Should I prepare for chemo?

98hgmom

Hello. I had my lumpectomy last Wednesday and today I heard from my surgeon that there is a small amount of cancer found in the sentinel lymph node. I am really hoping to avoid chemo. I have a family trip to Europe leaving June 2 and I am worried that I won’t be done with treatments. Arrgh

Georgia1

Ugh, so sorry. Did they call it a micro mets? That would not necessarily require chemo since you are ER+. Ask if they are going to do an Oncotype DX test to assess your risk of recurrence and the relative benefits of chemo. And best wishes. I know you've already been through a lot but be strong and realize this will all be in the rearview mirror pretty soon.

98hgmom

Thanks Georgia. They didn’t call it micro Mets. My BS is going to do an oncotype test. That is 10 more days of waiting which is driving me crazy

Hopeful82014

98 - Sorry you got such disappointing news. Whether or not it's expected it is certainly hard to take.

Depending on the size of the met I would - strictly based on my own knowledge - think that there's a reasonable chance you could pass on chemo. Your tumor was fairly small and low grade and you're ER/PR+ although your signature doesn't indicate by what percentage. IF you're high ER/PR you would probably get equal or more benefit from endocrine therapy than chemo. Of course, that means fully committing to the prescribed course - at least five years.

Once you know your Oncotype you'll have more to work with. When you get it, bear in mind that for node+ it only predicts risk of distant recurrence out to five years, rather than the ten years that is offered for node-. I don't think it's as robustly validated as for node- either. If it's equivocal you may want to consider a Mammaprint as a tie-breaker.

In the meantime, try to keep your mind busy with other concerns - maybe focus on the details of that family trip. Good luck.

98hgmom

Thanks hopeful. I am very high er and pr positive. One is 98% and the other is 99%. I cant remember which is which. My BS was surprised to find it in the lymph node. Two more weeks of waiting is going to be the death of me

Hopeful82014

I completely understand - I've been through it. Your high ER/PER levels are excellent news - you should derive a LOT of benefit from endocrine therapy. (Did your surgeon request ER/PR, etc. pathology on the node? More and more surgeons are doing that and it can provide useful info. It's not too late to ask for that.)

Some oncologists are pretty stodgy in their thinking on chemo for node+ patients. It doesn't sound as though that's the case with yours. I'm not against chemo when it will actually provide benefit but who wants to go through that if the benefit is minuscule? As you may know, your Oncotype will show the anticipated percentage of benefit from chemo - pay close attention to that. If the benefit is high, throw a tantrum at the world followed by a huge pity party and then figure out how best to deal with that - especially in light of your family vacation. (I hope you have insurance for your travel plans.) In the meantime, it's tough. I think my Oncotype came back pretty quickly - maybe you'll get lucky at least in that regard.

Hang in there!

98hgmom

Unfortunately I do not have insurance for our vacation. It was booked almost a year ago and I was very healthy then! Who would’ve known? We are taking all of the kids and my sons wife too. 7 of us in total. 16 day trip

Do you remember how many days it took to get your oncotype score back?

Hopeful82014

Hi, 98 - I had to look back through my records. I guess it did take about 2 weeks for the Oncotype to return, although in retrospect it doesn't seem that way. I think I'm repressing a lot of memories of that time, frankly.

Regarding your travels - be prepared that even if you go straight to radiation without chemotherapy you may still be pretty tired in early June. Be sure to cut yourself some slack! Radiation fatigue is unpredictable, however.

98hgmom

I’d much rather deal with the side effects from radiation. I meet with my BS tomorrow. Hopefully she can shed some light on some of my pathology results. Fingers crossed!

Sjacobs146

Having a positive node isn't a guarantee of chemo. My doc recommended chemo for me because My Oncotype came back Intermediate and I was fairly young at diagnosis (48). If any one of those things were not true she would not have recommended it.

Fingers crossed that you won't need it.

98hgmom

Thanks Sj! Thanks for sharing your experience. I hope my oncotype score comes back low

LimnoGal

98hgmom-here’s hoping for a low oncotype! On the other hand, if chemo is recommended, you might just be able to work your schedule so that your trip falls during your good weeks, or even squish it all in and be done by the time your trip rolls around. Once it was determined that I would be doing chemo, and that there was no way around that, my MO worked with me to accommodate some work and personal travel that I had planned. I started chemo on April 9, and left for Alaska on June 9. I was more tired than I wanted to be, but I still had a lovely trip. No hair and all

98hgmom

Linmo - that’s encouraging that hopefully I can work my treatments around our trip. This trip is really important to our family. My mom died last summer and left me a small amount of money. All of my kids were so close to her that I wanted to use the money to take everyone on a great trip. My mom traveled with my family on all of our trips and loved to travel. We are dedicating this trip to her and will honor her on the trip! I cannot cancel it!!

GreenEyes81

98, I would not hesitate to share with your doctors how important this trip is.