Whether to chemo or not

ChristineHS

I am looking for some information/experience from members concerning my 88 year old mother.  She was diagnosed with Stage 3 breast cancer and just had a mastectomy.  The cancer was also in one lymph node.  The doctor has recommended chemo for her.  Cytoxan and Taxotere.  She is 95 pounds.  Triple negative.  My family and my mom are in discussion on what might be the best route for her given this information.  Worried she won't be able to handle the chemo.  Any thoughts?

voraciousreader

I would ask that her case be presented to a tumor board and get a second opinion. 

My mom is approaching 89. She is in excellent health.  According to the current recommendations, unless an older person is expected to live beyond ten years, one must decide whether to continue having mammography.  In your mom's case, the benefits of mammography outweighed the risks.  So now that she had the mammo and it revealed cancer AND she was well enough to have surgery, the question you ask really has no correct answer.  Would she be better off just having radiation? If she chooses chemo, how much benefit might she have?  If her life expectancy is more than 5 or more years and SHE thinks she is up to the possible risks and side effects, then doing chemo might be warranted.  Does she have other co-morbidities?  Are they well maintained?

I don't think any of us can tell you what the appropriate path should be.  Do 88 year old women get chemo?  I'm sure some do.  Let a tumor board with multiple doctors guide her.  Ultimately only she will know what she needs to do.

I wish her well.

ChristineHS

Thank you for your reply.  Could you tell me a little bit more about a tumor board and how do I contact one?  This has not been mentioned to me before.

jessica749

The doctor recommending this…is the doctor at a NCI ranked comprehensive cancer center? see link http://www.cancer.gov/researchandfunding/extramur…

I've not really heard of giving someone who is 88 chemo…I would think there'd be many things to consider, such as the effects of the treatment weighed against its benefits at that age. I mean, what are the stats on recurrence without chemo, vs with chemo? How aggressive is cancer at that age? Cells are just growing slowly aren't they, even if it's a cancer that might be aggressive in a younger person….I don't know these are just my random thoughts.  I would definitely get a couple of opinions of HIGHLY RANKED/EXPERIENCED people.  They could lay out the pros and cons based on current data and help you make the right decision

voraciousreader

Oncology physicians have tumor boards.  That is weekly meetings where various oncology specialists gather to discuss special cases.  They comprise oncology surgeons, radiologists, pathologists and medical oncologists.  They make recommendations.  Ask your doctor to have your mom's case presented to a tumor board.

ruthbru

If your mom is in sound mind, then it is really her call. Chemo can be very rough & may have long term SEs of its own. Does she feel the risks are worth the possible extension of life, or is quality of life RIGHT NOW the most important to her? Just for my own self (and me only); I would never, ever have chemo at the age of 88, nor (if asked my opinion) would I advice a loved one to have it either (but I also won't want tests for other potential problems at that age, so my idea of 'don't ask, don't tell' might be kind of 'fringy'). Sending my very best wishes to your mom and your family!

jessica749

Just curious, and perhaps I'm ignorant-but why would say a radiation oncologist have an opinion on chemo? The hospital I go to is specialized, and doctors in various specialities wouldn't necessarily be in a position to pronounce on what treatment should be done by another specialist.  I.e. a radiation oncologist could only speak to radiation treatment, etc.  I personally would rather  go to two different breast cancer medical oncologists - ideally affiliated with different institutions(ie.. chance of differing philosophies/opinions) and get their opinion.

jessica749

My post above was in response to VR suggesting a tumor board. 

voraciousreader

Jessica...tumor boards consist of multiple disciplines who come together.  My mother recently had a favorable lung cancer diagnosis.  Her case was discussed by a tumor board.  The decision came down to an oral chemo or a couple of radiation zapps.  It was decided by group to do the zapps and if she relapsed, then move on to the chemo.  It's three years and she is doing well. 

ChristineHS

Thank you all for your caring insight.  I think a second opinion is in order before any decision can be made.  I AGREE wholeheartedly that this is my mother's decision.  I am trying to give her the best knowledge I can in order for her to make that decision.  I will support her 100% either way she goes.  Again, thank you. 

Pessa

I did not find chemo to be so onerous.  I continued to work full time and raise (alone) my 2 sons, who at the time were 13 and 15.  Friends helped with shopping and some meals.  The meals were important so that I could have some semblance of a normal routine for my sons,  Had I been alone, I could have prepared meals that suited me.  It is your mother's call, but people react differently to the same chemo and I had virtually no problems with it, just fatigue.  I am 4 years out and have no lasting side effects (that I am aware of).