Is is safe to skip chemo?

Jenny4210 · January 2010

Hi, my name is Jenny and I had a mastectomy on Dec. 21, tumor was really small, but found in 7 lymph nodes. I really don't want to do chemo, knowing some of the short and long term side effects. In my situation, has anyone declined chemo and just done radiation and tamoxifen?

Or am I flirting with disaster by refusing chemo?

Thanks for any replies!

dualgate · January 2010

Jenny, I had a lumpectomy nov. 16th but had no nodes involved. I got the OncotypeDX test done with a score of 13 so I am doing radiation and tamoxifen. I would certainly consider chemo with the nodes involved. My advise is to do a lot of online( reputable sites only) research. and get a second opinion, by a breast oncology specialist if possible. The knowledge you gain will help you with your decision. I wish you all the luck and will pray for a good outcome for you. Jamie

idaho · January 2010

Have the oncotype test done and that will tell you if chemo will work on your type of cancer. Tami

Merilee · January 2010

Jenny

I opted out of chemo a year ago as I had a small tumor and no node involvment. However, I recently had a recurrance and am starting Chemo on Thursday. I think it is a crap shoot at best.

Follow your gut but do look at the different type of chemos and then make a decision.

rinna40 · January 2010

Jenny - chemo is scary and I really didn't want to do it either. I was told that I had a 55% chance of it coming back without chemo and only a 20% chance that it would come back with chemo, and I had no node involvement. I did it, and hope it worked. I agree about getting a second opinion and go with your gut. Whatever you decide, be at peace with it.

dlb823 · January 2010

Jenny, the fact that your tumor is very small, and yet had reached 7 lymph nodes, makes me think your bc is pretty aggressive. I don't think any of us ever want to do chemo, but with 7 positive nodes, I don't think you have a viable alternative. It sounds to me like you really do need chemo, and I can't imagine an oncologist who wouldn't recommend it for your situation -- at least based on the basic info' you've shared with us.

And Tami, doesn't she have too many positive nodes to be Oncotyped? I thought the new guidelines now include women with 1 positive node, but not multiple positive nodes. Deanna

Merilee · January 2010

Jenny

I was scared to death of Chemo but it helped when I learned just what the various chemicals do to cancer cells. For example: the tratment I am doing is called CMF

The C attaches itself to the cancer's DNA making it impossible to replicate itself. The M prevents my body from using folic acid which is needed for cancer cells to grow. The F is made up of molecules that looks very much like normal cells but are structured slightly different, once F makes its way inside cancer cells, they die.

j414 · January 2010

Oncotype was developed for patients with early stage, node negative breast cancer. More recently it has been studied for women with (only) one to three positive nodes.

You had a "really small" tumor, which spread to 7 nodes, which indicates your tumor was aggressive. There are possible long term side effects to chemo, but without it you are risking a metastatic/distant (lungs, bones etc.) recurrence. The first link will direct you to several recurrence calculators, which will allow you to calculate the likelihood of a metastasis with and with out chemo.

The second link is for another thread ("Stage II w/Lymph Node involvement"), which is another area that you may want to pose your question for more feedback.

Best,
J

http://community.breastcancer.org/forum/108/topic/743397?page=9#idx_267

http://community.breastcancer.org/forum/108/topic/743397

jenn3 · January 2010

Jenny - I know doing chemo seems overwhelming, but with node involvment it would be in your best interest to do chemo. If you really have your doubts maybe a second opinion and/or more research online.

Laurie09 · January 2010

Agree with what everyone else said. I would proceed with chemo in your case.

Whether it's safe to avoid chemo depends on the size and type of tumor and whether there's any evidence of extension beyond the tumor. When there is lymph node involvement, the concern is that there may be more nodes that have tumor still present and there can be tumor cells that have gone to other organs and the risk of distant metastasis is higher. Therefore, the risk of skipping chemotherapy becomes much higher than the risks of chemotherapy.

I was afraid of chemo at first, too. I had 4 dose dense AC and 4 taxol treatments and it wasn't a walk in the park, but I made it through OK as do most people.

Good luck to you whatever you decide.

NatsFan · January 2010

Jenny - as so many others have said, chemo is no walk in the park, but it is doable.

I also agree that a second opinion might help you make your decision. Seven positive nodes means that the cancer was in the process of escaping from its place of origin. Radiation will only kill cells in the local area that's radiated - if any cancer cells have escaped past the nodes and that radiation area, then rads will not touch them and they'll have free rein to keep circulating in your system and perhaps come to rest somewhere else. Chemo attacks those cells that may be circulating already in your system. Yes, you have to give up a quality of life for a few months while undergoing chemo. But I think most of us would sacrifice a few months of quality of life now if it has a good chance to buy several years of life later.

Good luck as you make your decision.

cookiegal · January 2010

I do not want to give you false hope, because that sounds like an agressive cancer...but on the oncotype node pos page of the report they do have the stats for more than 4 nodes. (I think it's 4-10)

the pattern of chemo benefit holds.....according to the one study, which was a small study, low oncotype does not benefit from chemo even with 4+ nodes.

That being said, I think most oncologists are going to be iffy about using that in your case. It's based on a small number of cases.

I had one node and they were iffy with my declining chemo. But if somehow you truly were very low oncotype and high hr, maybe there is a case.

Good luck, sorry you have to face that.

Is is safe to skip chemo?

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