Chemo vs. Radiation

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tovahsmom
tovahsmom Member Posts: 196
edited June 2014 in Managing Side Effects of Breast Cancer and Its Treatment

I am wondering:

My oncologist has already suggested radiation for my DCIS. And I understand that radiation, and not chemo, is the standard of care for most cases of DCIS.

BUT

there is permanent damage that is done by radiation. So my question is about chemo. Once the chemicals go through you and out, is there any permanent damage to your body? I understand there is temporary damage, i.e. the killing off of healthy, fast-growing cells and the loss of hair, but once chemo is done, is the damage temporary or permanent?

Radiation sounds like it causes more permanent damage than chemo, but maybe I'm wrong? 

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  • tovahsmom
    tovahsmom Member Posts: 196
    edited August 2009

    Never mind. I'm reading Shelley Lewis' book (Five Lessons...) and I just came across this:

    Now that I was doing my research and beginning to understand the ramifications of chemo on my body, I didn't like was I was learning. One kind of chemo caused heart problems in some (a few) women. Another kind had the possibility of causing leukemia....


    And then there was chemo brain. In 2004 doctors were beginning to acknowledge that for a fair number of women, chemotherapy causes cognitive loss, maybe permanently. Cognitive loss, it seemed to me, was another way of saying "brain damage." Women who have chemo brain report an inability to concentrate, to remember certain words, and to handle more than one task at a time. p. 116 This has answered my question.   
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  • Leah_S
    Leah_S Member Posts: 8,458
    edited August 2009

    Tovahsmom, from what I understand chemo is not given for dcis since it is in situ - has not spread past the duct so why use a systemic treatment for a local disease? However, I think the rate of recurrence after lumpectomy without radiation is about 40% while with radiation it is about the same as for mastectomy.

    Best of luck.

    Leah

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  • bluedasher
    bluedasher Member Posts: 1,203
    edited August 2009

    Chemo and radiation don't do the same thing. Chemo treats your whole body at least wherever blood flow goes to kill off cancer cells that might have spread. Since the spread is often through the blood, this can be quite effective against recurrence for those of us at risk but with DCIS, you don't need it. Radiation kills off any stray cancer cells in your breast (and in the nodes for women who need that but they wouldn't be targeting those for DCIS) that may have been missed by surgery. It does that better than chemo because surgery may have disrupted the blood flow in the breast. So chemo isn't a replacement for radiation and vice versa.

    There is at least one chemo drug is associated with permanent heart risk and very small risk of leukemia (about 0.25%). There are other chemos that don't have those risks though they have risks of long term neuropathy (numbness and tingling in feet or hands).

    Radiation doesn't necessarily do significant permanent damage. I finished it about 4 months ago. During radiation, I got a minor burn in an area about 2 inches square - just redness, no blistering. Now if I compare the two in the mirror, the radiated breast is slightly larger, a little tan (I'm quite fair skinned) and the nipple is a little enlarged. The size difference isn't much - cup size is the same on both sides. That side is perhaps slightly firmer than the untreated side. Nothing that causes permanent problems or that I notice in a more casual glance. I don't know if these differences will stay or not.

    Edited to add my experience with chemo. I finished TCH 6 months ago - the Taxotere in that can cause neurapathy, but I just had a little in my fingertips and it went away in a couple of months. The Herceptin can cause decreased heart function, but the heart recovers when the drug is stopped. I'm still getting Herceptin because in the US it is usually given for a year. I haven't had any chemo brain symptoms. My red blood cell count is still slightly anemic - my oncologist says that it may not come back up until after I'm done with Herceptin. And my creatinine levels (a measure of kidney function) is still a little high partly due to a drug study that I have gotten off because of elevated creatinine. I'm hoping they will come back to normal now that I've stopped the study drug. I think in the end I may not have any permanent damage from chemo either but it was certainly a lot harder, longer treatment (18 weeks for the TC vs 6 weeks for rads) and a longer recovery time.

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  • shiny
    shiny Member Posts: 892
    edited August 2009

    Yes, I would say, that chemo does have permanent S.I's I think it does depend on the type the level (dose) and the person receiving it. I have the chemo brain, the fatigue, the neuropathy and worse bone and joing pain and a few other things. I am grateful I had treatment, but if you can do without it, and it looks like you can great. I tdoesn't sound like anyone would recommend this for you anyhow.

    Good luck, all the best.

    Shiny

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  • tovahsmom
    tovahsmom Member Posts: 196
    edited August 2009

    Thanks.

    No one suggested I get chemotherapy. I was just wondering if it had fewer side effects than radiation, but now I've got my answer.

    It won't even be a choice I have to make, just wanted to know.

    Thanks! 

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