Is Chemo necessary?
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Topic: Is Chemo necessary?
Posted By: Taharadale
Subject: Is Chemo necessary?
Date Posted: Mar 07 2010 at 8:23pm
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Hi, I am new to this site and have been diagnosed with triple negative breast cancer. I am 53 years old with no history of breast cancer in my family. I have had a lumpectomy with clear margins and the sentinal nodes were clear. The cancer was stage 1 Grade 3. I have an appt with an oncologist tomorrow and I would be interested to know if others in my situation have had chemotherapy or radiation treatment.  |
Replies:
Posted By: 123Donna
Date Posted: Mar 07 2010 at 8:57pm
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Hello! Our stories are similar. What size was your tumor? Chemo is almost always recommended for Triple Negative Breast Cancer. It's the only thing in our arsenal to fight this aggressive bc. Please feel free to post any questions you have. Someone is always willing to step in and offer advice or support. Here's a great brochure explaining tnbc: http://www.lbbc.org/data/media/LBBCunderstandtriplenegative.pdf - http://www.lbbc.org/data/media/LBBCunderstandtriplenegative.pdf Have you had your Vitamin D3 level checked? Most of us with bc have very low levels of D3. There's a good website explaining the importance of D3: http://www.vitamindcouncil.org/ - http://www.vitamindcouncil.org I'd also recommend a good book called Anticancer: A new way of life by Dr. David Servan-Schreiber http://www.anticancerways.com - http://www.anticancerways.com ------------- DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09) 11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15 |
Posted By: TNBC_in_NS
Date Posted: Mar 07 2010 at 9:11pm
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Hi Taharadale and welcome to our site! Sorry you had to find us but you will find that all the members are very good at answering your questions as it related to themselves. We share our experiences and hopefully it helps others. There is so much of the unknown with TNBC but the more we learn the more we understand it.
We have a brochure here is the site: http://www.tnbcfoundation.org/tnbcbrochure.htm - http://www.tnbcfoundation.org/tnbcbrochure.htm
In answer to your question about having chemo and radiation. Because triple negative is so aggressive, it is normal procedure to have both modalities. I am sure your oncologist will discuss this with you and when you get the information about what type of chemo they will use, post it here on where your first post it and you will have so much information because others will discuss what they were taking.
I had cyclophosphomide and Taxotere for 4 treatments and then 16 radiation treatments. I was Stage II, Grade III. Because there are no other treatments out there for us, we do not get to take tamoxofen for the 5 years after like the positive breast cancer patients can. Be strong and know that you are not alone anymore. We are here for each other.
Check out the other resources and tips when you get a chance. I am sure you will find that there is someone who has had the same diagnosis as you. We also have the spiritual forum if you are in need of prayer just check in there and we will be there. Take care, and all the best with your appointment tomorrow! Let us know how you are doing.
Helen in NS Canada  ------------- Diag@57TNBC04/092.5cm Lquad 05/09 TCx4Radsx30CT03/01/10 FU03/31/10ClearBRCA- 01/2011 RTNBC BMX 06/14/2011~2013 clear |
Posted By: scared
Date Posted: Mar 07 2010 at 9:55pm
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Hello, Lots of decisions to make concerning cancer care. So you are finding out from us who have gone through treatment. In our situation our oncologist recommended the treatment to have the BEST survival rate that she knew of. Doing everything she suggested gave us an 82% survival rate for a five year period, so you do what you have to to get the odds in your favor. Being TN besides surgery chemotherapy and radiation are the only weapons we have to fight it. When you eliminate chemotherapy then the odds go down, as it does when you eliminate radiation. So each person must find out all the information they can about their cancer. Breast cancer is so different for each patient and each patient must KNOW what their options are for their best chance of survival. So my best advice is to get all the information, weigh the consequences of your actions and then decide if you can live with your decision. As for us, we chose chemotherapy. You are different, and you must make your decision wisely because your life depends upon it. Wishing you the best and I am glad you found us, Dave ------------- Wife diagnosed 7/08 stage 2B 4.78cm with 3 nodes. 15 weeks of Adriamycin and Cytoxin, Mastectomy, 12 weeks of Taxol, and 6.5 weeks of radiation. |
Posted By: Kerry OK
Date Posted: Mar 07 2010 at 10:51pm
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Hi Taharadale,
As with so many others, I am glad that you found this site for comfort in what you are going through. I am also 53 years old and a stage1 grade 3 TN with no cancer in my family. I was in your same situation on why should I do chemo if I had a lumpectomy and my nodes were clear. My first oncologist said since my cancer was so small that I should do radiation only. He was so concerned (since it was TN) that he did take my case to a local breast conference. Half of the oncologist said that they would offer me the option for chemo since it was TN. We went for a second opinion and he also said radiation only. In the meantime my 1st onc changed his mind after researching and he said to do chemo. I then had the opportunity to go to MD Anderson in Houston to a specialist. She was a wonderful doctor and she gave me the advice that I needed to hear. I am now fighting TNBC with all I can. I do not want this to ever come back. Good Luck in what you decide~it will be the hardest decision ever, but in your heart it will be the right one. You don't want to look back and ask yourself "what if..."
Knowing what you are about to face...
Best wishes,
Kerry
------------- DX 11/11/09, IDC, <.5cm, 0-2 Nodes, Stage I, Grade 3 TNBC, Lumpectomy 11/27/09, Age 53 Treatment begins 2/5/10, 12 wkly doses Taxol, 4 doses every 2 wks of A C Then 6 wks Rads |
Posted By: kirby
Date Posted: Mar 08 2010 at 2:16am
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I was told many years ago the reason I was having chemo was because of my age, the size of tumor and being pre menopausal. And that was before they knew what TN was. ------------- kirby dx Feb. 2001. Age 44 Lumpectomy 2cm. no nodes stage 1 grade 3 4 rnds AC, 35 rads |
Posted By: Taharadale
Date Posted: Mar 08 2010 at 4:04am
Thank you so much everyone t\For your wise words - It is so nice to find others in the same boat - especially you Kerry who it sounds haa much a similar journey to me!  I will most definitely let you know what is suggested by the oncologist and the decision that I make.T
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Posted By: caro36
Date Posted: Mar 08 2010 at 6:05am
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Hi Taharadale,
Welcom to the forum, glad you found us, sad for the reason why.
Just to let you know. My tumor was only 6mm and chose to have chemo and rads. I too did not have any family history of BC but I did turn out to be BRCA1+. I don't want to freak you out. But I would recommend you talk to a genetic counsler.
In your corner.
Big hug, Caroline ------------- lumpectomy 9/2/08 6mm TN tumor 38 rads, 13 boost 6xTAC finished 04/10. BRCA1+ bill. mastectomy, imm. reconstruction using tissue exp 01/10 |
Posted By: Carol (Tenn)
Date Posted: Mar 08 2010 at 7:47am
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Welcome Taharadale,
I am so happy you found us. I didn't find this wonderful site until after my treatment. I learned a lot here that I didn't know going in. I was one of those people who chose to be passive and not taking charge of myself. Surely God was watching out for me as I had the best treatment available for me.
My tumor was 2.0 Cm and underwent surgery, chemo and radiation and it still recurred. But that's me, not you. We are all different as stated earlier. That is why I recommend Chemo AND Radiation. TNBC has a nasty habit of hiding from treatment, so I would aim all my weapons at it and blast it with all that's available. Let us know how you are doing. We all care and you are not alone. As Helen mentioned we do have a Spiritual Support thread and we would come your visits there as well.
Love and Prayers,
Carol ------------- St 2 Gr 3, A/C/T, DD Radiation x35 Rec chest wall 07/09 Radiation x28 NED 10/24/11 NED 10/5/12 NED 03/15/13 |
Posted By: Joanie
Date Posted: Mar 08 2010 at 11:38pm
| I had a bilateral mastectomy for DCIS breast cancer in the right breast Feb. 4,2010. Lesion one is 0.4cm, lesion two was 0.3cm neg. sentinel nodes, grade 1 margins uninvolved, 3 lymph nodes-uninvolved- early microcalcifications no lumps. Triple-negitive cancer. I also wonder if Chemo is necessary? My oncologist left it up to me, i was not thrilled with that decision, but she explained thats all they have to offer for triple-neg. i am choosing not to have Chemo, but I am getting a second opinion, with a different oncology group. I live in San Diego, Calif. I would appreciate some feed back. There is no breast cancer in my mothers side of the family, biological father unknown. Thank You joanie |
Posted By: 123Donna
Date Posted: Mar 09 2010 at 7:55am
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Joanie, I'd definitely get a second opinion. If possible, someone in your area who specializes in TNBC. Good luck and keep us posted on what you find out and your decision. Donna ------------- DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09) 11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15 |
Posted By: SusanE1104
Date Posted: Mar 09 2010 at 8:19am
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Hi Taharadale,
Welcome to our site. I know you'll find lots of good information and support here.
 Now, I have a question for everyone who has had both chemo and radiation. Where was the radiation directed? I was stage IV on diagnosis in Jan. 09....mets to the liver. I had a bilateral mast. and chemo...still on chemo. But no one has suggested radiation to me. Did you have radiation to the mets area? I think I read somwhere that radiation isn't given to the liver, so maybe that's the explanantion. Thanks for any input.
Susan ------------- Susan 62 1987 Stage 1 1/09 Stage IV bilat. mast. liver mets BRCA1+ Taxol & Avastin 8/09 NED 12/09 liver mets Taxol/Avastin 4/10 liver mets 11/22 Parp Car/gem parp failed 2/2011 Ixempra |
Posted By: Carol (Tenn)
Date Posted: Mar 09 2010 at 8:33am
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Dear Susan
I wish I could help you with an answer but I can't. What I can do is encourage you
 , love you  and pray for you. God bless you everyday in your journey.Love and Prayers,
Carol ------------- St 2 Gr 3, A/C/T, DD Radiation x35 Rec chest wall 07/09 Radiation x28 NED 10/24/11 NED 10/5/12 NED 03/15/13 |
Posted By: 123Donna
Date Posted: Mar 09 2010 at 8:40am
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Susan, I have a friend who was dx with Stage IV to the liver. She was bc er/pr+. They only treated her with chemo, no radiation either. I hope this helps. Others may have more information. Donna ------------- DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09) 11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15 |
Posted By: outnumbered
Date Posted: Mar 09 2010 at 8:58am
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Taharadale, I did not have chemo. My IDC was multi-foci largest 2mm. Let me just say that if I had it to do over again, I would have insisted on chemo. I was not given the option. I have not had a recurrence; however, I think my fear of it would be less if I had had the chemo. Sometimes I feel like a sitting duck. Also, I want to add, that I do not have a family history either and I turned out to be BRCA1+. Joanie, It is my understanding that they do not offer chemo for DCIS as it has not become invasive. Especially since you had a mastectomy and no additional IDC was found, you may be ok. I am not a doctor, so obviously do whatever your doctor says. But if they tell you no chemo, I would not get worried about it. This is a personal choice to make which is based on your understanding of your medical history. Gather as much information as you can. Do your research. Go to the best doctor you can find who is TN savvy. Get as many opinions as you need. Once you have all the information, try to make your decision based on science, not fear. Please know that we are with you no matter what path you take. You have found a network of sisters here, who will be here for you day and night. Best wishes! ------------- ~Sara DX @ age 40 6/24/08 Stage 1 Grade 3 BRCA1+ 187delAG BMX (nipple-areola-sparing) 8/5/08 Redo BMX (remove nipple and areola) w/ Lat Flap 7/6/09 BSO 9/3/09 NED since 08/05/2008 |
Posted By: 123Donna
Date Posted: Mar 09 2010 at 9:07am
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Joanie, I have a friend who was dx with tnbc about a year before me. Her's was dcis, stage 0. She had a mastectomy due to a botched lumpectomy. The path report showed it in other lobular areas so that may mean she was multi-focused (I'm not a medical expert). They found some cells in the lymph node that wasn't cancerous but they couldn't identify them. Out of 5 oncologists, 2 recommended chemo, 2 didn't and one said she could go either way. In the end, she chose no chemo. She's 2 years past dx and no recurrence, but sometimes I think she worries more than I do. Please get the advice of as many tnbc experts that you can talk to about their recommended treatment plan. Good luck. ------------- DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09) 11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15 |
Posted By: Sugar77
Date Posted: Mar 09 2010 at 9:37am
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Hi Taharadale, I'm new to this site, too. Just joined this morning. Regarding chemo, my tumor was very small and I was surprised when it was offered to me. The choice was mine and in the end, I decided to go ahead so that I knew I had done everything available to me. I completed TC chemotherapy four weeks ago (Feb 8th) and will be starting radiation in the next couple of weeks. While chemo is no fun, it's doable and I tolerated it just fine. It wasn't as bad as I had envisioned. Good luck with your treatment. ------------- DX IDC TNBC Oct. 27, 2009, age at diagnosis 45, Stage 1, Grade 3, <1 cm, 0/2 nodes, lumpectomy, Taxotere/CytoxanX4, finished Feb. 8, 2010, radiation completed Apr. 21, 2010. |
Posted By: Joanie
Date Posted: Mar 09 2010 at 11:21am
| Donna, thank you so much for your response. It's helps to have others with TNBC. I have so many friends with hormone receptor positive BC, NONE with TNBC. I'm so glad my niece e-mailed me this site! Thank You Joanie |
Posted By: Joanie
Date Posted: Mar 09 2010 at 11:37am
| Thank You Outnumbered, I was offered Chemo as a precaution, in case a tumor was lurking somewhere in my body! I'm scared of Chemo! I am getting a second opinion, but have full confidence in my San Diego Cancer Center and oncology. I have a friend thats a surgeon and she has referred me to an oncologist that she feels is the best, so I am going to see Him. The TNBC was in the right breast with slight invasion, stage 0 grade l, I chose to have a bilateral Mastectomy with reconstruction, I am 67yrs. I really appreciate that you replied so quickly. Thanks Joanie |
Posted By: dmwolf
Date Posted: Mar 09 2010 at 11:38am
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The way I would decide is: if IDC<.4 cm, then no chemo. If 1cm>IDC>0.4cm, then TCx4. If IDC>1cm, the full chemo meal. No mastectomy unless BRCA+, radiation if lumpectomy. -Denise ------------- DX 2/08@43 stg II IDC; gr2,0 nodes. Neoadj chemo, first ACx2 (fail) then CarboTaxotereX6(better). Lump, Rads done 11/08; Clodronate. False alarm queen: PetCT lung & TM marker. NED. PBM w/recon 9/10. |
Posted By: Taharadale
Date Posted: Mar 09 2010 at 12:07pm
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I am sitting here in the middle of the night because I can't sleep for thinking! I met with the oncologist yesterday she offered me 4 cycles of chemotherapy - EC, followed by radiotherapy - and outlined the reasons for that. She said there is a 5 to 8 percent chance that the cancer has spread ( I say that's a 92-95 % chance that I am cancer free!) I still don't know - my family are all very supportive whichever way I go and have all said they think I should take the chemo option. But I still don't know - I have always been such a healthy person, I exercise, eat fairly well - I rarely even have a cold! My cancer was small (12mm) - sentinal nodes clear. Stage 1 Grade 3. Has anyone investigated alternate therapies or decided to go down that track? I have many people supporting me and my church praying for me as I process this decision. I know God is with me in this and that he wants me to trust Him. I just don't have clear direction. I don't know I don't know I don't know!!  |
Posted By: Carol (Tenn)
Date Posted: Mar 09 2010 at 12:30pm
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Taharadale,
I've given you my opinion...I'm not a doctor....It's just my own experience....Like someone already said, chemo is doable. But in the end you have to decide for yourself. This may not help.....but what if you choose no chemo and you have a recurrence (which tn does very often) then you'll wish you had....if you don't have it and it doesn't recurr then you made the right choice. The complexity of all this in no one knows for sure. For me, better safe than sorry. I know this doesn't help a bit.
I will pray for you that you make the decision that suits you the best.
Love and Prayers,
Carol ------------- St 2 Gr 3, A/C/T, DD Radiation x35 Rec chest wall 07/09 Radiation x28 NED 10/24/11 NED 10/5/12 NED 03/15/13 |
Posted By: Taharadale
Date Posted: Mar 09 2010 at 12:37pm
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Thanks Carol I appreciate your opinion! Barb
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Posted By: diane1234
Date Posted: Mar 09 2010 at 12:59pm
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Hey sweetie....sorry u had to join, but I can promise u this.....LOTS OF LOVING LADIES and MEN on here. I am 36 and u can see my signature below. I met women during chemo that was stage I and yes they did do chemo. Of course it is an individual choice. I have also met women doing chemo who knew their tumors did not have hormone receptors. They were triple negative and did not know anything about it......I believe knowledge is POWER....... If I was in your situation I would do it. Again individual purpose. I had my surgery first. I was given the option of lumpectomy and immediately said oh NO I want that left one OFF...(cancer was in left breast) Surgeon said ok HON...... Couple of days later I called her and said OK....I want em BOTH gone....she said honey that is a HUGE decision on your part being 36 years old. I said well my gut just tells me to....I am SURE it was the Lord. She then said As a surgeon I am suppose to give you the option of lumpectomy or mastectomy, but with YOU choosing a double, I must say GOOD GIRL!!!!!! That was when she thought we were dealing with a 2.5 to 3.0 cm tumor with NO NODAL involvement....Had that surgery 3 weeks later and ended up being 4.7 with 3 positive nodes.....I was in shock. Before surgery I had a consultation with a Plastic Surgeon about reconstruction....I said this lump is driving me crazy. I HATE waiting 2 more weeks. What if it growing....Which I could tell it was. He stated.....They have studied this stuff long enough.... They KNOW how they grow...... With that being said.....UM I must SAY WRONG!!!!!! They DID NOT KNOW and still DONT......That is why my Oncologist reassures me (I can tell U one thing....the greatest minds in medicine are working on YOUR kind all over the world right now) My point to my post was to tell u to go with your gut. I did and have NO regrets about loosing boobs. I NEVER went to Doctor Before...NEVER......I was always healthy and well. If hubby or kids got a sniffle I was on that phone getting them into see a doctor. That lump showed up and I must say OUT OF NOWHERE on a Saturday.....That Monday morning I WAS ON THAT PHONE with my obgyn.....That was 4/13/2009...told me first available appt. was May 8th.....I said ummmm NO I need in QUICKLY.....I was just there 2.5 months ago for my yearly and she did not feel ANYTHING during her self breast exam....NO MAMMO yet as I was 36 and NOT considered High risk...u know NO FAMILY HISTORY....had kids young....NURSED....yadayada!!!!!!! We know our bodies and we know what our instincts are telling us....LISTEN to it and MAY GOD BE WITH YOU.....I AM AGAIN SORRY U HAD TO JOIN.....wish I could wrap my arms around you.....instead I will send loves through the internet...... LOTS OF LOVE ------------- dx 4/09 at 36 yrs old. dbl Mast. 5/09. 12 weekly Taxol 4 FAC tri weekly. 32 rads completed 2/2010. Its Back 5/2010!! Chest wall, Mediastinal node, Lft mammary node and liver. Back on chemo. |
Posted By: dmwolf
Date Posted: Mar 09 2010 at 3:24pm
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Taharadale, 12mm=1.2cm = a decent sized stage I (not tiny, like the women talking about 3mm). The 5-8% he gave you is on the low side for TN. I'd put it at more like 15%. I think you should do the chemo. Also, you might consider doing TC instead of EC, which is easier and supposedly more effective. T=taxol, C=cytoxan. Good luck deciding! Love, Denise ------------- DX 2/08@43 stg II IDC; gr2,0 nodes. Neoadj chemo, first ACx2 (fail) then CarboTaxotereX6(better). Lump, Rads done 11/08; Clodronate. False alarm queen: PetCT lung & TM marker. NED. PBM w/recon 9/10. |
Posted By: LRM216
Date Posted: Mar 10 2010 at 2:09pm
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Please make sure your oncologist is learned and very familar with triple negative cancers - that is so very important.
I was 62 at diagnose (one year ago Feb. 23) and extremely shocked. Have had mammos since I was 40 every year and never even 1 call back -then this! I was shocked beyond compare as I too come from a family with no cancer whatsoever on either side - I am the first.
I also was stage 1, Grade 3, 1.2 cm IDC right breast (11:00 and 5cms. from nipple), no nodes, no vascular seen. With my onc's persuasion, and my desire to live, we went as agressive as we could, since I am also a widow, work full time and raise my 14 yr. old grand-daughter. I wanted to hit it with everything possible at the time so I never had to say - if only..... While what I did I can only pray will have killed this beast, of course, there is always the chance that I might not be one of the lucky ones. I choose to think otherwise.
Wish you all the best on your journey. We are here for you every step of the way.
Linda ------------- Linda - diagnosed at age 62 Diag 2/23/09 IDC 1.2 cent. IDC right breast,Stage 1, Grade 3,0/1 nodes - Triple Neg 4 DD AC every two weeks, 1 Dd Taxol, then 3 Taxotere every three weeks - rads x 33 |
Posted By: Kellyless
Date Posted: Mar 10 2010 at 11:57pm
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I agree with LRM216 - you really need to understand that grade 3 triple negative aspect of your cancer. Most of us here were young to younger, healthy and happy before our diagnosis. As my doc said - "you are 100% healthy - except for that really agressive breast tumor they just removed from your breast! You are young, you are healthy - take the best most aggressive treatment you can. I've never had a patient come back in and say "'gee, I wish I had done less chemo" but I've had way too many wish they had taken the chemo!" This is a sneaky disease, if you do nothing, - and if you don't do chemo there's not much else to do, will you worry excessively? Will you be more stressed than you would have been with treatment? ------------- IDC, 2.2 cm, Stage IIb,lumpectomy 1/30/09 ACx4,Tx4 36 rads 6/1/16 Local recurrence same breast, same spot 1.8cm Carb.4x every 3 wks, Taxol 12x once wk. Dbl Mast. PCR!! Reconstruction fail, NED! |
Posted By: outnumbered
Date Posted: Mar 11 2010 at 12:09am
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I said this before, and I will repeat it...I wish I had chemo and I think I do worry more than I would have otherwise.
The standard for er/pr+ is if it is 1cm you get chemo. Less than that, no chemo. When it is TNBC all bets are off and they offer it almost always. Unfortunately my first onc was not TN savvy. By the time I got to the right onc, the window of time had closed for me. ------------- ~Sara DX @ age 40 6/24/08 Stage 1 Grade 3 BRCA1+ 187delAG BMX (nipple-areola-sparing) 8/5/08 Redo BMX (remove nipple and areola) w/ Lat Flap 7/6/09 BSO 9/3/09 NED since 08/05/2008 |
Posted By: Carol (Tenn)
Date Posted: Mar 11 2010 at 9:26am
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Good morning....I have two words for you......BE AGGRESSIVE!!!
Listen to Sara...I guess that's more than two words.....but they are sincere!
Love and Prayers,
Carol ------------- St 2 Gr 3, A/C/T, DD Radiation x35 Rec chest wall 07/09 Radiation x28 NED 10/24/11 NED 10/5/12 NED 03/15/13 |
Posted By: Kellyless
Date Posted: Mar 11 2010 at 9:31am
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Hey Sara - don't you pass that critical 2 year mark this summer? Once we get past the 2 year mark our odds drop dramatically - CONGRATS! When I get to 2 years I start seeing my medical oncologist every 6 months instead of every 3 - WOOT! ------------- IDC, 2.2 cm, Stage IIb,lumpectomy 1/30/09 ACx4,Tx4 36 rads 6/1/16 Local recurrence same breast, same spot 1.8cm Carb.4x every 3 wks, Taxol 12x once wk. Dbl Mast. PCR!! Reconstruction fail, NED! |
Posted By: outnumbered
Date Posted: Mar 11 2010 at 9:36am
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Hey Kelly,
Thanks for the cheers.
Yes, I am at the every six month visit point. I saw my onc last month and I am good for 6 month now... ------------- ~Sara DX @ age 40 6/24/08 Stage 1 Grade 3 BRCA1+ 187delAG BMX (nipple-areola-sparing) 8/5/08 Redo BMX (remove nipple and areola) w/ Lat Flap 7/6/09 BSO 9/3/09 NED since 08/05/2008 |
Posted By: Mary58
Date Posted: Mar 11 2010 at 10:01am
| I hear you - I think we want to do the RIGHT thing! That time of indecision is very difficult. I think you do need to listen to yourself, God, and gather information. It seems like there is no person just telling you what to do, that is what I think I was looking for. I am borderline everything, size, age, etc. .5 cm, 58 years old. I finally decided to go with radiation. I don't know if this was the right choice - but imagine I will down the road. After radiation I am going to continue what I call my chemotherapy - (what I can do) by staying on the low fat diet and daily exercise. I know that God has a plan for me - sometimes we get overloaded with so much information we don't know which way to turn. I wish you the best and know that you aren't on this journey alone. Mary |
Posted By: Taharadale
Date Posted: Mar 23 2010 at 5:56pm
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I just want to thank everyone for their input and support - this really is a wonderful forum. I did decide to take the chemo path - EC and have had my first cycle a week ago. The decision just became really clear to me as I prayed and shared time with the Lord. So far not too bad. Nausea has been well controlled and generally I feel okay. I have made an appt with a wigmaker and am having my hair cut short on Friday. I was away at a women's conference in Sydney before going in to start chemo and the girls I was with all bought a scarf which they are going to wear when we get together at church as support - not only for me but for others who are going through their own battle with cancer. Barb
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Posted By: LRM216
Date Posted: Mar 23 2010 at 6:28pm
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I am glad you chose the way you did. All of us question it, and God knows, I dreaded it so much, but I went as agressive as I could. Will it allow me to live longer and not die of cancer, I can only hope, but at least, when all is said and done, and all of your treatment is behind you (and that will happen, I promise!), at least you won't spend the rest of your life asking "woulda, coulda, shoulda". Best of luck to you - hope your chemo journey is a relatively easy one.
Linda ------------- Linda - diagnosed at age 62 Diag 2/23/09 IDC 1.2 cent. IDC right breast,Stage 1, Grade 3,0/1 nodes - Triple Neg 4 DD AC every two weeks, 1 Dd Taxol, then 3 Taxotere every three weeks - rads x 33 |
Posted By: cherylt
Date Posted: Mar 23 2010 at 10:49pm
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I am a stage 1a and had a very tiny tumor and had radiation. Even the top docs that I found said no to the chemo. I know these are scary decisions. I pray that i made the right one! Good luck to you!
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Posted By: Carol (Tenn)
Date Posted: Mar 24 2010 at 1:05pm
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Cheryl,
How small was you tumor? ------------- St 2 Gr 3, A/C/T, DD Radiation x35 Rec chest wall 07/09 Radiation x28 NED 10/24/11 NED 10/5/12 NED 03/15/13 |
Posted By: 123Donna
Date Posted: Mar 29 2010 at 7:02pm
Pam, Thanks for finding this article.Even Tiny Breast Tumors May Need Aggressive Treatmenthttp://www.drugs.com/news/even-tiny-breast-tumors-may-need-aggressive-10364.html - http://www.drugs.com/news/even-tiny-breast-tumors-may-need-aggressive-10364.html ------------- DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09) 11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15 |
Posted By: outnumbered
Date Posted: Mar 29 2010 at 7:11pm
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Articles like this make me sick to my stomach. I know I cannot turn back the clock, but it really worries me. Especially today when I went to my orthopaedist to confim that my neck pain is just a run of the mill pain in the neck. The x-ray did not show anything, and he said my symptoms are consistant wih a cartiledge irritation which should resolve on its own in a few weeks. Without a MRI he cannot completely rule out mets. I have decided to wait it out. He is sending a note to my oncologist though.
Sorry, did not mean to hijack the thread, but see what anxiety you go thru when you don't get the chemo? ------------- ~Sara DX @ age 40 6/24/08 Stage 1 Grade 3 BRCA1+ 187delAG BMX (nipple-areola-sparing) 8/5/08 Redo BMX (remove nipple and areola) w/ Lat Flap 7/6/09 BSO 9/3/09 NED since 08/05/2008 |
Posted By: kirby
Date Posted: Mar 29 2010 at 11:23pm
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paranoia is easy to set in when dealing with cancer. When I found this site and read how much chemo everyone was getting, I became worried. It had been 6 years since chemo ! I really had to reign in the logic to keep my mind from wandering. ------------- kirby dx Feb. 2001. Age 44 Lumpectomy 2cm. no nodes stage 1 grade 3 4 rnds AC, 35 rads |
Posted By: 123Donna
Date Posted: Mar 29 2010 at 11:34pm
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Sara, I didn't mean to cause you any undue anxiety. I think we all worry that we made the right decisions. There are things I know now that I wish I would have known at dx and tx. I wonder if the anxiety will ever truly go away. I think people like Kirby and Rena are great to give us hope that many do survive tnbc. Donna ------------- DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09) 11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15 |
Posted By: trip2
Date Posted: Mar 30 2010 at 9:38am
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Hi Donna,
There is another article in the Resource section regarding the aggressiveness of small tumors so I've read this before.
Thanks for bringing the link up to the forum. So many times we think the larger the tumor the worse it is and it just isn't the case. ------------- Stage 2 2003 Stage 1 2007 BRCA 1+ |
Posted By: trip2
Date Posted: Mar 30 2010 at 9:46am
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Hi Sara,
Please don't agonize over your not having treatment. I know it isn't easy. The thing is articles, studies come along, some affect us personally and we think oh no! When in fact this information we find online is ever changing.
When I learned Adria only worked for 8% of women and it didn't include TNBC I was floored.
Then as time went along I read about Taxol not working, then Cytoxin, all chemotherpies I had had my first time around. It's upsetting when we read certain things, I sure understand that! And I did get it back on the other side. Will always wonder if I had something else maybe it wouldn't have come back. Have no idea if it was the chemo or just the cancer being mean.
But we have to try not to look back. As mentioned above I bet many of us would have done something different.
You'll be fine. So glad you went and had your neck checked. Hope the pain goes away quickly for you, poor thing. ------------- Stage 2 2003 Stage 1 2007 BRCA 1+ |
Posted By: Mary58
Date Posted: Mar 30 2010 at 10:41am
| Pam - What a kind response you had and what an ordeal, do have gone through the chemo and then find out it doesn't work. Did you say you had re-currence AFTER chemo? I am going for my second opinion to a university setting this Friday. I had a small tumor, finishing radiation, but still wondering .......... - I think over all, we have to learn to live in peace each day. Thank you. |
Posted By: dmwolf
Date Posted: Mar 30 2010 at 10:51am
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Sara, don't panic. That study has only 24 TNs in it, and even with this small number they only found 12% recurrence. With such a small number of women, one can't really draw any conclusions. Plus, even if the 12% is about right, that's an 88% probability of being cured without chemo. Pretty damn good!! Relax...breathe.....you made a fine, rational decision. Having chemo would only increase your odds (if these numbers are right, and personally I think they are not) from 88% to about 92% cure. Would you really have wanted to poison yourself for about 4% when you are starting off in such great shape? Many women have effects from chemo FOREVER. Neuropathy, messed up white blood cells, fatigue, possibly even secondary cancers like leukemia. Your decision was totally rational, one I would have made as well if I had been lucky enough to have a very small cancer instead of my big 'ol beastie. Love, Denise ------------- DX 2/08@43 stg II IDC; gr2,0 nodes. Neoadj chemo, first ACx2 (fail) then CarboTaxotereX6(better). Lump, Rads done 11/08; Clodronate. False alarm queen: PetCT lung & TM marker. NED. PBM w/recon 9/10. |
Posted By: dmwolf
Date Posted: Mar 30 2010 at 10:56am
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Pam, the 8% effectiveness of Adria number thrown around is WRONG, totally unsubstantiated. Of TN women who respond super well to chemo (close to half) a big % of them respond well to adria (about 50% of pCRs happen during the adria phase of ACT). Cytoxan, I don't know about. Nobody ever tests it by itself. But we know that the combo AC IS effective for many. As for taxol, more data is coming out about it, but I can tell you that about half the women who have pCRs on ACT see their tumors melt away during the taxol phase. That tells me this is a good drug for many. The moral of the story: don't believe everything you read, even (especially?) in science!! You always have to look at the particulars of a study to draw your conclusions. Not just the abstract. And as in many other parts of life, SIZE MATTERS! (;)) Small studies don't have the power to say much, especially when looking at a disease as heterogeneous as TN. Love, Denise ------------- DX 2/08@43 stg II IDC; gr2,0 nodes. Neoadj chemo, first ACx2 (fail) then CarboTaxotereX6(better). Lump, Rads done 11/08; Clodronate. False alarm queen: PetCT lung & TM marker. NED. PBM w/recon 9/10. |
Posted By: Taharadale
Date Posted: Mar 30 2010 at 8:13pm
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I agree - sometimes we read too much and it just makes us more anxious! I am at day 15 after my first cycle of chemo and the hair is coming loose - did others find that? Apart from that I have had no other side effects this week. Visited the oncologist yesterday and she said my white blood cell count was where it should be - so doing okay so far. Back in Tuesday 6th for cycle 2! I believe that Taxol has only just gone onto the pharmaceutical benefits scheme here in Australia - maybe that's why it is not offered here as much as in America? |
Posted By: 123Donna
Date Posted: Mar 30 2010 at 8:24pm
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Taharadale, I started to lose my hair on day 15 also. We went ahead and shaved my head (about 3/8" on the trimmer). The hair continued to come out for the next few days. I had some hair around the base and side burn area and a few on top. Kind of reminded me of a newborn with sporadic hair. Donna ------------- DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09) 11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15 |
Posted By: 123Donna
Date Posted: Mar 30 2010 at 8:31pm
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Denise, I agree with what you say about percentages and studies. It can definitely drive you crazy, especially when we hear contradicting studies. If we had an accurate test for mets, then we'd know which one of us would need further treatment. There's much talk about circulating tumor cells and coming up with an accurate predictor of which patient has it and more likely to develop mets. Right now it's just a crap shoot. We guess at the chemo (adjuvant) to use and hope it works. If you are told you have a 25% of recurrence, then to me that means you treat 4 people with chemo in the hopes of saving the 1 person. If you have only a 10% chance of recurrence, then you treat 10 to save 1. Maybe one day we'll have a better predictor. To me, it's very frustrating. I see how much research and science needs to progress with bc treatment. Donna ------------- DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09) 11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15 |
Posted By: dmwolf
Date Posted: Mar 30 2010 at 9:03pm
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Donna, if you have a 10% chance of recurrence you treat 10 to *try* and save 1. With 50% chance of chemo making the difference, you treat 20 to save 1 (this 50% is generous...it is closer to 35%). 18 didn't need treatment, 1 needed some type of treatment but not the one that was offered, and 1 needed the treatment offered. A 1/20 (5%) chance that chemo is worth doing. 95% chance that either chemo is unnecessary or unhelpful. Doesn't this make Sara's choice (and every other woman with a smallish Stage I tumor) to avoid chemo sound rational? -Denise ------------- DX 2/08@43 stg II IDC; gr2,0 nodes. Neoadj chemo, first ACx2 (fail) then CarboTaxotereX6(better). Lump, Rads done 11/08; Clodronate. False alarm queen: PetCT lung & TM marker. NED. PBM w/recon 9/10. |
Posted By: 123Donna
Date Posted: Mar 30 2010 at 9:35pm
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Denise, I agree. I guess I'm wanting something more accurate than what we have today. Too many people are given treatment that may not be necessary. I have a friend who's about 2 years out now. She was tnbc, stage 0, grade 2, DCIS. I think it was multifocal or something like that because she said the path report indicated it was in several ducts. Her lymph nodes were negative except that they found 35 cells in a node. They said they couldn't identify what type of cells they were. 2 oncs recommended chemo and 2 said they wouldn't. Her percentages were pretty low and she figured that with chemo it only reduced her chance of recurrence by a few percentage points. She's very worried she made the wrong decision. I keep telling her I think she made the right decision. She had a bi-mx and no other treatment. Sometimes I think she worries more than I do (and that's saying a lot!) about it returning. I wish I could say more to help relieve her mind. Donna ------------- DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09) 11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15 |
Posted By: Carol (Tenn)
Date Posted: Mar 31 2010 at 9:33am
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My recurrence came back after Chemo and Radiation. It was about 4 months after I completed my treatment, about 1 year after first diagnosis. Sometimes chemo just doesn't work for everyone. I was one of those. But that's something you don't know until later if you have surgery before chemo. Usually with tumors over 2cm they will do chemo first to shrink...mine was just barely 2cm so they did surgery first. ------------- St 2 Gr 3, A/C/T, DD Radiation x35 Rec chest wall 07/09 Radiation x28 NED 10/24/11 NED 10/5/12 NED 03/15/13 |
Posted By: AKA04
Date Posted: Mar 31 2010 at 11:46am
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Good morning! Our story is the same - my cancer was in the right breast. I did have chemo CTx4 and Radx36 as well as the lumpectomy in May 2008. Finished everything by October 2008. All blood work and mammogram done every 4mos on breast that had cancer and every 6mos on other breast. Exactly 2yrs later mammogram on both breast resulted in no cancer in the previous cancerious breast, however, cancer in the other breast. The right breast was triple negative and the left breast is ER/PR+ and HER2 is 1+ and I am waiting on final HER2 test. The nature of the beast is unknown and the delivery is different for each us. My suggestion to you is do your research, talk to fellow cancer individual, your doctors and what ever your gut feeling is go with it, because your happiness will be derived from within your decision and no one else. You will find the right way! Good luck.
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Posted By: MsBliss
Date Posted: Sep 04 2010 at 3:49am
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Dear Denise, Your explanation of what the actual percentages mean with regard to chemo is right on the money. My experience has been that most patients misunderstand what the numbers mean. It is also true of radiation therapy. When they tell us that radiation reduces the risk of recurrence by, for example, 33 percent, it is often misunderstood by most patients. They think that it is reducing their actual personal recurrence risk by whatever figure is presented, but that is not in fact the case. When my onco radiologist, told me I would have a 33 percent reduction of local recurrence with radiation I pressed a little further. What he meant was that in my class of disease, out of 100 patients, 3 would have local recurrence without radiation. With radiation, only 2 would have local recurrence, a reduction of 33 percent! But it didn't mean that I would personally have a reduced risk of 33%, and that is what was implied. It is what I call a "rubber" number and sadly misleading. I am not devaluing the therapies, but I wish the numbers were more absolute in terms of their actual meaning. Bliss |
Posted By: CiGi
Date Posted: Sep 04 2010 at 12:58pm
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I'm still debating on going through radiation therapy or not. I go for my 5th chemo treatment this week and have one more after that in three weeks. I don't know..... I feel that I needed to go through chemo since my body was not strong enough to prevent the cancer from growing in the first palce so if there are some cells that have broke off and wondered around hopefully it will kill it. I have very mixed feelings about radiation. With all these scans and radioactive contrasts to detect it plus then radioactive therapy, how much radiation can our bodies take? I'll have to check with my onc to see what the % benefit is before I make my choice on it. If it's something as little as 1% (total risk) I'm not going through with it, if it's something of 5 or more I'll consider it. ------------- Age 40, 4/28/10 lumpectomy (3 cm) TNBC Grade 3 Stage 2 0/3 nodes, TAC 6x 3 week cycles start 6/15 finish 9/27, 33 rounds rads 11/22. BRCA1 & 2 neg. Lymphedema rt hand 8/14. Joint pain Dec 2010. |
Posted By: Carol (Tenn)
Date Posted: Sep 04 2010 at 1:20pm
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Cigi, This is just my humble opinion...but with stage 2, I'd take the rads...If it were stage 1 I'd consider not taking them. You are so young not to throw whatever is available at it.
I had clear margins after mastectomy and took the rads and still had a recurrence one year later. I am not trying to scare you. I just wanted to share my two cents worth. But ultimately the decision is yours and we support you what ever that is.
Love and Prayers,
Carol ------------- St 2 Gr 3, A/C/T, DD Radiation x35 Rec chest wall 07/09 Radiation x28 NED 10/24/11 NED 10/5/12 NED 03/15/13 |
Posted By: CiGi
Date Posted: Sep 04 2010 at 1:27pm
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Thanks Carol. I felt this way before I started chemo, and now I'm almost done with it. I have a few more weeks to think about it. I'll need to read more and try to convince myself. Enjoy your weekend and have a happy Labor Day! ------------- Age 40, 4/28/10 lumpectomy (3 cm) TNBC Grade 3 Stage 2 0/3 nodes, TAC 6x 3 week cycles start 6/15 finish 9/27, 33 rounds rads 11/22. BRCA1 & 2 neg. Lymphedema rt hand 8/14. Joint pain Dec 2010. |
Posted By: Lillie
Date Posted: Sep 04 2010 at 2:38pm
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Hi CiGi,
I did not have radiation, but I had a MASTECTOMY. My oncologist said with a lumpectomy, radiation is almost always given. If there are any cells left in the breast tissue after lumpectomy, chemo and radiation will wipe them out hopefully. If a mastectomy, no radiation in my case. Just sharing.... God Bless, Lillie ------------- Dx 6/06 age 65,IDC-TNBC Stage IIb,Gr3,2cm,BRCA- 6/06 L/Mast/w/SNB,1of3 Nodes+ 6/06 Axl. 9 nodes- 8/8 thru 11/15 Chemo (Clin-Trial) DD A/Cx4 -- DD taxol+gemzar x4 No Rads. No RECON - 11/2018-12 yrs NED |
Posted By: SagePatientAdvocates
Date Posted: Sep 04 2010 at 3:14pm
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Dear Lillie, my daughter did not have radiation either because she had bi-lateral mastectomies. She had negative nodes. However, the radiation oncologist told us that if there are positive nodes, radiation therapy is often advised even if mastectomy/ies. Different physicians have different opinions. all the best, Steve ------------- I am a BRCA1+ grandson, son and father of women affected by breast/oc-my daughter inherited mutation from me, and at 36, was dx 2004 TNBC I am a volunteer patient advocate with SAGE Patient Advocates |
Posted By: Lillie
Date Posted: Sep 04 2010 at 3:55pm
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Dear Steve,
I know what you mean about different doctors have different opinions. My oncologist said with 2 or more nodes positive, always radiation. In my case I had an extra drug, gemzar, (clinical trial). Also the node affected was a miniscule amount. He just said that he didn't think radiation was necessary in my situation..... I am so happy about your daughter being 6 years NED. I am thankful that she is sharing her experience to help other people. God Bless, Lillie ------------- Dx 6/06 age 65,IDC-TNBC Stage IIb,Gr3,2cm,BRCA- 6/06 L/Mast/w/SNB,1of3 Nodes+ 6/06 Axl. 9 nodes- 8/8 thru 11/15 Chemo (Clin-Trial) DD A/Cx4 -- DD taxol+gemzar x4 No Rads. No RECON - 11/2018-12 yrs NED |
Posted By: SagePatientAdvocates
Date Posted: Sep 04 2010 at 4:06pm
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Dear Lillie, to be clear, no criticism was intended by my comment...just different perspectives...I don't know that there is any "right" here. my daughter also had gynecologic surgeries and spoke to one gynecologic oncologist who recommended that a hormone patch be put on her the same day as surgery...The gynecologic oncologist who actually performed the surgery told my daughter "if my wife was BRCA1+ I would never put an estrogen patch on her."...But he did, as my daughter requested.. Who was right? Is there a right? Just different opinions, I think... all the best, Steve ------------- I am a BRCA1+ grandson, son and father of women affected by breast/oc-my daughter inherited mutation from me, and at 36, was dx 2004 TNBC I am a volunteer patient advocate with SAGE Patient Advocates |
Posted By: MsBliss
Date Posted: Sep 04 2010 at 5:04pm
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Dear Steve, You mentioned a hormone patch; was your daughter just put on the hormones temporarily? If not, do you know what kind she is being treated with? Bliss |
Posted By: trip2
Date Posted: Sep 04 2010 at 8:58pm
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CiGi,
I certainly cannot tell you what to do about the radiation but I do hope you will research before you make your final decision. I will see if I have any info I can share with you.
With TNBC being as aggressive as it is, the feelings now being that it may also travel through the blood, radiation is that extra something to cover all bases which is what we want to do.
The main thing is that you research, discuss it with your Oncologist and decide on what is best for you.
http://www.sciencedaily.com/releases/2009/11/091104132654.htm - http://www.sciencedaily.com/releases/2009/11/091104132654.htm
http://www.breastcancer.org/treatment/surgery/lumpectomy/plus_radiation.jsp - http://www.breastcancer.org/treatment/surgery/lumpectomy/plus_radiation.jsp ------------- Stage 2 2003 Stage 1 2007 BRCA 1+ |
Posted By: Lillie
Date Posted: Sep 04 2010 at 10:04pm
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Hi Steve,
You are a dear person and I can assure you that you would have to do something really drastic for me to take it as criticism. As you said, Dr's take different views of treatment. Also circumstances are so different. I was 65 when diagnosed, your daughter in her 30's. I have had to feel all along that I got the best treatment for me and "move forward".... Steve, You and I are about the same age and I have a daughter about the age of your daughter. I have never faced the cancer trauma that you have experienced with your mother and your daughter. I have wanted to tell you for a long time how I respect you for using your pain to be a tireless advocate for so many others. God Bless, Lillie ------------- Dx 6/06 age 65,IDC-TNBC Stage IIb,Gr3,2cm,BRCA- 6/06 L/Mast/w/SNB,1of3 Nodes+ 6/06 Axl. 9 nodes- 8/8 thru 11/15 Chemo (Clin-Trial) DD A/Cx4 -- DD taxol+gemzar x4 No Rads. No RECON - 11/2018-12 yrs NED |
Posted By: CiGi
Date Posted: Sep 05 2010 at 12:17pm
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Thanks Pam and everyone's comments on radiation therapy. I know in the back of my mind I'll need to do it. I just did not mentally buy into it yet. Still reading and trying to convince myself it's what I need to do. ------------- Age 40, 4/28/10 lumpectomy (3 cm) TNBC Grade 3 Stage 2 0/3 nodes, TAC 6x 3 week cycles start 6/15 finish 9/27, 33 rounds rads 11/22. BRCA1 & 2 neg. Lymphedema rt hand 8/14. Joint pain Dec 2010. |
Posted By: unklez
Date Posted: Sep 11 2010 at 9:03pm
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Dear CiGi, You are absolutely right to question the treatment plan. Educating yourself and evaluating the risks and benefits is a very important part of the treatment. My experience before and during my wife's treatment was that doctors take the time to explain things but you are responsible for being persistent with the questions! Good luck with making the right choices for yourself. ------------- Wife Dx: Jul/09. Age: 37. Size: 3cm. BRCA: -ve. Lumpectomy: Aug/09. Micromet 1/9 node. Chemo Start: Sep/09. E5103. DD ACB-> DD Abraxane (Taxol reaction). Zometa (S0307). Canadian Fraction Rads. |