Your 2 cents worth...

[Jean]

Posting this article here for open discussion.

"Delays in Radiation"...
http://www.medicalnewstoday.com/articles/131382.php

I found this article to be very interesting since this has been a point of interest to me. While I realize the urgency in starting chemo treatment and it is the first treatment that begins, to be followed with radiation, I have been wondering for a long time if those with early stage disease would be served better to be treated with radiation first (especially now since there are new shorter radiation treatments lasting only days) instead of weeks.

The theory being that you attack any cells that may be left behind immediately....at the bed of the tumor. While at SABS last year I saw a film on a new radiation treatment that was performed in the OR right after the surgeon removes the tumor and treatment is applied before the surgeon closes the lumpectomy...very interesting.

My thoughts on this are - since the patient is Stage 1
node neg. maybe radiation should be applied first to offer a complete procedure then go forward with chemo? Note this would only apply in early breast cancer patients...

I can only speak for myself, when I was first dx. and I began to make appointments for my radiation portion of treatment I was met with delays...and the dr. assured me that a couple of weeks would NOT matter. I did not buy it then - (3 yrs ago) it made no sense to me. I pushed and pushed and did get my rad treatment 30 days after surgery....strange that my situation is....I did not have chemo/herception until much later....becasue at the time all onc. would not treat me since I was stage 1 with a small tumor...

Maybe the future for early stage patients is faster treatment with the new methods shorter treatments of radiation to be followed with chemo/herceptin or maybe just herceptin.....Dr. Slamon and I, and my onc. here on the East have discussed this a few times, and they are
keeping records about my "different case"....

Yes, I know sisters, I am weird...
Your input and thoughts ....?

Kind Regards,
jean

[Jackie07]

Have you ever thought of Jean as being weird? I doubt it.

Bringing this up for everyone to 'toss the coin' (She wanted our 2 'cents'.

[hutchibk]

Jean, you, weird? Ummmm.... LOL - if smart is weird, then I suppose so ~

I was interested when I saw this on the news yesterday... as I chose NOT to do radiation when first dx'ed.

Then, I noticed that a very important aspect of the story was that it highlighted "older women, over 65" as being the group they were referring to... just FYI.

[Jean]

Hi Brenda,
I realize the study group was in older women - I am still curious to the effects of having radiation ASAP upon healing from surgery (30 days min.) now going forward with the new shorter treatments and then to be followed by chemo/herceptin...or just herceptin?

Wondering if this could be a new approach?
I would consider that younger women would have higher risk factors being pre menopausal and therefore,
any delay in treatment should be questioned. I have heard dr. saying up to 3 months for rad treatment.

Also still wondering if the new shorter rad treatments should be applied first.

Jean

[Jackie07]

I've read from signatures that some members were having radiation first to shrink the tumor before surgery. Since there are post surgery problems involved (like my fluid (swelling)problem in the lumpectomy site), I wonder if everyone should have radiation first before surgery to cut down the recurrence.

[Jean]

Hmmm that is an interesting tought Jackie,
but I think that the benefit of radiation is to mop up the area afer surgery, but in the case of a larger tumor radiation is used to shrink it.

The study was interesting in that it is showing time is an important issue.

jean

[Jackie07]

Sorry about the misinformation. I was thinking about the presurgery chemo (neoadjuvent)to shrink the tumor size. It might not be good to 'burn' the tissue before 'slashing' it.

[Mary Anne in TX]

I have never understood why they would wait to do the radiation later if the purpose is to kill any stray, closeby cells left from surgery. It made more sense to me to do the radiation first, even if they had to start chemo midway.

[tricia keegan]

I also think it makes far more sense to have rads first asap after surgery and then go on to chemo. I wonder why they don't??? I assume there must be a reason to do it this way.

[CLTann]

Postponing treatment for cancer, whichever is the method, is not medically and scientifically defendable. It is pure self serving lie to fit the doctor's schedule. The doctor ought to be sued and sanctioned. The patient's life, to the doctor, is another routine piece of merchandize. I bet he would not take the same view if the patient is him or herself.

[ElaineM]

It is quite possible that there is no normal or no standard way of treating patients. Each person's situation is different. Each person might need something a little different than the last person or the next person.
There are so called "standards" of treatment, but even they change from time to time depending on the combined experiences of scientists and doctors with patients. Maybe they should call those "standards"
"guidelines" instead.

[schoolteacher]

Jean,

I started radiation one month after my surgery, so maybe this was a good idea. I started the adjuvant chem almost a month after radiation.

Thank you Jean for posting this article. It has helped me feel a better about my treatment plan.

Amelia

I was an early stage also, however the surgeon thought radiation would be part of my tx., but when discussed at weekly board, they went with chemo. Even though I did not get 100% clear margins on one of my tumors near the chest wall. (had 4 small individual primaries)
I have always wondered if not having the radiation would make a difference?

Well wishes, to all,
Murph
Feb/07 39 yrs dx IDC (4 seperate tumors, all Her2 +++)
AC/Taxol
Herceptin 1 yr
oopho--followed with Femara
Feb/08 tissue expanders (unhappy with them, looking into changing them Feb/09)