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Old 06-21-2012, 04:17 AM   #1
LeahM
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Location: Bethlehem PA
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Radiation and the Tumor Board

Good Morning All

I know I mentioned before that rads was now on the table for me because of a micromets in my SNL. And I know I mentioned that my surg onc and med onc told me that they both felt I would be fine if I didn't do rads. And I know I mentioned that I was in agreement with them.

Last Fri. the "tumor board" met and discussed my "case". Seems they had a collective change of heart and now feel that because of my "young age" (39...who knew?) I should "seriously consider" rads. (sound familiar mandamoo?)

So of course, I have had a change of heart too. I meet with rad onc on July 6 and hope that she has some data...some research...some studies...some something that she can show me to help me with this choice.

Is it weird that choosing a BMX was easy but choosing rads is hard? Messes up my timeline...silly, I know.
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39 year old wife, mother of one and nurse.
April 20, 2012: Dx Invasive Ductal Carcinoma
April 25, 2012: ER+(5%), PR-, HER2+++
May 10, 2012: BRCA 1,2 Negative
May 23, 2012: MUGA Scan EF 70%
May 31, 2012: B/L Mastectomy. 2/2 nodes removed and CLEAR!! Power Port placed. 2 Drains. 2 Expanders placed
June 5, 2012: Drains OUT! Ahhhh..
June 12, 2012: Final Pathology Report, .8x.3cm tumor. Micromets to 1 node .35mm under cytokeratin staining. Stage 2A. Onc says "you are lucky to have found this early"
July 10, 2012: Started 6 rounds of TCH with weekly H
Sept 5, 2012: MUGA 65%
Sept 20, 2012: CAT scan of brain clear!
Oct 23, 2012: LAST TC! AMEN! Continue Herceptin every three weeks until July 2013.
Nov 19, 2012: Port out!
Dec 5, 2012: Started radiation
Dec. 10, 2012: MUGA 65%
Dec. 13, 2012: Turned 40. BEST BIRTHDAY EVER!
Jan 23, 2013: Last radiation. Told I am NED. Continue Herceptin every three weeks till July 2013.
Jan 29, 2013: Begin 5 years of Tamoxifen.
Feb 28, 2013: CT Scan with Contrast of lungs. 5mm and 4mm nodules of unknown origin. Rescan in 3 months.
Mar 6, 2013: EF 60%
May 8, 2013: Exanders out, implants implanted...abd. lipo and fat moved up. Girls are looking good!
June 3, 2013: CT Scan with Contrast of lungs. Previous nodules gone. New nodules (2mm and 3mm) found. Rescan in 3 months. So sorry I opened this can of worms...
June 11, 2013: EF 60%
June 25, 2013: Last Herceptin. wow...
Aug 20, 2013: Tumor markers within normal limits. Xray to sore left ribs shows no disease or fractures.
Sept 9, 2013: CT of lungs shows no disease. Closing this can of worms and moving on.
Nov 20, 2013: Tumor markers within normal limits. Severe Vit D deficiency, started on prescription Vit. D. Blaming chemo for this.
Feb 2014: Tumor markers within normal limits.
May 2014: Tumor markers within normal limits. Graduated to twice yearly onc appts.
Oct 2014: Tumor markers within normal limits.
May 2015: Tumor markers WNL. Bone density scan fine. Bone scan and xray of ribs shows "something" 4th right rib. Could be healed fracture but if it is healed why does it hurt?
Nov 2015: Tumor markers WNL. Follow up bone scan clear.
Feb 2016: Syncope! WTF? Dizzy too. Brain scan clear, ECHO EF 60%, Halter Monitor shows heart is fine. Viral? I will never know.
June 2016: Tumor markers WNL.
Oct 2016: Stabbing pain right eye. Long story short, trigeminal neuralgia.
Nov 2016 Brain MRI clear.
Jan 2017: Tumor markers WNL, still getting weird pain right rib area, and sometimes right upper chest. Xray x2, Bone Scan, Breast MRI all clear. Scar tissue? Rads. I may never know.
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Old 06-21-2012, 11:54 AM   #2
roz123
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Re: Radiation and the Tumor Board

hi leah
i was also in a grey area for rads, seems a lot of ppl are

i had chemo before surgery, while in treatment I was told that i would have to have rads whether i had a msx or lump because i had lymphovascular invasion (negative nodes as per imaging)

i wanted to avoid rads aswell and would have done the msx at the get go if i got a free pass...anyway i decided to do the lump and then do the bmsx after i healed b/c here in canada they will not put expanders in if you are having rads

fast forward to surgery...i have the lumpectomy and they tell me i had a complete response, zero cancer in the lump sample or nodes. My BS and MO tell me now that i can go straight to a bmsx and skip rads. RO is on the fence because of my complete response. So of course i am totally confused because i was told all along regardless of the surgery i chose i would have to do rads

i decided to do them...why? well the LVI was playing on my mind, some RO's consider it a positive node. Also my nodes were not tested prior to starting chemo so i really don't know if they were effected. My reasoning is that rads get everything, even tissue that cannot be surgically removed (you can't get everythin in a msx) Did i make the right decision? who knows. I am still going ahead with the bmsx in september

as for micromets in one node -that is a big grey area, some radiate some don't -

I would check NCCN guidelines and see what that says. I think (and this is just a layman's opinion) that you could go either way, it is just what you feel comfortable with. They would probably only radiate your axilla so you would not be getting the full rads exposure

good luck
this cancer crap is tough!
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diagnosed aug/11
right breast IDC 2.2 cm LVI
neoadjuvant fecx3, tax and her x3
surgery -pCR 0/2 nodes
25 rads
herceptin x18
tamox
prophy bi-msx with TE's oct 15/12
LD flap reconstruction (PM me if you want the details)
zoladex shots monthly until SOFT studies come out
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