I want to refuse chemo and radiation

juneping

kicks - my doc didn't write me off. but age was a factor when she made my treatment plan. she was not a bigot....geese....

Anonymous

How many women diagnosed in their 40's have been told that they had to do aggressive treatment due to their young age?  Is that age discrimination or bigotry?

A woman over 85 is more likely to be in overall frail health than one who is 60 at diagnosis, but there are exceptions to that scenario.  Every doctor should take the situation of their specific patient into consideration when developing a treatment plan.  There is no benefit in pushing an aggressive and debilitating treatment that will last for months plus a number of months of recovery on someone whose comorbidities mean that they had a life expectancy of less than a year before diagnosis.  On the other hand, an octogenarian who is active and healthy might just outlive her doctor.

AlaskaAngel

June, one of the functions of chemotherapy (as well as hormonal treatments) is to create a strongly menopausal state, which can be somewhat related to age. If chemo was likely to be only very marginally effective for you, and/or if you have other health issues that might be complicated by the use of chemo, that might be reason not to recommend chemo, in part due to age.

ruthbru

Well, maybe it is better to say that things aren't always black and white; and that people who are in frail health and/or have other serious health conditions, whatever their age.....might want to/be forced to weigh their treatment options in a different light than an otherwise healthy person of any age.

Momine

Bronx, yes, I was in Westchester for several years and DH grew up there and in the Bronx.

Momine

Patmom, I was never told that (young=aggressive treatment). I was told that I had a very serious situation, that the success of treatment was not a given and that I was lucky to be in overall good health and shape, because this meant that I would be able to get through very aggressive treatment. The main reason they wanted to go at it with machine guns and chain saws was that they feared micro-mets.

The only context where I have gotten the age spiel was the several times my onc tried to talk me into breast reconstruction, on the grounds that I was "young" and "attractive" [an argument I find all kinds of offensive]. But that is a whole other discussion.

NancyHB

I got the "we must be aggressive because you're so young" speech - and I was 48!!  (This before we knew my Onco score, then being young suddenly didn't matter anymore).  My 81-year-old father had quad bypass 4 months ago; doc said the only reason they even considered it was because he is so strong and determined and (besides the bad heart) had the "physical constitution" of someone 20 years younger.  Everyone is different, and treatment options should be tailored to the individual with a holistic approach.  We are always treating more than a disease or condition; we are also treating a person.

BrooksideVT

What they told me was that bc tends to be more aggressive in younger women, less so in us elders. At age 70, rads after a lumpectomy for stage one, grade one becomes optional, not because of age, but because they are finding good results in older women who choose to opt out of rads.  Or maybe they're finding rads doesn't do much for a cancer whose cells are not propogating like bunnies.  Not sure whether there are any actual studies out there, but it does stand to reason, doesn't it?

Momine

Here are the results of one recent study that looked at the elderly again, because they were less likely to receive chemo. It is relevant to the discussion here, since patients with stage 1 fared no worse in this group but stage 2 and especially stage 3 women did:

Results

Seventy-five percent of patients aged 75 + were seen by an oncologist compared with 78% aged 70–74 and 84% aged 65–69. Women aged 75 + seen by an oncologist were more likely age 75–79, stage II/III, hormone receptor negative (HR −) or her-2/neu positive. Of these patients, age, stage and HR status were related to a chemotherapy recommendation. Of 106 patients recommended for chemotherapy, 18 refused (17%) and 24 did not complete treatment due to complications, patient choice, disease progression or death not related to treatment. DSS was equivalent for patients 75 and older with stage I BC compared to 65–74 year olds, but significantly worse in stage II and III patients, respectively (stage II 5 year DSS 90% vs. 97%, stage III 5 year DSS [Disease Specific Survival] 65% vs. 81%). http://www.sciencedirect.com/science/article/pii/S1879406812004407

HomeMom

Brookside I agree with your post. You took the words right out of my mouth!

BrooksideVT

Thanks, HomeMom.  I reread my post and, come to think of it, of course there have been studies of the aggressiveness of cancer in older vs. younger women; I just do not know which ones, where, and when.  I'd also add that just about every onc wants his patients to live longer and better than those of every other onc, and treats his or her patients to the best of available medical knowledge through the filters of the patient's medical condition and wishes.  Family members also weigh in.  Perhaps more often than appropriate, they do not want Grandma  to "Be put through that," in part because of their lack of understanding that the outcome of skipping treatment may be far worse,

HomeMom

I think there ARE instances where chemo is not a good option or is at the very least in the gray area. I think as long as your are healthy, the age really shouldn't matter. I find it alarming how many women under 40 are dx each year. Maybe it's my imagination but imho they should lower the age for starting mammograms to 30. My DIL is 25 but her grandmother and aunt both had bc so I'm all over her about breast exams. 

madeditor

I want this monster stopped and if chemo and radiation is the way to do it, then so be it. I have three grown sons whose father died at 51, a mother who doesn't need to lose a child, and then there's me, who doesn't think 66 years on this earth is nearly enough. I'll be done with chemo at the end of the year and will begin radiation in 2015. Doc is optimistic about my recovery. And so am I. the treatment is saving my life.

GrammyR

Momine- I quit reading stats a long time as ago. I chose to believe that 50% survival rate at Stage 11b meant I had beat it after 5 years. Wrong-- it came back w/agression . The only reason I would contemplate more chemo would be because of family begging me. Quality of life and side effects  all must be taken in to consideration. So for each women it may be different, just know/ read/ ask what you are agreeing to before starting a long treatment.

AGL

I can understand your perspective on not wanting to do chemo and radiation, but if you plan on fight cancer you have got to be all in. My sister passed from Cancer on Aug. 17 2013 because she refused to take chemo and radiation treatment. I am sure it is a difficult decision for you and can somewhat understand the agony associated with making such a decision. However, think of all the things we use and do on a daily basis knowing and unknowingly that harms us. If we can live with that then the decision to go all in and let the experts provide the right treatment the outcome will more than likely be one that will bring you joy for years to come. But refusal to get the complete proper treatment can lead to years of agony and pain not just for you but also for your loved ones. Keep you in my thoughts. 

Anonymous

AGL, it seems that on some level you are blaming your sister for not fighting hard enough.  

The decision to do chemo and radiation or not after surgery is a gamble that you are not doing more harm than good.   If the surgery removed all the cancer, then the additional treatments won't make anything better, but the patient still experiences all of the devastating side effects of the treatment.  Let me assure you that neither chemo or radiation treatment are a guarantee that the cancer won't come back, or metastasize. I have seen far too many women here who are diagnosed with metastatic cancer less than a year after they finish chemo if not before.  

No matter what treatments your sister had or didn't have, once her cancer was diagnosed as metastatic, there is no cure.  Your sister chose the route that she believed would give her the best quality of life for the time she had left.  Be grateful for the time that you had with her, but don't blame her for not making the same choices you believe you would make in the same position.    

More than six years ago, I decided that taking Tamoxifen sooner rather than doing chemo for months before starting the Tamoxifen was a better treatment choice for me than chemo.  So far so good. I made the choice that was right for me, and that is the best that any of us can do.  

wrenn

Well said Patmom.

Lunalin

As was previously stated, you already have an agressive poison within you. I didn't want to op for chemo 10 yrs. ago, but I did. I'm glad I did. I had 10 good years and saw the birth of 3 grandchildren. Well, it's back and I have to do it all over again. I will and it won't be fun. I will do it for those 3 grandchildren. Best of luck to you, whatever your decision.