Need Advice for My Mom's Rads(Re: Boost) - Please everyone Help!
Hi everyone,
I would like everyone's advice concerning my Mom's Rads treatment. Here is a short history first:
She was diagnosed with IDC,5 CM, ER/PR +, Her2- on 01/27/09. Her Onc opted for Neo-adjuvant chemo(4 AC and 4 Tax) to shrink tumor which was well tolerated and did a great job. Her response was fantastic and prior to the lumpectomy there was no tumor felt or seen on the mammo - completely disappeared. The surgery results were incredible - 0/21 nodes postive and no invasive cancer found in the breast tissue removed - her onc says its a complete pathologic response wich is rare. Only thing found was less than 0.5MM of DCIS. Great results and awesome chemo response.
The radiologist first recommended 16 whole breast rad treatments over 3 weeks(I guess higher dose per day) which we were relieved with, but then changed it to 25 treatments over 5 weeks, which we were a bit disappointed with cause it would be longer but we're over that now since he says its less toxic. On Friday of this week(12/04) she will have completed 3 full weeks with no side effects except slight skin darkening. Well tolderated and 2 weeks left!
My question is - I asked the radiologist whether or not she will receive a boost. After checking with his colleagues, they deem a boost to not be necessary as there is no data to show in her case that it would be beneficial. However, if we want a boost he will give 4 boosts(to only the tumor area) after the 25 reg treatments. The 25 will finish on Dec 18 and with the boosts on Dec 24th! What do we do? They say it may not be necessary because of the fantastic response to the chemo and no invasive cancer found at surgery and it is upto us, but they feel the 25 is sufficient. Does everyone who does rads get a boost? Is it always necessary?
My main thing is that everything has been going really well since January, the chemo, surgery and rads thus far and I do not want a recurrence. I am scared and think its best to do the boost instead of regretting it later, but I get the feeling that Mom rather not do it as she wants it to be over asap rather than on Dec 24th! Would the 4 boost even make a huge difference after doing 25 reg rads? I have been her main advocate and health advisor since diagnosis and I don't know what to do. Maybe the 25 reg treatments is sufficient? I mean if the rad docs aren't making it mandatory, why whould I insist? Even though they said we can have them if we want? I hate gray areas!
Can, you guys please help me! Advise me with your situations and experience/opinions? Any help is so appreciated as we must tell the doc on Friday morning!
Thanks!
Dean
Comments
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I would definitely do the boosts, but that is just my own opinion. I had 33 treatments, the last 5 were boosts to surgical cavity only (1.2 cm IDC/lumpectomy). Since she had such a great response and the tumor is no longer there, I'd still want to hit that area for any stray cells that may have been left behind. Good luck eitherway you choose to go.
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Hi Dean --
If i remember correctly, the boost is mainly to prevent local recurrence -- the idea is that if there are cancer cells around after the lumpectomy, they'll be zapped by the boost. Since there was no tumor left - no cancer cells - this may be unnecessary. And even if there were a few cells, they would cause a local recurrence, not a distant one. So the rads might be overkill (I should add that i'm always very aware that treatments have side effects; i tend to go for the least-harm treatment, not the absolutely most aggressive one.) My onc said, pretty emphatically: local recurrence isn't what kills you; distant recurrences are way more dangerous.
But do check with your radiologist once more about what benefit if any there is to the boost...that will give you a better idea of what is necessary.
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I had a complete path response too. Not even dead cancer cells were found.
I was not even given the option of no boosts.. and I had a mast. They were to hit the scar line on me... they are no big deal and faster... I would do them if offered.
Blessings!
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I haven't got any advice
but you and your mom are in my prayers! How lucky she is that you are by her side! XOXO- Tamara
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If I were in your mom's shoes I'd do the boost. The problem with cancer detection is that there have to be a lot of cancer cells before they show up. A negative test doesn't necessarily mean that there aren't microscopic cells still in there. A boost will help clean them up.
Best of luck to you and your mom, and I hope you all have a safe and happy holiday!
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I think the boosts give you added insurance. I had 15 regular sessions and 3 boosts. I was trying to plan a trip and my radiation oncologist said I could come in twice a day for a couple of days to finish up earlier. My work schedule didn't accomodate going twice a day. Going twice a day for a couple of days would give allow your mom to finish up a little earlier. If it fits her schedule you could ask your RO. I don't remember the exact timing, I think there needs to be about 6 hours between the sessions. Good luck.
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Hi everyone,
Thanks so much for all your advice and input. Your time to reply is much appreciated. At the end, we have decided to do the boost. It will be done in 4 session from 12/21 to 12/24. Just in time for Xmas!
Thanks so much,
Dean
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