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Old 12-05-2005, 12:14 PM   #1
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Question What if I said no to Rads

Has anyone said no to rads? I was dx, with IDC, 2.5cm tumor, clean margins, no lymp nodes or lympathic. Did 4 rounds A/C, 12 taxol and herceptin and will do herceptin every 3 weeks for the next 40 weeks. I'm triple positive (er/pr/her2neu). Just tossing the idea of not doing rads. Sick of hospitals and all the treatment. I'm not sick of living, but darn, do they really need radiation after all I had...............

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Randi
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Old 12-05-2005, 12:34 PM   #2
Becky
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It is recommended therapy to have radiation if you have lumpectomy. The chances of local recurrence is great without it as chemo and herceptin do not penetrate the scar tissue from surgery adequately. This is why one not only has the rads but the 3-7 "boosts" to the area where the tumor and incision are. Chemo and herceptin are given to prevent distant recurrence and rads for local recurrence (and you really do want to do everything to prevent both).


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Old 12-05-2005, 12:48 PM   #3
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Ok

What is a boost? is that what you called it. I'm sure I will do them, hell of course I will, it is just one of those days when you play, what if...............

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Randi
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Old 12-05-2005, 01:52 PM   #4
tammymarie1971
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Hi Randi...I can understand that you're so DONE with procedures and pokes and prodes and you just want your life back!!! I felt the same way.I had a mastectomy and chemo with no node involvement..I actually said no to rads..and then all of a sudden it hit me that I needed to do all I could to prevent a recurrence....I'm glad I did..It was hare though I have four kids and I would bring them with me everyday the nurses loved it and I think it was good for the kids to see what they were doing to Mom!!!
If you do all you can now to prevent recurrence and IF(BIG) if it comes back at least you won't be dealing with the guilt of not doing everything you could of..RIGHT? Although really the chances of recurrence in your case seems quite remote...but...........
Tammy
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Dx'd Dec'01 while 6mos preg. with #4. child (30yrsold)Mastectomy/AC chemo/radiation/ Recur:Mar'04 liver mets: 3 taxol/herceptin /liver resection/3 taxol/herceptin. Cured?
Recur: May'05 spine & Hip. New onc
treatment in Mexico Feb'06-Mar-06
back to Mexico June/July '06
Currently on herceptin/Zometa/Femara-recently added navelbine
Switched to arimidex Nov'06
ovaries removed June '07
ca15-3 in May'06 was 102
ca15-3 summer of '07 holding steady at 23!
ca15-3 slowly rising Dec & Jan 36, 38, 41 and Feb was 36
Feb '08 Liver, lung & Brain scan NED... bones are stable with even a couple spots gone. as compared with '06 scans
May '08 ca 15-3 is 55. Treatment is zometa, vinorelbine, herceptin and aromasin.
No signifcant changes.
Feb'09 Started Xeloda with herceptin..no more hormonals
Feb'09-June'09 tumor markers coming down again from 155 to 84
May'09 blood clots in lungs vena cava filter put in..Heparin shots daily for now.
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Old 12-05-2005, 02:04 PM   #5
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Thanks Tammy

Thanks Tammy, and your right, do every thing you can. It is not like I have hard, I mean I work two minutes from the hospital I plan on doing rads at. I live 4 miles from there, so logistically it is not hard at all, plus I have no kids so it is not like it is a big deal for me to pop over and get zapped. It is just one more thing to do.

Now why do you think I have a low chance of it coming back, I mean I am her2neu++

I pray it does not come back.

Thanks,
Randi
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Old 12-05-2005, 02:42 PM   #6
tammymarie1971
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Randi..I'm not a doctor I can only go by the experiences I've had and witnessed...Your orignial tumor was not super large,no node involvement and HERCEPTIN...Herceptin dramatically reduces your chances of recurrence..Especially now that they're giving it to ladies at the get go and not waiting until we reoccur!!!! All the best to you Randi..This is a great place to come and get encouragement as well as pretty great advice!
Tammy
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Dx'd Dec'01 while 6mos preg. with #4. child (30yrsold)Mastectomy/AC chemo/radiation/ Recur:Mar'04 liver mets: 3 taxol/herceptin /liver resection/3 taxol/herceptin. Cured?
Recur: May'05 spine & Hip. New onc
treatment in Mexico Feb'06-Mar-06
back to Mexico June/July '06
Currently on herceptin/Zometa/Femara-recently added navelbine
Switched to arimidex Nov'06
ovaries removed June '07
ca15-3 in May'06 was 102
ca15-3 summer of '07 holding steady at 23!
ca15-3 slowly rising Dec & Jan 36, 38, 41 and Feb was 36
Feb '08 Liver, lung & Brain scan NED... bones are stable with even a couple spots gone. as compared with '06 scans
May '08 ca 15-3 is 55. Treatment is zometa, vinorelbine, herceptin and aromasin.
No signifcant changes.
Feb'09 Started Xeloda with herceptin..no more hormonals
Feb'09-June'09 tumor markers coming down again from 155 to 84
May'09 blood clots in lungs vena cava filter put in..Heparin shots daily for now.
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Old 12-05-2005, 03:26 PM   #7
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Randi,
Like you I had a small tumor, no lymph involvement, am ER+++,PR+,HER2+++, and a lumpectomy. I never questioned getting radiation because I know that it really aims at the locaton of the disease and I wouldn't dream of risking needing more chemo. Radiation was a breeze for me without any ill effects unless you count a sunburned boob a disaster. I am grateful for every treatment modality that will keep me from having a recurrence. I had my first post treatment mammogram on November 9 and there was NED.
Hang in there and go with the recommended treatment.
Marlys
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Old 12-05-2005, 03:38 PM   #8
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Radiation - Decided No

Randi,

I had a .9mm tumor ER/PR - , Her2+, no node involvement, grade III. I had a bilateral mastectomy followed by AC and then Taxol. Radiation was a BIG decision for me. I had clear margins but I had DCIS within 1 mm of the margins. THe docs would not decide for me - said it was my decision.

I went to Hopkins for a 2nd opinion. The rad onc said it was a close call. I said "what if I was your sister, mother, or daughter?" She said she would tell me no but that she did not want to see me back with a recurrence. She consulted 3 other rad oncs at Hopkins and they also said they would lean towards not doing it.

So... I spent a month deciding. I finally sat down with my onc, she said she thought that since I had AC and was going on Herceptin - which can both damage the heart...... radiation - even to the opposite side of the heart can scatter to the heart.

So I decided no - and I wonder about it, but at the time I, and my onc felt good about it. I was very aggressive in everything I did.

Good luck in your decision.

Olivia
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Old 12-05-2005, 04:01 PM   #9
panicked911
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radiation?

I am also triple positive er, pr her2, no nodes, no vascualr and primary tumors were 1.2 had a lumpectomy on 10/5, herceptain 1x a week amd luprene shots - I saw three separate oncs and all said the same thing - lumperctomy = radiation - should never do one without the other -
I am starting radiation next week - scared to death - but know that i have no choice- b/c of my anatomy, the rads will have to involve the lymphnodes - hence the real prosepct of lymphdema -
like the rest I have to be sure that i am doign all I can to prevent a reoccurance- i have two kids to raise amd intend to do so for many years to come ....
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Old 12-05-2005, 04:15 PM   #10
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Geez, you got me thinking about this too. My oncologists said I didn't need rads.No lymph, large tumor. Mastectomy with clean margins, ER/PR-,HER+3. Herception for a year. Neoadjuvant & adjuvant chemo. I sure do hope they're right. Janet
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Old 12-05-2005, 04:20 PM   #11
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I drove an hour each way for 33 rads after completing mast, driving two hours each way for dd a/c, taxol/herceptin and continuing herceptin. I would gladly do it all again to increase my odds that my boys will have me around as they grow up and have their own families. I never want to regret what I didn't do.


Sassy
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Last edited by sassy; 08-22-2011 at 08:35 AM..
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Old 12-06-2005, 01:24 PM   #12
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These links may be of interest. There is a hube amount of information out there. Trying to find what you are looking for and making sense of it is another thing. I would stress I am simply an interested party and cannot offer any advice. I have all sorts of saved material and found these interesting.

Cleary trials are only indicational as they may not be relevant to your specific circumstances.

RB

http://www.cancer.gov/clinicaltrials...-radiation0205

ABTRACT

"Summary

Women with moderate- to high-risk early breast cancer who received radiation therapy in addition to mastectomy and chemotherapy were more likely to be alive after 20 years of follow-up than women who received surgery and chemotherapy alone, Canadian researchers report. ".....



I realise that the folowing is with tamoxifen but it gives an indication that RT is doing something

http://en.wikibooks.org/wiki/Radiati...rmonal_therapy

"Radiation with tamoxifen
NSABP B-21, 2002 (1989-98) - Node negative <1 cm tumors - randomized to tamoxifen alone, RT alone, or tamoxifen + RT
o 1009 women. Lumpectomy + AND. ER/PR status not required but was available for 70%
o PMID 12377957 — "Tamoxifen, radiation therapy, or both for prevention of ipsilateral breast tumor recurrence after lumpectomy in women with invasive breast cancers of one centimeter or less." Fisher B et al. J Clin Oncol. 2002 Oct 15;20(20):4141-9.
 At 8 years, ipsilateral breast recurrence in 16.5% (TAM), 9.3% (XRT), 2.8% (T/RT). (That is, about 0.5% / year for T/RT). No difference in DM. Contralateral breast cancers in 5.4% (XRT without TAM) vs 2.2% (TAM +/- RT). XRT alone group had fewer IBTR than the TAM group for both ER+ and ER-. In ER+ tumors, adding TAM to RT resulted in a N.S. lower rate of IBTR. Adding RT to TAM resulted in a lower IBTR rate for both ER+ and ER-."





This link covers a wide range of treatment issues which may or may not be of interest, but does contain an interesting paragraph on boost mentioned above which I have pasted. I have seen other mentions that boost provides benifits but have tried searching for statisitics for boost but without much success.





http://store.yahoo.com/annieapplesee...nbreascan.html

"......Among those younger patients who did not receive boost radiation to the primary site (N = 132), a 30% local recurrence rate was observed at 8 years median follow-up, compared with a 10% rate of recurrence among the 109 younger patients who did receive boost radiation......."
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Old 12-07-2005, 08:50 PM   #13
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Randi


Sorry about not responding about the "boosts" earlier. I just didn't come on the site for about 2 days. The last 5-7 radiation treatments are boosts that focus only on the site of where the tumor was (and the rest of the breast is "done" and can start to heal). This always encompasses the site of the incision too as this area is the most likely place for recurrance because it is different and chemo does not penetrate that tissue well due to lack of good circulation.

Best regards

Becky
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