Radiation Therapy for early stage

I think it is because cancer is cancer and rads kills the cells. If you do decide to do rads, ask your RO about the Canadian protocol. It is 16tx at higher Gys.

I am going for a consult next week....I was told that with three nodes with "micro" mets I may not need radiation. The last patient that was sent with less then four nodes didn't need radiation. I soooo don't want it as i need to have a re-construction of my right side that had a staph infection. They took out my expander and if I need radiation then they have to use my back muscle to reconstruct that side. I am physically in pain from rheumatoid arthritis and need an easier road. As it is now I wake up with such bad back spasms. I feel like I will live on pain meds. At this rate will my life be pain free? ! I am trying to stay opened minded and if I need it...then i need it...we shall see what this next chapter will bring. I have a glimmer of hope and am holding on to it with the belief that there is always a chance. I feel like they removed everything (bilateral mastectomy and nodes removed) and having chemo....what are they radiating? Just curious....there are side effects with that too. Can't wait to ask. One of my opinions is Sloan Kettering one of the leading Cancer Institutes in the US. Based out of NYC they have a satellite 6 minutes from my house here in NJ. Trying to not get ahead of my self....small steps.......

Kaara, I think that's a damn good question, and it applies to so many treatments. Every woman who's prescribed Tamox gets 20mg a day for 5 years as well. No customization.

I don't know why this is, but I suspect it's because research is done using one or two protocols only, so they only have longitudinal evidence from those protocols. Doctors may suspect that something different would work just as well for certain patients, but they have no research to back up their suspicions. So they're taking a professional risk if they recommend something without research, because if it doesn't work...

It's one thing for a doctor to fool around with different treatments for a sore throat, and quite another to fool around with cancer treatments. And IMO that's why doctors stick to the "tried and true" "one-size-fits-all because it's the only thing that was tested" approach. 

Cindy, your explanation is better but somewhat similar to what I figured was behind the one-size-fits-all approach. And it probably presents no particular problem with drugs that are taken for a short time or when other alternatives are available. But with Tamoxifen, there are lots of known SEs and for many women there's no alternative. So sure would be nice to know if 10 mg (or 12 mg or whatever) would work just as well since so many SE sufferers find the SEs are minimal at 10 mg.

Kaara - I don't know if you have already had surgery yet (lumpectomy); but I had the SAVI radiation treatment and had no problems. Mine was also on my left side. My RO recommended this; but ultimately it was my decision. It is more stable once placed in the breast than the mammosite and can be customized by the individual cathethers for each woman. If it's close to the skin I believe they can choose to not deliver to that cathether. No rash, no burns, no heart or lung damage and all done in 1 week. Can't beat that! Take care and God bless!

Kaara, as I understand it, the length of time is only one of many measurements.  It's always very similar (in the 32 to 36 dose range) because it's a cumulative amount they need to achieve, but a lot of other varying measurements are based on the size & location of the tumor, size of our bodies, etc.   Most sizeable facilities have a radiation physicist and a dosimetrist to plan each patient's individual RT.  It's definitely not a one size fits all tx.  

Hormonals are a whole different story, and one reason I declined an A/I after 1/2 dose of Femara clearly didn't agree with me.    Deanna     

Amen, Kaara! I could not agree more with you in terms of the "one size fits all" treatment women with breast cancer are offered. I am 40 years old, and therefore there is a good chance that I may get another cancer at some point. That said, treating me with Chemo, followed by Rads (left breast) and 5 years of Tax feels a bit much, particularly since the very real long term side effecs of all these treatments are known to include secondary cancers and very serious heart disease. - Having said this, I also agree with some of the other posts here, that doctors prescribe what they do just to be on the safe side. And in my opinion, also to not open themselves up to potential lawsuits.



Personally, I am open to explore less conventional treatments perhaps (after having had a lumpectomy and undergoing chemo right now), if that can be geared more to my personal situation
and medical history. I have not made a choice yet, but continue to read and learn for now. I also have an appointment with a naturopathic oncologist next week, to see what other treatment options may be. There are many paths and options for treatment, I believe. Unfortunately all the choices are Not presented to us on a display to pick and choose. It takes a lot of time, reading, time, reading... To learn what is out there, and to ultimately choose what we feel is best for us - as individuals.

I start my 6 weeks of rads next week and I have early stage BC.  I agree with several others regarding the length of treatment no matter what your stage is.  Treatment is targeted at the whole breast to kill possible cells that have jumped to other sites in the breast. 

Would like to inject my thoughts on mammosite radiation.  I was offered this treatment and did a very thorough research on it.  Yes, less treatment appointments but what I learned is that women who have had this treatment reported apporx 2 years later that they have cyst growth at the site of seed implant.  They also report pain at the site.  They then have to have the cyst drained/biopsied.  This can occur several times.  They are constantly in pain and stressed from having to go through biopsy after biopsy.  I encourge everyone to do their own research.  I opted for the 6 weeks.

Cycle-path... The impression I had after reading the study was based on why the study was conducted in the first place. Not unlike the treatment for other chronic illnesses, the researchers knew that many patients were not compliant in taking their medication. So the researchers set out to understand why the patients weren't taking the medication and low and behold they realized the side effects were the reason. The researchers suggested future research to determine what would perhaps help reduce side effects so women would be more compliant. Likewise, educating them about the importance of taking the medication should be explored. I applaud the researchers for conducting the study because they recognized a problem and sought an understanding. Again, I think side effects from medications for a variety of diseases prevent many people from being compliant.

Cycle-path... Those recommendations... Like little pill boxes as reminders are pretty standard for the treatment of many chronic illnesses. My friend who has a Ph.D in pharmacology and is a pharmacist gets busy at work and has been non compliant in taking her medication in treating her diabetes. Her endocrinologist had a hissy fit with her. She told her that if she, a well educated professional was non compliant, what hope was there for those less educated to remember to take their meds? I think doctors are as frustrated at getting people to be compliant as we patients are equally as frustrated at dealing with side effects. Please try to understand their perspective as they try to sort out ours.

I'm surprised at the comments about BC treatments being one-size-fits-all. I can only speak  factually about my own treatment, but have talked to many in a support group and of course by the interactions with the many women on different threads on this site. I guess I can understand your frustration and concern if some of you get a cookie-cutter treatment!

Chemo is clearly different for each patient. Some go weekly, some go every other week and some go every three weeks. Some get 4 doses, some six, eight, or 12 or 16! The medicines vary. I was weighed every time and the dosage adjusted accordingly. I was also questioned extensively about previous SE's, especially nausea and neuropathy and again-the dosage was adjusted accordingly. Because I had stage 2 neuropathy my taxol was reduced 25% for my 2nd dose and again on the 3rd dose. They were prepared to eliminate the taxol if my symptoms didn't subside. That scared me as much as the neuropathy did! Surgery can be before or after chemo. Many patients participate in clinical trials, including me. That by definition deviates from the norm.

Radiation is not always 33 sessions. I was originally scheduled for 40+, but then got a second opinion and ended up with 33. However, if my skin didn't hold up, I could have been done sooner. I was weighed and had a CT scan and x-rays every week to very precisely measure where the beam would go. Some have 28 rads then boosts immediately following; others have a week or two in between. I know some who had 28 rads, but not the boosts. Still others had more or less than 33.

Because I was stage one, 3 nodes all negative, I was prepared for rads only. It was the triple negative status that added the chemo for me. Rads is a very important piece of treatment, IMHO. I think Beesie gave a very thorough explanation. I would probably give up chemo before rads if forced to make a choice.

To those that have a center and/or hospital nearby, you are so fortunate! To have a naturopathic oncologist, how cool is that! My clinic only has two oncologists and they are 30 miles away. I got a second opinion at a center 95 miles away. For radiation, there was only one RO and he was a jerk! So I drove 95 miles one-way, every day, for 33 treatments. Although it was a hardship, I did have a choice. It's just that sometimes the choices we have aren't all that great.

I think something like a weekly pill box is a perfectly fine thing, and in fact I've used one for years. But if a researcher thinks it's going to make a difference in getting someone to take a pill that makes her ill, well, then.... Well, I'm not going to say what I think should happen to that researcher but believe me it's not a pleasant fate.

Here's the reason women are non-compliant with Tamoxifen.

We're told that if we take it for 1825 days it "might" keep us from getting something that we "might" get. We don't know we'll get BC again if we don't take it. We don't know we'll be protected from BC if we do. It only reduces risk -- and in many cases the risk is already pretty small -- by half. And we have to take it for a long time to get that dubious benefit.

Oh, and BTW, most women get at least some SEs, however minor, from it!

But that report seems to think that telling us to use a little pill box is going to make a difference! Once again, I won't say what I really think of a person who gives such advice and will settle for the term MORONIC!

If there were no SEs, women would be willing to put up with the uncertainty of whether Tamoxifen made a difference. Or if there was certainty -- if one could be guaranteed that BC wouldn't come back if one took it -- more women would put up with SEs.

THAT'S the problem. It's a pure risk/reward scenario. Too much risk, too little assurance of reward. Instead of giving this problem to medical folks to analyze, it ought to be looked at by MBA candidates, who learn about this when they study asset rates of return!