Chemo plus radiation or just radiation?

abiecat

• Hi. I am 76 years old! Diagnosed tnbc in June. Had lumpectomy in July.
• stage 1, grade 2. Lymph nodes and margins clear. Oncologist recommended tc chemo plus radiation but said many women my age do not do the chemo. My husband is very concerned about long term or permanent neuropathy and brain fog which, we were told, has a 2-5% chance of happening whereas the chemo can possibly (not for sure) of preventing recurrence by 7%
• I'm very anxious. Do I do the chemo and make myself more vulnerable especially with the covid surge or just do the radiation and enjoy my family and life as long as I can? I am physically and mentally well and active. No health issues other than this. My mom had bc at age 35 and lived to be 92. Not one other person in our family had bc. No aunts, cousins... No one. My grandmothers did not have health issues and lived to be 97 and 99. I am making myself a wreck over what to do. Anyone "older" out there who has thoughts about this? Need to decide very soon.

MountainMia

abiecat, I'm sorry you're faced with this decision. I can understand why it can seem like neither choice is a clear winner.

I don't know your definition of "older." I was 58 when I was diagnosed in 2019, stage 1 tnbc, grade 3, lymph nodes and margins clear with a lumpectomy, great health aside from the cancer. Surprisingly, my medical oncologist (MO) did not push chemo hard for me, but given my age and tnbc, I was sure I wanted to do it.

I had 4 rounds dose dense (every 2 weeks) of adriamycin and cytoxan. The taxanes have a higher chance of causing neuropathy. I reacted to Taxotere so couldn't use it or taxol. Taxol often is used in combination with AC, making the ACT or AC+T combination you see in people's signature lines. Anyway, I couldn't use it, so only did the AC part of the regimen.

The side effects were manageable and I'm glad I went ahead with that much of the program. Again, especially at my age, I'm glad I had the systemic (whole body) treatment to prevent recurrence.

There is a great tool called Predict, which calculates risk of death from recurrence or other causes, given your age and cancer characteristics. You might take a look at it. For me, it predicted a pretty small improvement in life expectancy, which I'm sure is why my MO was wishy-washy on the idea. However, I decided I wanted to be on the side of living longer. NOTE this is probabilities over a population of people with your characteristics, of course, not predictive to you in particular, and not of course any guarantee! But it might give you more information to think about.

https://breast.predict.nhs.uk/tool

Good luck. Whichever you choose, people here will support you and help you with the process.

abiecat

Thank you. I will be 76 in a few weeks.

Moderators

abiecat, welcome to our Breastcancer.org Community! We're so glad you've joined us and hope you find it to be a place of support and encouragement.

You may be interested in also posting in the Older Than 60 Years Old With Breast Cancer forum. There you'll meet other women who are similar in age and dealing with similar issues.

We hope this helps! Please stay connected and keep us posted.

The Mods

Esther01

Hi Abiecat,

It's a tough decision with just 7% benefit. You're right in that chemo will "temporarily" take out your immune system, but you can build it up again afterwards with clean diet, muscle-building exercise, the right levels of vitamins and supplements, nutritional IVs and EDTA IV chelation (for removing all the toxins we get from chemo and radiation). The best immune system test I know of is by SpectraCell- it even shows you how much of your nutrients you're absorbing and how strong your immune system is operating. It's not covered by insurance (of course) but is a good indicator of how you're doing at any point during cancer treatment.

I don't want to sway you either way, because I don't know what's best for your situation so I will pray you get peace from the anxiety, whichever decision you make. I learned from an oncologist who teaches biochemistry that chemo and radiation typically take out the soldier cancer cells but that the cancer stem cells hang back in other tissues, and they're the ones we most want to target with chemo/rads, or at least keep them silent and dormant forever so another tumor will never form. I'm going through radiation right now and trying to make my body as hostile as possible to a recurrence.

No matter what you decide about chemo, I'd definitely build up the rest of your body and correct any cellular issues to repair you from chemo and reduce recurrence risk. I've read and listened to many doctors on this.

Speaking of, if you have or visit with a good integrative doctor (can find one on ACAM.org) they can help build up your immune system, correct the metabolic cellular issues we seem to have when our cells form a tumor, correct any hormonal imbalances or slow elimination pathways (I had that problem as a type A blood type). If you are blood type A, please message me about digestive enzymes which are very important for type As especially with cancer.

A good integrative doctor can help you whether or not you choose to go through chemo and will support you through it either way- to help you get through treatment, restrengthen your immune system and gut function, restore metabolic cell health, reduce stress and help maximize your chances of avoiding a recurrence.

Blessings,

Esther

AliceBastable

Esther, there is a section somewhere on this forum for alternative treatments. Most of the people on these threads are going with the science-based therapies.

Esther01

Thanks AliceBastable,

I appreciate that. I am, as well. I gave myself eyestrain from researching the studies and interviewing doctors and oncologists for the past six months. One such study published right here on breastcancer.org has given me new hope for reducing the radiation-induced inflammation I'm going to get after 33 rads treatments. Our sister has a right to know everything that is safely and currently available to her. At this point I wouldn't recommend a piece of gum without scientific validation behind it. Sugar-free, though I have been longing for a stevia cake with buttercream frosting for months.

Blessings,

Esther