Treatment Yes or NO?

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  • lebrecht
    lebrecht Member Posts: 68
    edited May 2010

    I have a stage 11A  Breast cancer. 10 lymph nodes removed  2 cancerous.

    Now the treatment is radirtion and Tamoxifin.

    I have many problems such as diabetes (on insulin) and asthma. Also overweight with problems walking and am suffering dizziness and also have Vertigo (room spinning) when I lie down then when I get up again. During the day I cannot walk without holding on to the walls as I am dizzy. I also have cataracts all of these symptoms are ones that say I should not take Tamoxofin...

    In addition I mcannot drive so need someone to take me if I decide on radiation. My Pet Scan showed all was normal. I had a lumpectomy and then some problems when something burst inside two days after surgery. Had the drain in for 6 weeks. It is now over two months and I am not feeling so well.

    My question to everyone is, What if I now decide to do nothing more? No radiation or tamoxifen?

    Sometimes the possible side effects are worse than the chance to recuring breast cancer.

    The treatment only is to try to prevent another breast cancer...I am 75 years old.

    I cannot get another opinion as I am with SCAN and am limited in Doctors. All are in the same medical office.  I know the accepted treatment is radiation and tamoxifin...BUT has anyone here said NO?

    What other choices are there?

    Thanks for your input,

    Anne

  • ruthbru
    ruthbru Member Posts: 57,235
    edited May 2010

    Why not Arimidex? For post menopausal women it has a better chance of  non-reoccurence and less side effects. I think with the positive nodes, you really have to do the radiation. Do you have friends/ church people/family who will help you out with the driving? (if not talk, to social worker connected with your clinic for advice on how to do this). I had to drive 100 miles each way for my radiation, so I got a calendar and when anyone asked me if there was anything they could do for me, I whipped it out and said, "Yes, you can drive me to radiation, what dates can you sign up for? " I never had to drive at all. Best of Luck! Ruth

  • lebrecht
    lebrecht Member Posts: 68
    edited May 2010

    Thank you for the response. I am starting to accept the radiology concept. As for the pill I am now also wondering about Tamoxifin vs Arimidex? I wonder if this is NOT covered by my HMO. Is the cost too high? I will pay $ 12.50 for a 90 day supply of Tamoxifin. Also how new is Arimidex? Tamoxifin has been on the market for over 15 years so maybe that was a factor?

    Thank you so much for your response.

    Anne

  • ruthbru
    ruthbru Member Posts: 57,235
    edited May 2010

    Arimidex is newer and more expensive, but the patent is suppose to expire in June, so the cost should go down considerably. It's worth exploring, I think.

  • wallycat
    wallycat Member Posts: 3,227
    edited May 2010

    There was a new study out about women over 70 and radiation.

    Here is a quick summary:

     Radiation Not Needed in Many Older Breast Cancer Patients
    HealthDay
    By HealthDay - Fri May 21, 8:48 PM PDT

    "The standard of care for women 70 and older with very small tumors that are estrogen-positive and node-negative -- the largest group of breast cancer patients in this age group -- had been lumpectomy and radiation," study lead author Dr. Kevin Hughes, co-director of the Avon Comprehensive Breast Evaluation Center at Massachusetts General Hospital in Boston, said in a news release.

    "Earlier reports of this study with shorter median follow-up have shown the risk of recurrence without radiation to be only marginally worse than with radiation, but there was concern that longer follow-up would show a blossoming of recurrences," he said. "This study confirms that for older women with early stage breast cancer, lumpectomy without radiation is a viable alternative, and tamoxifen may replace the need for radiation."

    It has been standard for younger women with early stage breast cancer to receive radiation therapy after a lumpectomy.

    The researchers reached their conclusions after randomly assigning 636 women with early stage breast cancer -- all 70 or older -- to receive tamoxifen (319 patients), or tamoxifen plus radiation (317 patients).

    After a median follow-up of more than 10 years, the researchers found that the risk of recurrence was lower among those who received both treatments (2 percent) compared with those who received the drug alone (8 percent). But the two groups didn't differ significantly in terms of overall survival and risk of dying from breast cancer.

    The findings were released May 20 and the study is to be presented at the annual meeting of the American Society of Clinical Oncology, June 4 to 8 in Chicago.

  • ruthbru
    ruthbru Member Posts: 57,235
    edited May 2010

    But lebrecht is node positive.

  • lebrecht
    lebrecht Member Posts: 68
    edited May 2010

    Thanks for the feedback. Yes unfortunately I am node positive   2 out of 10....

    I am definitely going to ask about Arimidex. The only bad difference is that this one can cause osteoporosis but not blood clot and or stroke as Tamoxifen can. Not great choices but one I have to make. My over all health is so bad and I am so dizzy and hurt all over that it is those things that I fear now having to take radiation and new pills. It is almost three months since my surgery so I need to start and fast. It is difficult to start something that will weaken me more and add new problems when I live with so many now.

    Anne

  • dlb823
    dlb823 Member Posts: 9,430
    edited May 2010

    Hi, Anne ~ I'm not sure what kind of insurance Scan is, but with all of your complicating health issues, I would certainly want an opinion on what to do going forward from a comprehensive breast center such as the ones on this list:

    http://cancercenters.cancer.gov/cancer_centers/map-cancer-centers.html

    We are fortunate to live in California, where there are quite a few of these top-rated facilities.  I personally went to UCLA, although I live out in the desert, and am so happy I did.  The care there is exceptional.  Facilities like UCLA (and UCS and UC San Diego, etc.) see the most breast cancer patients, so will have the most experience dealing with women in your age group and with your pre-existing medical problems.  And perhaps they could also refer you to someone who could figure out the cause or your vertigo, which sounds miserable.  And are you not a candidate for cataract surgery, which is in most cases quite a simple procedure these days, although perhaps your diabetes is the complicating factor?  It just sounds like you might really benefit from being seen by a new medical team, and it might be worth asking how you can get a second opinion on your case.  I'm not entirely sure, but I believe there are laws to protect our right to do that, even with the most limited HMOs.      

    Good luck to you, and please see what it would take to get an opinion from both a medical oncologist and radiation oncologist outside of your current medical group, and preferably at one of the facilities on that list.  Take care ~    Deanna

  • lebrecht
    lebrecht Member Posts: 68
    edited May 2010

    Thanks Deanna:

    I am with Scan and they are also with a Cancer Group from the Saddleback Memorial Hospital. I may be getting the best help, but not accepting all of this so that it may be just ME. I will start  radiation or at least the first appointment to set it up on Friday. My Doctor also said that if I would rather take Arimidex instead of Tamoxifen that is okay. She wrote a prescription got Tamoxifen because that one is covered and will cost me $12.50 for 90 days. The Arimdex will cost me $150.00 for 90 days. She really was not saying which was a better choice only that both were good. SOoooooo, I think I will go for Arimidex only because it seemed to have a few less bad side affects, BUT it will mean giving up some pleasures to afford it. I have to pay $150.00 a month for the two insulin's I take for my diabetes and we have to afford this all on our social security. BUT it would be best to take what causes the least problems, regardless of the cost.

    I hate the decisions as I usually wind up making the wrong one.

    Anne

  • ruthbru
    ruthbru Member Posts: 57,235
    edited May 2010

    Your clinic should have a social worker to talk to and help you how to pay for your medications. Also the maker of Arimidex has some programs to help people pay for it that you should check out (you can find them online by googling arimidex, or else talk to the social worker and let him/her guide you through the process. My Best! Ruth

  • kayakgirl
    kayakgirl Member Posts: 172
    edited May 2010

    Hi

    The Tamoxifen and Arimidex both will  helps minimize the risk of metastatic breast cancer. The Arimidex may cause a worsening of your joint problems and that maybe the reason the Doctor suggested Tamoxifen. Cataracts can be fixed with surgery and most of us will get them when we age whether or not we are on Tamoxifen. I didn't have cataracts before my chemo, large doses of steroids, and starting Tamoxifen (all three can cause cataracts) and I do have them now and at some point I will need cataract surgery (and I am only 56 )but I faithfully take my Tamoxifen every day. Because these 2 classes of drugs does save lives of women with estrogen positive breast cancer.

  • Erica3681
    Erica3681 Member Posts: 1,916
    edited May 2010

    Although you do have some health problems, you are only 75 -- not so old. You hopefully have many good years ahead of you. Both the treatments you're considering, radiation and Tamoxifen, can be tried and then stopped if you have bad side effects. I think it would be worth at least starting radiation treatments and seeing how it goes. It's true there are some risks, but most women do very well, with fatigue and local discomfort as the major complaints. I tend to be sensitive to many things, but I went through 33 radiation treatments with almost no side effects. I really didn't feel fatigue and my skin was only moderately burned -- like a bad sunburn. If you started radiation and felt awful, you could simple stop at that point. By the way, my mother had radiation for breast cancer at age 74. She breezed through it with no problems (not even skin effects).

    The same thing is true of Tamoxifen. Again, despite the fact that I'm usually sensitive to medications, I had almost no side effects from Tamoxifen. Like you, I was post-menopausal (though only 54). I did have some hot flashes, but I was having them already. I had no joint pains, which I did get on Femara (which is like Arimidex), which I took briefly several years later. I didn't develop cataracts while on Tamoxifen. As Agnes17 said, cataracts are easily removed (with out-patient surgery).

    With your diagnosis of Stage 2 breast cancer and the fact that you had two positive lymph nodes, I would be as aggressive as your health allows in fighting the cancer. Your health problems will become much worse than they are now if the cancer metastasizes. In your place, I'd do everything possible to prevent that.

  • lebrecht
    lebrecht Member Posts: 68
    edited May 2010

    Thank you so much Erica.

    You are right....

    I will start radiation tomorrow..At least the first scan to set it up and then start the Arimidex.

    I guess I needed the shove in the right direction.

    Thanks,

    Anne

  • lebrecht
    lebrecht Member Posts: 68
    edited May 2010

    Thanks Agnes for your comments.

    I  will try to be more positive.

    Anne

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