Chemo - since I have a choice, why would I?

Also, question for PLJ -- when your onc said that the Adjuvant Online stats were inflated, did he mean they are too optimistic? Or too pessimistic?

Beeb75,

He meant they were too optimistic. I wouldn't worry about it too much though. Every MO has a different opinion.

Cheers,

PLJ

Actually, I think your onc might have meant the opposite...that Adjuvant Online is too pessimistic. I looked at some of the technical reports from Cancermath. One of them looks at Adjuvant and says "Indeed, we found that Adjuvant!Online tends to over-predict patient risk ."

Adjuvant's numbers are much more pessimistic than Cancermath, but cancermath seems to have been developed by smart people (Harvard types) so hopefully, they know what they are talking about. 

My husband is 36 years old and was diagnosed in february after having symptoms for about a year. He has a full right mastectomy on april 13, it was stage 1, grade 3 with an Oncotype of 12. His onc left it up to him as well! Due to the fact of his age and length of time he had symptoms without being treated he opted FOR the chemo. He is on his 3rd of 4 Taxotere/Cytoxen cocktails. He is going by the mentality of doing everything he possibly can to prevent reoccurrence. He will also be taking tomaxifen for 5 years after chemo. He has not had any neuropathy side effects. These drugs effect everyone differently.

BobbiMarie, my oncotype dx score came up on the high end of moderate risk.  I found my head spinning with statistics.  I did a ton of research online.  My estrogen and progesterone receptors were high.  I opted out of chemo after much thought and prayer.  The improvement in survival stats didn't seem worth the risks of chemo.  My MO told me that there were no wrong decisions in my case, and she would support me in whatever I decided to do.  I decided to go with radiation and hormone blocking therapy.  If my decision turns out to be in error in the future, I will not blame myself or anyone else.  I did my best to make the decision that was right for me.  Most physicians are worried about not doing the most they could do to prevent further problems.  Many cancer patients also want to err on the side of being too cautious.  Each person must make the decision that feels right to her.  if I remember correctly, your stats showed Progesterone negative receptors.  I would research that, and the effectiveness of drugs like Tamoxifen in that case.  That might help you decide which way to go.  Good luck.  It is not easy.  One would think there would be more firm answers, but alas until the TAILORx results come out, it is a bit of a crapshoot.

I too had an onco score of 20 and did 6 rounds of chemo. Cytoxan/Taxotere every 3 weeks.  I decided to do chemo because I know I would never forgive myself if I didn't and the cancer metastasized.  Also I knew that if bc metastasizes it does so in the bones, brain, liver and lungs.  That decided it for me - I didn't want to chance that.

I know you are worried about neuropathy, but I read somewhere that if you wrap your hands and feet with ice packs that cuts down on the neuropathy since the chemo does not penetrate cells that are cold.  That is the theory behind the cold caps women wear to avoid hair loss. See if you can arrange to have your feet and hands wrapped in ice packs, or if there is a freezer in the chemo area, maybe you can freeze a few pair of gloves and socks and bring them with you and change them as each one thaws out.

Judy

There are no statistics that I know of that also factor in diet and lifestyle changes and how much that improves one's odds in regard to developing a new tumor at some point.  Anyone know of a resource that would factor in diet, weight loss and improved exercise, as well as stress reduction?

Just a comment on neuropathy. I had 6 rounds of taxotere/carboplatin every three weeks. I did get some neuropathy in my left foot. After my 2nd round I though I also had some pins & needles in my fingers. My onc said if it got worse she would reduce my does. I started taking *Acetyl-L-Carnitine after that. (Check with your onc before taking this). Never got it in my  fingers again. My heel seemed to resolved after each treatment too until I got to the 5th round then it stayed. I'm 6 months past chemo and my heel still is a little numb especially on humid days. It really doesn't  bother me. I was told in time it will resolve. To be honest if I only did 4 treatments chemo would have been much much easier.

*Check out the 3rd to last paragraph: linky  

BTW I thought cancer math was pretty close to the numbers my onc gave me although cancer math claims their stats are not reliable for tumors above 5cm or more than 10 positive nodes.

I will definitely look for that book.  Thanks.  Since my diagnosis, I have done a ton of research and reading. I haven't found the book by Dr. Shervan, however.  

PLJ I seem to recall diet and exercise brings about a 20% decrease. There is an excellent thread called natural girls that talks about nutrition. I've found these ladies very helpfull to me.

There has been one (maybe two) studies done on diet and exercise - here is a link to a summary of the WINS study:

http://www.cancer.gov/newscenter/pressreleases/2006/winsbreaststudy

ER/PR+ women showed a 20% overall reduction in recurrence when they lowered their fat intake and upped exercise.  So if you have let's say a 20% chance of recurrence, diet and exercise can theoretically lower that to 16%.  The benefit is more obvious for triple negative breast cancers, with recurrence rates dropping by as much as 40+%.  More studies need to be done obviously.

For the OP - do you have any other information about your cancer?  What is the proliferation rate (Ki-67)?  How big is the tumor actually?  I know it says 1cm in your stats, but is it closer to 2 cm?  Size also plays a role in possible recurrence.  How much of it was DCIS?  Did they identify lymphovascular invasion (different from positive lymph nodes).  It is Grade 3, and those cancers are at greater risk for metastisizing.  They also tend to respond better to chemo.  A bit of a quandry.  I would agree that age and overall health should also be taken into consideration.

Would your doctors be willing to offer Taxol rather than Taxotere? It has a decreased incidence of neuropathy, although the chance is still there.  Taxol can be given weekly as well to deal with this.

In the end, this is a decision you have to be comfortable with, as well as your family.  Do they have any opinions?  I hate it when doctors don't give you their clear opinions, it is frustrating.

Good luck with your decision!

BobbiMarie, The icing is something you need to tell them about. Some places know about it others don't.