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Lani · 10-24-2006, 09:55 PM

is because they don't really know the right answer

With so many unknowns, it becomes a risk/benefit choice which everyone feels differently about.

They radiate many more than a dozen people unnecessarily to prevent 1 recurrence
(and even if an occurence takes place, it doesn't increase the chance of distal metastasis or survival)

For those who are not triple negative or her2+, they give a lot of chemotherapy when the vast majority do not need it and do not benefit from it. Should the doctors be the ones deciding the acceptable ratio of unnecessarily treated patients(in whom they could cause a second cancer with the treatment) to one patient benefiting?

Once breast cancer starts to be treated as separate diseases they may be able to quote better statistics and find better tailormade treatments (hopefully more targetted and less toxic) and their and your decision will become easier

It is scary to realize they don't know all the answers--but if that is true, your opinion/ wishes carries/carry all that much more weight!

I am tryiing to help an 84 year old her2+ breast cancer patient get information to help her decide whether, at her age, to have radiation therapy. They don't do prospective randomized trial for people in her age group (too many would die of other causes before results could be tabulated), rather they "mine" Medicare data (unfortunately medical records/billings are not always accurate) to see how people do.

The question is for an improvement of a few percent in local recurrence, what chance of fatigue (which might be debilitating in an 84 year old) would one risk? Only the person knows how tired they are, how much fatigue might impact their quality of life, how it might be psychologically to have to have another lumpectomy or a mastectomy if it recurred, etc.

Would you want a doctor deciding this for you when you are 84? The articles are there, the information (as it is/that there is) is there--I even found one for rate of recurrence with lumpectomy plus radiation therapy in patients over 70 that are her2+. I hope she has the inner strength to make the decision herself as I doubt a doctor could make the decision any better than she can.

10-24-2006, 09:55 PM	#14
Lani Senior Member Join Date: Mar 2006 Posts: 4,780	The reason the choice is yours... is because they don't really know the right answer With so many unknowns, it becomes a risk/benefit choice which everyone feels differently about. They radiate many more than a dozen people unnecessarily to prevent 1 recurrence (and even if an occurence takes place, it doesn't increase the chance of distal metastasis or survival) For those who are not triple negative or her2+, they give a lot of chemotherapy when the vast majority do not need it and do not benefit from it. Should the doctors be the ones deciding the acceptable ratio of unnecessarily treated patients(in whom they could cause a second cancer with the treatment) to one patient benefiting? Once breast cancer starts to be treated as separate diseases they may be able to quote better statistics and find better tailormade treatments (hopefully more targetted and less toxic) and their and your decision will become easier It is scary to realize they don't know all the answers--but if that is true, your opinion/ wishes carries/carry all that much more weight! I am tryiing to help an 84 year old her2+ breast cancer patient get information to help her decide whether, at her age, to have radiation therapy. They don't do prospective randomized trial for people in her age group (too many would die of other causes before results could be tabulated), rather they "mine" Medicare data (unfortunately medical records/billings are not always accurate) to see how people do. The question is for an improvement of a few percent in local recurrence, what chance of fatigue (which might be debilitating in an 84 year old) would one risk? Only the person knows how tired they are, how much fatigue might impact their quality of life, how it might be psychologically to have to have another lumpectomy or a mastectomy if it recurred, etc. Would you want a doctor deciding this for you when you are 84? The articles are there, the information (as it is/that there is) is there--I even found one for rate of recurrence with lumpectomy plus radiation therapy in patients over 70 that are her2+. I hope she has the inner strength to make the decision herself as I doubt a doctor could make the decision any better than she can.