I always think it is a bit unfortunate when surgery is performed without ever seeing an oncologist beforehand. It takes away the option of having chemo before surgery which is often more effective. Her medical oncologist has expertise in chemo. Surgeons do not. Ultimately the decision is hers and I am glad to see she has the information she needs to make an informed decision.
Breast Cancer Questions
Chemo or no chemo??
Asked by Erika on Friday, February 22, 2013
Chemo or no chemo??
My sister had a lumpectomy 3 weeks ago and this week she saw a ongologist and radiologist. The original plan from the surgeon was only radiation for 6 weeks. After seeing the oncologist they recommend chemo as well. My sisters tumor was 3mm and they mentioned that typically they do chemo for over 5mm but with 3mm the guidelines are still unclear. The lumpectomy had clear margains and the lymph nodes came back free of cancer. She is feeling very overwhelmed and doesn't feel the chemo % increasing her odds is worth all that is involved with the chemo. She is a single mother of a special needs chid and she works... she doesnt think she can handle all the side affects that accompany chemo.....Based on this info what do you think?
5 Answers from the Community
I agree with Nancyjac, oncologist should be seen before surgery. However, since it is too late for that now, she should make sure she is informed by her onc the pros and cons of having the chemo. My tumor was 1.9 cm, I had a bilateral mastectomy with recon. After recovery, I had the Oncotype DX test to see if chemo was recommended and it was. I then did 6 sessions of chemo. I did not need radiation. The chemo was bad but tolerable. I worked the whole time I was on chemo. I was fatigued but it was not unbearable.
Ultimately it is her decision to make.
I chose not to do chemo for my cancer (stage III melanoma) because it held little hope of being effective IF the cancer had spread and was useless, but debilitating if it hadn't. But breast cancer is a different dog fight. Get a second opinion. If the odds of success with chemo are good, I would go for it. Since surgery was performed without an onc consult (if I'm reading this right), I would def get another opinion at a different center. I understand the feeling of responsibility. Its valid and real. But longevity must not be left to chance if the odds are with treatment.
There is not enough info for me to even begin to say something about what "i would do".... Do you know anything about the type of cancer? Er / Pr positive? Her2 positive? If she had an Er/Pr positive tumor, then an oncotype score would help with this decision. If she had a Her2 positive tumore, then that information would be a big player in making a decision about chemo.
Everyone is different with side effect. In general, staying active helps minimize side effects, but it is true that she'll be more tired and feel kind of cruddy through much of it. However, the good days do out weigh the bad days...
Lastly, a second opinion is never a bad thing (well - almost never). So, having another expert look at the data about her tumor is an excellent suggestion.
I'm so sorry she has to make this decision. It sucks.
That was my original plan also surgery and radiation. The oncologist appointment was after surgery a week later and he highly suggested chemo. My tumor was 2mm, all margins clear and no cancer in lymph nodes. I DID NOT want to do chemo either, but I did 4 rounds, lost my hair, 6 weeks of radiation and now tamoxifen. Side effects were not as bad as people think especially being told you have cancer and she sounds younger than I. Onco DX score was 19.