Her2+ - is radiation after chemo necesary in older patients?

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irishmom4
irishmom4 Member Posts: 3
edited June 2014 in HER2+ (Positive) Breast Cancer

My mother was recently diagnosed.  She has already begun chemo with taxol/herceptin.  She met with her doctor recently and although radiation was initially prescribed to begin after the chemo, when my mom asked about it again, the doctor said it was "up to her".  She's in her 70s.  I've seen a lot of studies stating that radiation may not be necssary for women over age 70, even when one duct is involved, but I have not seen a study where the patients were also HER2+?  It seems like it is controversial at best as to whether radiation is necessary, but I would think that in HER2+ cases it would definitely be necessary?  Her tumor was 1.9cm.

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  • TammyLou
    TammyLou Member Posts: 740
    edited October 2010

    I think that I would like to consult with the radiation doctor BEFORE making a final decision.

    How much rads and where?

    Has she had breast conservation/ lumpectomy?

    What's the rest of her health like?

    In young women, radiation has a distinct survival benefit.

    tl

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  • irishmom4
    irishmom4 Member Posts: 3
    edited August 2013

    She had a lumpectomy.  The original recommendation was 25 doses of radiation directly to her left breast.  Is there a greater risk with the left breast?  Her Rad Onc originally said she could get radiation in a horizontal position so the rad would not be pointed towards her chest.  Haven't read about issues there.

    Her overall health is good and chemo is going well.  I was surprised because originally the onc prescribed radiation, then at her last chemo he said it was "her choice".  I know there are studies regarding radiation as unnecessary in older women - but I'm not aware of a study where the woman is HER2+.  I've told her to speak to her radiation doctor - but was surprised by the onc.  

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  • TammyLou
    TammyLou Member Posts: 740
    edited October 2010

    (I'm a big jerk...sorry).

     I would tell you that I have a long term / long standing relationship with my oncologist and I have, at times, discussed issues of philosophical nature.

    His bottom line, "Tammy, I usually do whatever the patient wants."

    This thought process may be very alien in the ordinary doctor business; however, cancer treatment is not an exact science and in some cases, there are gray areas.

    As a general rule, the BENEFIT of the treatment must outweigh the RISK.

    I would try to get the radiation oncologist to be very specific about the exact benefits and where.  My rad man was quite clear and went over the simulation data with me.  One of my lungs was in the field and it was impossible to deliver the rad dos without hitting a little.

    The technologies to stay off of your mother's heart are in place.

     The real problem is that in the cancer biz, there are no guarantees.  Thus, the physician may be inclined to let the patient decide.

    tl

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