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TNBC in the elderly

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SeekingGuidance View Drop Down
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    Posted: Mar 17 2017 at 8:34am
Thanks for this forum.  First, let me say that I am almost reluctant to ask this about a woman who has been blessed with a beautiful long life when so many young people are struggling with this awful disease.  Know that you are now part of my prayers every night. But here goes...My 86 year old mother has been diagnosed with TNBC.  She had a mastectomy (sentinel nodes positive) and has been advised by her oncologist to do nothing more due to her age.  She's pretty healthy, alert, enjoying life.  It was odd to us that no options were offered for treatment though we are not naive to the toll of chemotherapy and radiation, especially with her advanced age. Does anyone have any comment or words of wisdom for us?
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Post Options Post Options   Thanks (1) Thanks(1)   Quote gordon15 Quote  Post ReplyReply Direct Link To This Post Posted: Mar 17 2017 at 5:14pm
The year-old cutoff I thought was  70 years old, maybe, since mortality has risen, it's 73-75 years old...it's my opinion, since I'm not a doctor,  to give a person of 86 yrs- old chemo is almost the same as malpractice.
wife: IDC/Lobular Stage2B 2008 lumpectomy/TAC+rads
TNBC Stage 3A/w/metaplastic/squamous Nov2015 Carboplatin-Gemzar chemo/masectomy Taxolchemo+rads 4-16
PET scan stable 9-2016/ 1-2017
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Post Options Post Options   Thanks (0) Thanks(0)   Quote SeekingGuidance Quote  Post ReplyReply Direct Link To This Post Posted: Mar 17 2017 at 5:55pm
Thanks Gordon15. Radiation to the axilla/node area was offered as a possible option, but it seems that it will just give her more MD appts to go to and burn and exhaust her for the same outcome. So, she was told to come back to the oncologist in two months so she could be "monitored". After we left, I started thinking about that....guessing he means some sort of scans or something....but if we are doing nothing, what exactly is the point of seeing an oncologist? Is there something that they do as this disease progresses that is especially different than a primary care doctor would do? Sorry if I sound like a complete idiot, but I am just wondering. I do not want to rob today of it's pleasures by stewing about tomorrow...just trying to think things through....
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Post Options Post Options   Thanks (0) Thanks(0)   Quote gordon15 Quote  Post ReplyReply Direct Link To This Post Posted: Mar 17 2017 at 6:37pm
SG: normally, they want to do radiation on the armpit where the mastectomy was. My wife had a single mastectomy & they took out 5 lymph nodes in that armpit, and did radiation to the suture area around surgery, up to the lymph nodes under the clavicle, on that side, and in the armpit on that side but at 66 yrs old. Even radiation is exhausting and has complications.

This is a "quality of life" issue, I am sure others here have some opinions and help.


Edited by gordon15 - Mar 18 2017 at 8:19am
wife: IDC/Lobular Stage2B 2008 lumpectomy/TAC+rads
TNBC Stage 3A/w/metaplastic/squamous Nov2015 Carboplatin-Gemzar chemo/masectomy Taxolchemo+rads 4-16
PET scan stable 9-2016/ 1-2017
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Post Options Post Options   Thanks (1) Thanks(1)   Quote mainsailset Quote  Post ReplyReply Direct Link To This Post Posted: Mar 17 2017 at 10:14pm
Someone else had a similar question several months ago and some good comments came forward.

It occurs to me that you might ask the oncology team if they have a palliative care person on staff and see if you can get a meeting with them. Often the role of palliative care, especially when put in place while she's feeling spry and living life well, can help extend the quality of life.

It might also give you, if you're to be her caregiver, more ideas of what to keep an eye out for, how to design meals and exercise as well as how to tweak the house to make it more accommodating.

Thank you for sharing her story and reaching out to ask questions.
Mainy
dx 7/08 TN 14x6.5x5.5 cm tumor

3 Lymph nodes involved, Taxol/Sunitab+AC, 5/09 dbl masectomy, path 2mm tumor removed, lymphs all clear, RAD 32 finished 9/11/09. 9/28 CT clear 10/18/10 CT clear
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Jacklin Quote  Post ReplyReply Direct Link To This Post Posted: Mar 18 2017 at 9:41am
Dear Seeking Guidance, 

Know that you are in my prayers. Much strength, courage and wisdom for each day. Mainy has some excellent points above. I'm seeing a palliative care doctor for pain management and he has so much experience and has brought some much-needed relief for myself.
Dx: Nov. 27/15, TNBC, left breast & lymph, BRCA -; Chemo: Dec 4/15 - Mar 4/16; 4 DD A/C, 3 DD Taxol; BMX/ALND: April 26/16; Stage 3C; Radiation: June 10-July 15/16; 1 cycle Xeloda: Aug 15 - 28/16
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Post Options Post Options   Thanks (0) Thanks(0)   Quote SeekingGuidance Quote  Post ReplyReply Direct Link To This Post Posted: Mar 18 2017 at 10:57am
Mainy, Jacklin and Gordon15, thanks so much. I shared this with my mother. Your comments made me realize that our initial consultation felt empty...not warm. I thought it was because we were receiving news we did not want to hear, but it was more than that. There was no even passing mention of support, palliative care, etc. We will seek another practice, not for a new treatment option (we know there is none), but to find one with a more and patient-centered feel to it. God Bless you all for taking the time to comment on this string. What an incredible resource and comfort.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote mainsailset Quote  Post ReplyReply Direct Link To This Post Posted: Mar 18 2017 at 11:57am
Please do let us know how things come together for you. A final thought, and one that has helped me many times over...know that when you go about your daily business or when you walk into the doctor's office or wait for test results that you are not alone. There will be many of us standing in spirit with you in the room and sitting by your side.
dx 7/08 TN 14x6.5x5.5 cm tumor

3 Lymph nodes involved, Taxol/Sunitab+AC, 5/09 dbl masectomy, path 2mm tumor removed, lymphs all clear, RAD 32 finished 9/11/09. 9/28 CT clear 10/18/10 CT clear
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Post Options Post Options   Thanks (0) Thanks(0)   Quote SeekingGuidance Quote  Post ReplyReply Direct Link To This Post Posted: Mar 18 2017 at 3:37pm
Such a warm, kind response that brought tears to my eyes. The goodness and humanity in people I have never met is so comforting at a tough time. Thanks so much.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote SusaninVA Quote  Post ReplyReply Direct Link To This Post Posted: Mar 20 2017 at 12:57pm
Seeking Guidance, I just want to say it doesn't matter how old your Mom is in that you want to do the right thing for her. Was her positive node or nodes removed during surgery? Also, if this is her only major health issue, and she is mentally competent, I would offer her the radiation if she wants it. She would really have to be vigilant as her skin is probably thinner now in older age. Definitely get her with someone who has a caring manner - I hate to see older patients "written off" and oftentimes they will respond to therapy better than we think. Wishing you and your Mom the very best.
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