84 yr old Mom, Stage 2, Lymph node, CHEMO normal?

Mcgr45

My 84 year old mother was recently and officially diagnosed with Stage 2, Invasive Ductal Carcinoma. With a biopsy, it was not a guess it is a "fact." (One surgeon recommended a Mystectomy and while under anesthesia doing the biopsy to stage it, instead of the other way around and then deciding on the surgical option. She choose another surgeon.) Anyway, she has a 1.8 cm tumor near the back of her left breast with a "small" fat plane left for the surgeon to cut it out via a Lumpectomy. If they leave cells behind they said that radiation would kill them. The growths in her right breast are benign. The Oncologist said the tumor was 100% Estrogen and 100% Progesterone Positive, HER2 Negative, one or two lymph nodes involved, Grade 2, Ki67 (doubling time) is 30%. Not sure what some of this means but in the world of cancer, for an 84 year old, I guess it could be worse. They plan is to do a Lumpectomy, Radiation, and Hormone Therapy. They could run the "Oncotype DX" to determine if CHEMO is appropriate, but the Oncologist said her type of cancer responds well to Radiation and Hormone Therapy and that chemo DOES NOT add much to ones survival no matter WHAT the age of the patient. Does this sound right? Also, as an incidental finding, after a CT Scan of her Chest, with and w/o contrast they found a 5cm growth on the left side of her Thyroid, although the growth looks like it has liquid in it. Her Breast Oncologist and the Endocrinologist are not convinced that it is cancer. She had a biopsy and ultrasound of her Thyroid. So we are now awaiting those results. I am scared for her. Any words of wisdom in general? I am a only child. I live in chicago with my husband. My father is also sick. It's awful.

Sjacobs146

it is totally normal to not have chemo for Breast cancer. Chemo takes quite a toll on the body, and is not to be done lightly. The doc is correct, it doesn't do very much for survival, just a few percentage points. For someone In their 40s or 50s it might make sense because there are many years ahead where the Cancer could return, but at 84, chances are that she'll die from something else before the Cancer gets her. THe oncotype test could be done to see if she'd benefit from chemo if she feels strongly about it.

I'm So sorry that your family is having to deal with this, especially since you don't live near each other. Does your mom have any friends nearby that she can lean on? You could also give her a small recorder to bring to doctor appointments so that you can listen yourself after.Perhaps the docs may also be willing to do a conference call. Some of the information is so overwhelming and confusing, especially for older folk. Good luck, and I'm sure some others will be along shortly to share some of their wisdom.

bevin

I would suspect even a healthy 84, your Mom would not be offered chemo. I believe someone her quoted/stated that the guidelines state it not usually warranted for someone in their 70s. I honestly would see another opinion if someone wanted my 84 your old mom to go through Chemo. It has many risks/side effects itself and in an older person, those could even be more troubling.

CCtoo

hi, wonder how your mom is doing.I am 80 with same diagnosis, and coincidentally, had my surgery, lumpectomy on Oct. 27! They said no chemo. But I am afraid of radiation side effects! So may just do hormone therapy. I am also only child from Chicago, with relatives in Houston!! Can anyone tell me how bad rad. Side effects are?

Meow13

Would your Mom be able to forego radiation if she had mastectomy? Something to consider.

gracie22

Honestly, with an 82 year old mom who underwent uterine cancer surgery earlier this year, my own very personal opinion is lumpectomy only and the anti-hormonals, and she should skip even the drugs if they give her any side effects. Ask the doc about skipping radiation as well. It has limited value (according to recent studies, see link) for the elderly.

Though a different cancer, rads and chemo were recommended for my mom. We did not do chemo since other physical issues she had would have been greatly exacerbated by it (not to mention the much higher likelihood of chemo brain/dementia and permanent neuropathy for older patients). It has been 6 months, and she suffered immeasurably from the radiation which caused damage to her bones and very painful pelvic fractures. Radiation also causes exhaustion even in healthy young people; for the elderly it is much worse. My mother has been hospitalized twice and is currently in a rehab facility and heavily medicated for pain. I pray that these are not her last months, because they have really sucked. She was fine post surgery, and just fell apart towards the end of radiation treatment. If we had only known, we would have done surgery only. Less than 6 months ago, she was running her own home.

To the original poster, I am posting long after your original note, but I want to say that I really think it is terrible to visit the ravages of chemo and rads on elderly people. With positive nodes, you (and she) may feel more comfortable doing radiation, but my own experience is that its best to avoid it. Anti-hormonals work very well on ER+ cancer. I would go with that, and skip the chemo, rads and limit any node removal to sentinel nodes only. My grandmother-in-law was diagnosed with breast cancer and positive lymph nodes in her 80s also. She debated not treating, but the surgeon said to do a mastectomy and node dissection and she would be fine. She got through the surgery fine, but developed pretty severe lymphedema and died a couple of years later of unrelated causes. Frankly, we should have stopped at the mastectomy and refused the node dissection.

http://www.breastcancer.org/research-news/20130628-4

Meow13

I agree she shouldn't have the radiation. Probably would be fine with lumpectomy and AI therapy. If the drugs are taking too much of a toll she could stop.

MinusTwo

I agree & disagree. If a lumpectomy is enough to scrap it out, I surely wouldn't go on to do a mastectomy. Much harder surgery & much longer recovery. And I would never do chemo at that age. But I WOULD do radiation. It really was very easy for me with not too many side effects except fatigue. The side effects from the hormones are probably worse than the rads from what I've read, but I have no personal experience with that since I'm hormone negative.

Meow13

I doubt they would do whole breast radiation maybe targeted but my guess is no. When I was having my mastectomy there was a 99 year old lady having a mastectomy too. I was suprised. That was going to be her only treatment. I don't think they bothered with a node disection either.