Safe to Postpone Chemo?

I wouldn't delay chemo, but that's me. You should be able to do some work during chemo.



What is an SGS protocol?

Did you have the oncotype test done  on the tumor?

I'm on chemo right now (taxol) and still working. I've had the odd side effect which seems to go away as quickly as it comes. Otherwise I feel absolutely fine and I intend to work through this. I suppose though it does depend on the type of chemo and your individual response. Good luck with whatever you decide to do.

Nice to meet you, I understand where you are coming from but I've had two chemo's and my cancer has shrunk by 50% already. This must be very hard for you, do you have children or is it only you.

First, let me just say MY OPINION ONLY, I would flat out never put off chemo on a 2+ cm triple negative tumor, period. It doesn't sound "large," but as far as TN goes, it is a big tumor.



But this isn't me, and you need to consider some things. You say nodes were negative - even for micro-mets? Was there any lymphovascular invasion at all? What was your Ki-66 rate? (speed of cell division - is that right ladies?)? These are all important prognosticators for future potential recurrence.



You say you believe the odds are mostly in your favor for waiting, but even with ER+ that is not accurate. Studies have shown that it is best to have chemo started by 13 weeks post-op, and then survival starts to decrease. Bear in mind this is for tumors that are responsive to chemo and had a high Oncotype, which would hold true with TN.



Please consider your choice carefully and do your research. The effects of chemo can managed with the help of a good and responsive doctor.



I wish you luck with your decision.

My brain function was fine. Most chemo does not go into the brain. I am sure I will draw a lot of flack for this, but I personally don't believe in chemo brain for that reason. I think a lot of people may feel out of it or have trouble remembering things, but I think that is more the consequence of just having a hell of a lot on your mind with this diagnosis than it is a sideeffect of a drug.

eta - the chemo brain may come from the other drugs that go with it - steriods, anti anxiety meds, etc. Personally, I had no problems.

I am not even sure they would agree to provide chemo after such a delay. I know about the 12 week rule. I remember when I asked my onc if I could delay chemo till after Christmas (still within 12 weeks) he had to think about it.



I am guessing that a delay could give cancer a chance to spread which would change the entire game.



Personally, I would delay a couple of weeks to put arrangements in place to manage the chemo. There is no way I would have delayed beyond 12 weeks. In my opinion, this is your life and health that are at risk. Work is nothing in comparison if you don't have life and good health.



If work is truly important to you, you will find a way to manage it around your chemo schedule. Check with some of the ladies doing the same protocol that is recommended for you. They will have advice on ways to manage side effects and work.

I had essentially triple negative cancer, too - 5-10% ER receptors.  A KI-67 score over 30% is considered high.  Mine was 50%.  We really only have the first shot at this stuff - there are no good tools for triple negative other than rads, surgery, and chemo.  I'm sorry you are in this position, but nothing is worth taking a chance with your life and honestly I think you would be if you put chemo off til November. Median survival for us following distant recurrence is two years, give or take, with few exceptions - not like ER+ cancers or HER2+ herceptin responsive cancers.

I worked through TAC but did take at least 5 days off following each infusion.  Some people on this board did much better than that.  I have my own business and managed to even add a client during all this treatment. I did lose some income, but I would say I was at least 60-70% my usual productivity.  I just finished a 4.5 month clinical trial with more chemo to hopefully prevent recurrence, and it was with a single agent. I worked a lot more this time, sometimes only taking the weekend following infusion off. Good luck with your decision and take care.

Snoozy, here's a link to the study that showed no difference in outcome for those starting chemo 1, 2 or 3 mos. post surgery:  http://jco.ascopubs.org/content/21/20/3792.full.pdf

Surprisingly to me, it looks like the study did encompass women with all sorts of hormone+ & hormone- bc -- although TNBC isn't specifically noted as a group.

In spite of this research, I'm with the others here who feel it would be way too risky to delay starting chemo for TNBC.  Those of us who have been on BCO for awhile have seen TNBC friends experience fast recurrences, so we know how aggressive this particular form of bc can be.  And, besides, November (as you're proposing) is way past the 3 mos. time limit studied.

I guess the one thing I would add is -- no matter what you decide to do -- please be sure that your onc is very experienced with TNBC.  You really need an onc who is up on the latest research to the point of having a specialized interest in it -- not just a general onc who probably doesn't even see that much of it.

Also, keep in mind that many women work through chemo, so you may not be as incapacitated or unable to proceed with your project as you might be imagining.  Some types of projects might even be a positive diversion from dwelling on chemo SEs.

I'm sorry you have this tough decision to make.  I hope that talking it over here and perhaps even with a 2nd and 3rd opinion onc will help you to solidify your thinking about what to do.   (((Hugs)))  Deanna   

I had the same treatment that the are recommending for you.  I was 62 (very healthy other than the BC), a widow, raising my then 14 year old grand-daughter - and a Sr. legal asst. to a very busy Partner in a large law firm.  I had my chemo on a Thursday - neulasta shots on Friday before work, side effects hit over weekend.  I will admit there were many Mondays that I did not feel like going in, but I did.  I remained active throughout it all and suffered just about every side effect known to man from the chemos.  If it was known, then I got it.  From febrile neutropenia to blood clot in leg, terrible bone pain that nothing would eliminate, etc.  I am not trying to scare you, but only trying to show you that you CAN continue your life with some small alterations made along the way, if necessary.

With what you have, while it is only my opinion, but a warranted one nonetheless, I would not put off chemo.  You only have one shot at killing this beast, I would do nothing whatsoever to mess that up.  I wish you all the best,

Linda

Just another voice agreeing about the sizing of your tumour. The ultrasound sizing is not very accurate. According to ultrasound images my tumour had a maximum diameter of 10mm. After removal it was measured at 6mm x 7mm x 20mm. For the small difference you had in sizing I think if you could be bothered to do the stats you'll find the difference insignificant...



I wouldn't be putting my trust in brocolli alone is what I guess I'm trying to say.



Jenn

ImSnoozy, radiation only addresses the local issue (the site were you have had surgery).  Chemotherapy addresses rogue cells that may be circulating through your body and thus recurrence.  That is why radiation is given after chemo.

If work is your all and your passion, I can see your delimna.  But don't let cancer take you away from all of that and your life.

ImSnoozy...sorry that you have to make this decision..but...with tn..hitting it quickly seems to be the best route to go...have the dose dense treatments...you will be done in 4 months...it really does suck but will you be able to handle going 7 months without treatment?

Sorry but cancer doesn't give a crap about anything...get rid of it now.