• do i get chemo or not?

    Asked by libby on Monday, May 27, 2013

    do i get chemo or not?

    i have stage 2 and cancer was in only sentinel node all else is clear and clean--lymph and breast.

    16 Answers from the Community

    16 answers
    • AlizaMLS's Avatar

      Hi libby,

      I'm Aliza, a BC patient, and the site's unofficial Medical Librarian. Med Librarians answer questions, but usually stick to non-medical ones, as responding to medical questions constitutes "practicing medicine sans license" which is considered a bit illegal, so we tend to shy away from that...;) (I can't tell anyone even if I know the answer). We do however refer folks to docs, hospitals, institutions, agencies, books, websites, media, etc, and research when requested or required.

      I came on the site in my professional capacity (rather than just another patient) because I felt I had some unique things to offer. I am permitted despite what I mentioned above to speak about my own experiences as a Cancer patient and those of friends and family with Cancer (we number too many).

      The person who can truly answer the question you ask with any validity is your oncologist. She/he is the person who has all of the reports/scans/data from your mammography, your surgeon, the pathology report, visual information, etc. and to ask folks on this site may be comforting but the best that they might be able to do (minus the few who are medical professionals) is guess - underline guess (despite the fact that we know you're Stage 2 and your sentinel node was clean (congrats-that's good, btw). I think you'd want to really get a professional to give you her/his opinion and then come back to this site for support. You may even want to get a second opinion from a different oncologist at a different treating institution (your insurance very likely covers this). I'm sorry if I sound like I'm trying to discourage you. I'm not. But I know the other side of medicine as well since my former husband was a physician (not something I'd list on my resume)...;)

      You may wish to ask your Oncologist if she/he considers you a candidate for Oncotype genetic testing. This is really the litmus test (if the Oncologist determines that you might be a candidate for the possibility of escaping chemo) to see if that can be a reality. Otherwise, she/he has the experience (as long as you trust and like her/him to determine the course of action that's best for you (again, verifying with a second opinion is often a very good idea).

      I know that this isn't the easy answer you wanted to hear, but I think it's probably the best answer for you, and that's what everyone here would ultimately wish for you (since we're not M.D.'s)

      I hope you get the good news you're seeking. If you have any questions, please feel free to contact me here or email me offsite.

      Warm Wishes,

      over 4 years ago
    • karen1956's Avatar

      What does your onco recommend? a lot of factors going into determining whether or not chemo is indidcated. if you've already seen an oncologist and you are unsure, what about a second opinion. all the best to you...

      over 4 years ago
    • CAL's Avatar

      Talking to the oncologist is always first but that includes asking as many questions as you need to to feel like you have all the information you need. I am an RN and even what I just suggested was not enough and believe me I asked a hundred questions with my laptop in hand writing everything down. I researched everything possible, reading research articles, NIH (National Institute of Health) research reports/guidelines, and got a second opinion. I was also stage 2B with positive sentinel node and nothing else and I really was unhappy to get that news as I knew it meant chemo was recommended. I was far more worried/scared about chemo than I was my surgery or radiation. All my investigation helped me feel like I was making the best decisions for me. I did switch from my original oncologist to an Integrative Oncology Center 3.5 hours drive from my home rather than 10 minutes to my local clinic, because I felt then and still feel like the approach of using the same chemo with a distinctly different nutritional support and complimentary/alternative therapies was the best way of maximizing the effect of the chemo and increasing my odds of not having a recurrance. Chemo is never fun and I was so glad to be done with it at the end of December, 2012. Radiation was not bad for me and now I am on the Arimedex for 10 years. So now I am in the waiting stage to start my checkups for the rest of my life. Ultimately, you have to do whatever it takes to feel good about your decisions.

      over 4 years ago
    • JennyMiller's Avatar

      I chose to be aggressive against this evil and elusive enemy -- bilateral mastectomy, chemo, radiation and I am now on Arimidex. I have an excellent Oncologist who made chemo doable. Chemo is a powerful weapon in the battle and I realized that Chemo is not the enemy -- Cancer is -- chemo was actually my friend in the battle. However, everyone is different and have to make their own decision. After all, they are the ones that have to live with that decision. I suggest that you consult with your Oncologist and get a second opinion if need be. I wish you the best!!!

      over 4 years ago
    • SueRae1's Avatar

      Speak with you oncology team, you may also want to get a 2nd opinion on your treatment options. A second set of eyes and experience can only help in putting together the best plan for you. A lot will depend on what type of BC you have. most protocols call for chemo and radiation unless there are mitigating circumstances.
      When I was diagnosed with stage 1 TNBC I had a lumpectomy and radiation treatment, I did not receive chemo because i was in active treatment for advanced Kidney cancer, had this not been the case, I would have received several rounds of prophylactic infusion therapy.

      over 4 years ago
    • gwendolyn's Avatar

      Only your oncologist will know this, based on your pathology report. The sentinel node is a lymph node and if it tested positive that means you did have cancer cells migrating out of the breast. It is likely that chemo, a systemic treatment, will be recommended for you.

      over 4 years ago
    • attypatty's Avatar

      Dear libby:
      I have stage 2, no node, no mets, but my onc recommended chemotherapy and I did it. The determining factor was the grade of the tumor - it was fairly aggressive as shown in the Oncotype test. So my question to you is - did you onc recommend the Oncotype test for you? It measures the characteristics of the tumor itself, once it has been excised (removed) by surgery. The test shows how rapidly the cancer cells of your tumor divide and grow. If it's a fast-growing tumor, chemotherapy can reduce your chance of recurrence dramatically. Without chemotherapy, the chances that my cancer would recur after surgery was over 35%. With chemotherapy, the chance of recurrence was reduced to less than 8% - back to the normal population risk. Knowing the test results made my decision much easier - I didn't like the odds I was given without chemotherapy. Ask your oncologist about this test - insist on it, in fact. The cancer journey is never easy so the least we can ask for are some reliable road markers to point us in the right direction - and the Oncotype test is one of them.
      Fight On,

      over 4 years ago
    • JaneG's Avatar

      Hi libby,

      I also have stage 2 BC but out of 2 sentinel lymph nodes, only 1 was positive. Now at first, I was scared because this meant chemo. I really didn't want to go that route if I didn't have to. In talking to my onc it was decided to do the Oncotype DX test. I am glad I did. It showed that my risk of recurrence was genetically low. Having chemo followed by rad only lowered the risk factor by 2%. Not enough for me to consider doing chemo, so I chose to do radiation. I am now on Letrozole for at least the next 5 years. I had my doubts about the decision which you will have no matter what you decide. Have the Oncotype test. It has been proven a good indicator. In fact, they have so much confidence in it that they are considering using it for prostate cancer. Talk with your onc. Trust him/her. As someone here explained once, you need to look them in the eye and explain that you are trusting them with your life. This is very true. Trust their experience. If you don't get a second opinion.

      over 4 years ago
    • LAPD's Avatar

      Had the same level of breast cancer as you did in 2008. Tumor size 1.9CM, micrometastesis in one node. Had lumpectomy, chemo, radiation. Had the the Oncotype DX which indicated that I needed chemo. Don't regret having chemo as I felt I gave fighting cancer my very best shot. Have had a rocky road with Arimidex for three years, went off it for a year, and have now tried Aromosin. Good luck with whatever decision you make. I would definitively get a second opinion, however.

      over 4 years ago
    • debco148's Avatar

      I had only one sentinel with some cancer.. but because I was IDC stage 2B, my onc recommended both chemo and radiation. There were clear margins but because of the one sentinel involved, it was insurance to do the chemo and rads. They used to go back in and remove the anxilary nodes under the arm too, but I was told this was no longer standard procedure. Please take the advice you get from your oncologist..we each have unique factors to consider. If you are told to do it, do it..get another opinion if you are unsure. But, chemo is a strong systemic weapon against rogue cells, it is cancer's enemy! Use it, if needed.

      over 4 years ago
    • Giraffe's Avatar

      I opted for chemo as well, I would do anything to lower my chances.

      over 4 years ago
    • Ladykarla's Avatar

      From what I have seen, each situation is different. Here is my story. I personally went commando. We have a lovely eleven year old daughter. She is our focus. I had chemo. I had a 5 1/2 hour double mastectomy with flap surgery to prepare for reconstruction. I had 24 lymph nodes removed (sentinel one was positive but then negative after chemo). (Tumor was dead). I had clear margins. I have my last radiation treatment tomorrow. (33 with 5 boosts on the scar). A few weeks from tomorrow I start the reconstruction process with a top flap surgeon along with a hormone blocker and periodic testing. In the meantime, I am on Herceptin infusion through November. I am blessed with excellent doctors and nurses. I trust them completely. I researched the heck out of them. They care about ME, not a number, not a dollar sign. They have impeccable reputations. Never, never, never give up. Kick cancer's butt.

      over 4 years ago
    • pressinfwd's Avatar

      Hi Libby

      I had stage l BC, bilateral mastectomy w/immediate reconstructive surgery. No lymph nodes or margins involved. I did not want chemo, but after my oncotype score came back borderline, my onc recommended chemo. I agreed to have chemo because I felt like I wanted to do everything possible to lower my changes of recurrence. I agree with those who suggests asking your oncologist for the oncotype test. Once you get the results, you and your onc can decide what's best for you.

      Best wishes

      over 4 years ago
    • WendyLew's Avatar

      I chose surgery and chemo for my IIIC ovarian cancer treatment - because - first, I put my faith in God, then, I put my faith in God to work thru my oncologist. and trusted his recommendations.I believe the Bible is truth and Proverbs 18:9b indicates we should use every endeavor to be well and to live... Whether you believe in God or not, or whatever faith you may have, I would suggest that no matter what course of action - choice(s) you make for treatment - believe in it, put your positive attitude into it, put your faith in it to work! I opted for chemo and also read & meditate on healing scriptures, pray over my medications, drink plenty of water, try to eat healthy, take supplements and vitamins... and overall intend to live! Just don't give up!

      over 4 years ago
    • Marshah's Avatar

      Talk to your medical oncologist. There is a grading scale that they put you type of cancer, size of tumor, if it has spread to lymph nodes and other questions. That will tell them what kind of treatment that they suggest and/or recommended. The final decision is between you and the oncologist. Good luck and I will be praying for you.

      over 4 years ago
    • SandiD's Avatar

      You have good answers here! What does your oncologist recommend? I was Stage I but because I had early colon cancer a year earlier and scored fairly high on the Onco test, chemo and radiation was recommended. I would rather be aggressive and not worry so much later. You will worry! Fight and do all you can to beat this awful disease! You will be a Survivor too. A great site to go to is www.breastcancer.org. Good luck to you!

      over 4 years ago

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