tissue from the surgery and the third mops up what is left. I have had over 100 doses of radiaton for various lymph gland involvement and it has been successful, unfortunately I have been chasing the disease non stop since then. I have to agree with the philosophy because each sector I had radiated did the job and then another lymp would come up in the next sector, so maybe radiation should be give at the same time as chemo so it is double dosed.


Love & Hugs Lyn.

[JoyMiller]

Kirsten and Lyn- Thank you for your thoughts- I appreciate the additional info to mull over. My best wishes to both of you. JoyMiller

[Rozebud]

This study included women that had less than 4 + nodes.....


Radiation Following Mastectomy Improves Long-Term Survival in Breast Cancer Patients
According to results recently published in the Journal of the National Cancer Institute, the addition of radiation improves cancer-free and overall survival in women with node-positive breast cancer.
Breast cancer is diagnosed in over 200,000 women annually in the United States alone. Patients with early breast cancer, or cancer that has not spread to distant sites in the body, can achieve high rates of long-term survival with standard therapy. Standard therapy for early breast cancer includes surgical removal of the cancer, chemotherapy, hormone therapy, and/or radiation therapy. Women whose cancer is larger than 5 cm and those who have cancer spread to 4 or more axillary (under the arm) lymph nodes are considered to be at a higher risk of developing a cancer recurrence than their counterparts. Consensus guidelines indicate that women with these risk factors should undergo radiation in their treatment regimen. However, there has been controversy as to whether women with early breast cancer who are not considered to be at a high risk of developing a cancer recurrence (small cancer size and cancer spread to 3 or fewer axillary lymph nodes) benefit from the addition of radiation to their treatment regimen.
Researchers affiliated with the British Columbia radiation randomized trial have recently reported 20-year follow-up results regarding the use of radiation therapy in early breast cancer. This trial included 318 women with early, node-positive (cancer spread to axillary lymph nodes) breast cancer. All patients were treated with a mastectomy, plus chemotherapy consisting of cyclophosphamide, methotrexate, 5-fluorouracil (CMF). Approximately half of the patients received radiation therapy as part of their treatment regimen and the other half did not. At 20 years, cancer-free survival and overall survival were significantly improved in the group of women who had received radiation, compared to those who had not received radiation. Cancer-free survival was 48% for those who received radiation, compared to 30% for those who did not receive radiation. Overall survival was 47% in the group that received radiation therapy, compared to 37% in the group that did not receive radiation therapy. Patients who were considered to be at a low risk of developing a cancer recurrence demonstrated a benefit from radiation therapy consistent with those who were considered to be at a high risk of developing a recurrence.
The researchers concluded that the addition of radiation therapy to treatment including surgery and chemotherapy for patients with early breast cancer appears to improve long-term cancer-free and overall survival. However, with the current use of more aggressive chemotherapy regimens (compared to the one used in this trial), the definitive role of radiation therapy remains inconclusive for patients considered to be a low-risk of developing a recurrence. It is important for patients with early breast cancer to discuss all treatment options with their physicians to determine individual risks and benefits of each treatment option.
Reference: Ragaz JR, Olivotto IA, Spinelli JJ, et al. Locoregional radiation therapy in patients with high risk breast cancer receiving adjuvant chemotherapy: 20-year results of the British Columbia Randomized Trial. Journal of the National Cancer Institute. 2005;97:116-126

[Patty H]

I was dx in 2000. I had chemo, surgery with reconstruction and more chemo then radiation. I was feeling a little over whelmed and my plastic surgeon, put it this way for me, she said to do everything they ask of me and if it comes back, I won't be second guessing myself. The second time around and they wanted to do radiation again, my husband really didn't want me to do it again. The radiation Dr. convinced us to do it. We were glad we did because when it came back the third time, we knew if we hadn't had it we would be feeling if only we had. So maybe talking to a radiation Dr. and getting his opinion would help. Patty H

[Lyn]

I forgot to mention, quite by coincidence, 12 months before my diagnosis my nephew's mother-in-law also had a lump, they only wanted to take the lump and she said she wanted a mastectomy. They removed the breast and 4 nodes, she was convinced she was all clear, and told me I had nothing to worry about, she had done more than they had asked with the surgery, so they assumed she needed no more treatment. She passed away 3 years ago, not long after I got my BC which was very agressive, hers had travelled to the bones, then her tumour markers were climbing but they were only scanning her chest and abdomin, a seizure showed up brain mets, she did not tolerate chemo, she then had WBR, six months later she passed away, on the other hand a friend of mine same scenario, is still well today with no treatmetns what so ever, not even tamoxefin, this disease does not discriminate, I am a guts, I take what ever is going.

Love & Hugs Lyn