what do you know about neoadjuvant chemo

VKW

what do you know about neoadjuvant chemo

VKW

I am newly diagnosed with 1cm TN tumor and a surgery has been scheduled for next week. Now I am reading that neoadjuvant (before surgery) treatment can be good for TNs because then you can see if the tumor responds to the chemo regime. Does anyone know about this.

Analemma

Neoadjuvant chemo is only done for large tumors, as I understand.  1 cm wouldn't normally qualify, and I don't think insurance would approve it, either.

twink

Neoadjuvant comes with it's own set of worries too... like is the cancer spreading while I'm looking for effective treatment?  A complete pathologic response is not the norm (i.e. all cancer gone) but it does happen.  When it doesn't happen then you worry about needing more chemo and what the residual cancer burden (how much cancer was left after chemo) means in terms of prognosis.  As Brenda points out, it's usually used for large tumors in order to make a lumpectomy option available.  When you have a small tumor, the quickest way to get it out of you is surgically.  Good luck with your surgery.

formygirls

Twink has nailed my state of mind right now. I am getting neo adj chemo because my tumor is very large--size unknown as it multiples every time they look at it. So far I have seen a partial remission halfway through chemo but am not very optimistic about getting a complete response since there was still cancer left at the halfway MRI. So now I worry. Should I have more chemo after surgery and what cancer will show up during surgery? I am constantly worrying about the cancer spreading while I get chemo. In my case, I had to have neo adj chemo as the onc was more worried about cancer spreading to other organs and causing mets and I need to resolve my chest wall invasion before I could have my mast. In your case, your tumor is small so adjuuvant chemo should be all you need. Every option comes with its own set of worries.

Sadie-Rose

I just wanted to add a different perspective.  I did chemo before surgery because my doctors wanted to watch the impact of the medications on my tumor.  If the tumor got smaller we would know it was working. 

In my situation it was good that we did that.  After three treatments of AC my tumor had not changed size. This information allowed us to change the chemo cocktail.  We changed to Carboplatin and Taxotere which ended up working for me.  So the result was we were able to stop one combination that wasn't doing anything for me and add additional rounds of the combination that did work.

I worried less ( I think) because I had information in a few weeks that was showing success.  My surgeon said that you do not have to have a complete response (no sign of cancer) before surgery.  If the tumor is getting smaller, it has done the job on those traveling cells.

Everyone and every body is different.  I know it is a difficult choice, one sometimes based on intuition.

Sadie

formygirls

I should add that a worry wart like me would also be stressed if I was having chemo after surgery instead of neo-adj since I would have no way of knowing if the chemo meds were working. That is just my personality I think. I think most oncologists know when to use neo-adj chemo and if you trust them go with what they recommend.

twink

If there were a sure-fire cure, we wouldn't be here.  Unfortunately, almost every decision path produces 'what-ifs'....formygirls, you may be more of a worry-wart than some but I think most of us stress over whether or not we're making the right treatment decisions.  It's normal.  I wish I had good advice on that front but the best I can say is try not to regret anything...

Hugs.

PS.  Sadie -- how's it going?

Negative3Grade3

I agree with Twink.

You may benefit from reading the thread I created when I discovered breastcancer.org since I lay out the reasons I did neo-adjuvant (1.9 tumor so technically I didn't qualify since it has be larger than 2 cms but I wanted to know if the chemo was responding).  I ended up having complete pathological response but that is not the norm and I don't know how I'd have felt if I didn't.  Weigh the cons and pros but get second/third opinions if you can.

Best of luck,

Christina 

Sadie-Rose

Hi Twink,

I sent you a pm.

Sadie

Sadie-Rose

Hi Twink,

I sent you a pm.

Sadie

Sadie-Rose

Hi Twink,

I sent you a pm.

Sadie

Sadie-Rose

Hi Twink,

I sent you a pm.

Sadie

Sadie-Rose

Hi Twink,

I sent you a pm.

Sadie