Delayed treatment to prevent recurrence

Meow13

I was told if I didn't make the decision to start chemo immediately within 2 weeks after healing from mastectomy it would be too late. So if after a couple months I wanted to change my mind I couldn't do it.

I can understand you would want to kill cancer cells as soon as possible but why is it the chemo would not be effective say 6 months to 1 year down the road?

I am 5 years NED now but always wondered why the tight timeframe.

Anonymous

I think it's to try to keep errant c cells from escaping before it's too late. The sooner you get those suckers the better, because they multiply. And it only takes one.

I think the idea also is if you're going to get/need chemo anyway, why wait? Get it over with. My MO told me waiting about 6 weeks after dx is about max...I don't know why waiting 2 more weeks would make much of a diff.

I found out end of Sept and then began chemo the first week of Nov. I had to get my second opinions, scans, port placement etc done first.

Claire

Meow13

Thanks Claire, but your answer isn't really answering. The sooner the better is obvious but why would it not kill cancer cells months later? Afterall, you don't really know how long you've had the cancer when you are diagnosed.

stephincanada

I have heard that chemo is more effective at killing individual microscopic cancer cells than eradicating a tumour. Therefore, once the cells have had time to multiply and form a tumour, the chemo may be less effective/ineffective.

Meow13

steph, thanks I do believe that the sooner the better and maybe the reason for not offering chemo say 3 months after dx is because the statistical reduction in using chemo as a preventive treatment are reduced or unknown at that point. It would be nice to hear an explanation rather than a conclusion it is too late.

Perhaps the rogue cells only would stay in the blood stream for a certain amount of time before lodging somewhere to later grow into a tumor.

I suspect my tumors were there for atleast 6 months before I had my annual mammogram.

SpecialK

Here is some info that addresses optimal start of adjuvant chemo for breast cancer, and analysis for the window of opportunity. My assumption is that you are starting in a window soon after surgery to disrupt errant cells from setting up shop outside the breast - the basis of systemic treatment - but this information does not necessarily address the whys of that. I am an outlier of sorts - I started chemo, with Herceptin, 14 weeks after BMX due to the need for four additional surgeries, and I had node positive Her2+ disease - still here six years later, despite also receiving low benefit from anti-hormonals (based on BCI test results) which I am still on.

https://www.cityofhope.org/blog/chemotherapy-breast-cancer-surgery

http://www.breastcancer.org/research-news/20140220-4

http://www.jwatch.org/oh200611060000001/2006/11/06/optimal-timing-adjuvant-chemotherapy-following