Refusing radiation treatments?

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  • vik11
    vik11 Member Posts: 69
    edited August 2012

    So, how things continue to change and change again. I met with new surgeon whom I just love! She was so personable and is very respected in the bc community in her city. She is also very active in bc research, so I feel so confident with her. Having said that, since I was leaning to internal rad, it would be a tight fit since amount to remove in lx would take the major portion of tissue I have (I am a B cup) and the SAVI applictor I had my mind set on may be too large. My surgeon thought it could be done, but with my diagnosis yesterday coming back a grade 3, I'm wondering if this way to go. My surgeon told me with no hesitation (I did ask her what she would do), that she always said if she were dx with bc she'd do bi-lat mx with implants in a heartbeat. We talked at length about my implant fears and she was extremely reassuring. She recommended a highly regarded plastic surgeon friend of hers who she said would be her choice for herself. He is very meticulous and has had women who have seen top New York docs that have seen his work and said they could not improve on it. Some good points and almost 0 chance of recurrence (and isn't that reaaly the goal here?). Still somewhat bothered by destroying my healthy right breast for implant tho. Very hard decision to make. I do have a good month before surgery date to make up my mind. Meeting with RO and plastic surgeon on Tues., 8/14. Also getting a BSGI test at that time. Never heard of it before yesterday.

  • Dakota212
    Dakota212 Member Posts: 1,153
    edited August 2012

    Vik11-

    What type of test is that???

  • Shayne
    Shayne Member Posts: 1,500
    edited August 2012

    not to change your mind.......but the medical personnel  I asked- what they would do in my situation - all 3 of them said mx, even for as small dcis that I had (10mm)  - One admitted that it would be overkill, but thats what she would do.  I think seeing as much as they see every single day, thats what their reaction is.  

    Im glad you have such confidence in your BS.  SO IMPORTANT!!   

  • Infobabe
    Infobabe Member Posts: 1,083
    edited August 2012

    vik11

    That is true, if the cavity is too close to the skin, they cannot do the internal rad.  That is what happened to me. It would fry the skin.  I also have a B cup.  

  • Shayne
    Shayne Member Posts: 1,500
    edited August 2012

    I am a B cup.....they also told me it was too close to the skin.....thats why the Savi worked and not the balloon device.  There is also a  multi catheter device as well.......

  • vik11
    vik11 Member Posts: 69
    edited August 2012

    Dakota212 --

    So,the test is called Breast Specific Gamma Imaging. It is like a PET Scan specific to the breast/chest area. It will reveal any cancer in that specfic area.



    Shayne --



    Isn't it interesting that women who are in the bc profession lean towards mx. I have to tell you that despite my reservations, it does have it's upside. I am getting conflicting #s with regard to recurrence %. One facility says <5% and one says less than 1%. Either way, the odds are pretty darn good. Will know more after meeting with RO on Tues. with regard to Savi applicator. Appt was rescheduled with plastic surgeon to Sept 7. (Darn!!) Had hoped to get all info on same day to begin deliberations. Went on herbal menopausal remedy yesterday since I gave up HRT and seeing some od those nasty old symptoms which I don't need at this point in time. Boy, is it wonderful to communicate with wonderful women on this board who know what I'm talking about!
    <br />

    Infobabe and Shayne --



    Nothing was mentioned by my bs surgeon about being too close to skin. Perhaps RO will get into that more in depth. It gets to be so overwhelming that we only hear so much. My husband is so great and he picks up things in these appts I do not. He has been a wonderful support and has his own opinion on which way he thinks I should go, but says he will support anything I choose. I also have wonderful support from my kids and dear friends. So very important! I have to admit I feel pretty lucky in this ugly situation as my husband's cousin was diagnosed when I was and hers was rampantly invasive. Gone thru chemo, etc. Don't know if I could handle that! Praying for guidance every day.



  • Jo-Beth
    Jo-Beth Member Posts: 12
    edited August 2012

    What about 'stem cell breast reconstruction' ? Just put that into google for more info.  There's no way I would personally destroy a healthy breast.

  • Jo-Beth
    Jo-Beth Member Posts: 12
    edited August 2012

    Beesie and Infobabe, hehe um er you won't believe this or maybe you will but I um forgot to ask about a copy of my pathology report!  I couldn't believe it, I remembered while waiting but it was over 90mins later that I was finally called and I plum forgot.  Anyho it would of just been shoved into the deepest darkest corner of my room never to be looked at.  I have all the info in my notes of what was what and I'm all about moving forward - 'life take 2' a better, happier life.  I'm cancelling my rads next week, IF, IF I am one of the 30% well I'll see about rads then - if it's an option but I'm going to do everything in my power to be one of the lucky 70%.  There's also a  small part of me also wanting to prove all the nay sayers wrong! Only time will tell!!  Will have a mammo early next year and have regular checks etc so I'm not anti-medical at all despite the zero care level given apart from removing lump and advising on chemo and rads.  I had to use my own inititive to find alternatives and a lot of info myself - as I've said previously no medical staff mentioned diet, vitamin D and excercise etc including how to calm from stresses etc. I know plenty of healthy people still get cancer but adopting a healthy approach afterwards COULD be just as effective if not more so than conventional medical stuff.  I don't know and alternatives may just work for some and not all, some may only be cured by medical treatments-regarding preventative, it's all a very fuzzy grey random area.  That's why decisions are a very individual thing that everyone else should respect.  I feel sorry for my sister to have to tell all her very conventional extended family that I'm going against the traditional 'norm' but she'll live, if she herself is unlucky enough to have any type of cancer then she can go full on medical and I won't stop her, it will be her choice.  Finally about cows milk/dairy that I wrote in previous post, yes the big China study is very 'fuzzy grey' regarding if cows milk/dairy can have an effect on contracting bc but I've just chosen to adopt this as part of my overall 'life take 2' approach and I no longer like the taste of cows milk.  I still have dairy though, the thing is not to take things to extremes - that's what my naturopath advises anyway.  So ladies this could be my last post - I'm in the process of creating my own website blog - it won't be about bc though it will be about all things positive, natural, healthy and fun.  All the best to all of you :)

  • Infobabe
    Infobabe Member Posts: 1,083
    edited August 2012

    Jo-Beth

    There is no shame in forgetting to ask for the path report.  Call on Monday and ask for it.  

    Without it, and a clear understanding of your condition, there is no way to make a wise decision about treatment.  

    If it were me, there is no way I would select treatment based on diet and exercise.

  • Jo-Beth
    Jo-Beth Member Posts: 12
    edited August 2012

    Infobabe

    I do now have a clear understanding it's just I don't have a written official copy but yes will be interesting to see how I go on the phone asking for a copy.  I'm sure I'll be asked to collect at my next appointment.

    We will need to agree to disagree as there is no way I would select chemo and rads when there is no immediate danger and have been given the all clear post surgery.

    Now I'm more determined than ever to send you a 'I'm fine all clear' post in five years time!

    :):):)

  • Shayne
    Shayne Member Posts: 1,500
    edited August 2012

    Your medical records belong to YOU.  I never asked for mine - they always handed me copies during my appt and went over everything on there.  THey will mail it to you on request - they have to.

  • bdavis
    bdavis Member Posts: 6,201
    edited August 2012

    Vik... I chose to have a BMX even when all my docs considered it overkill... It's a personal choice, but I am glad I did it... I am not sure if I mentioned this before, but if you don't like the idea of implants, why not consider DIEP or GAP flaps? It uses your own fat, no capsular contraction, no rippling, no pec muscle interference, no pain afterward, no increased risk of LE...

  • Infobabe
    Infobabe Member Posts: 1,083
    edited August 2012

    Jo-Beth

    What Shayne said is absolutely right. 

    You may have a clear understanding but you have never told us why.  I don't know what you expect here if you don't share information.  

    Is your lesion (is it DCIS) hormone positive or negative?  How big is it?  Did they get big margins?  What do the doctors recommend besides radiation?   If you don't agree with them, why not?  Are you basing your decision on medical opinion or your own opinion?

    You say you are basing your decision on not being one of the minority 30%.  You are already one of the minority of 12% of American women who get cancer.   Those are not great odds.

    You say you will send me a post in five years.   I don't know how many of us will be around in five years.

  • Beesie
    Beesie Member Posts: 12,240
    edited August 2012

    I beg to differ..... and unfortunately I seem to be doing that a lot lately.

    I don't disagree on the pathology report. Jo-beth, I do think it's a good idea for you to get a copy of your pathology reports.  If you ever need to see another doctor, having those reports will be very important.

    Where I disagree is on what you need to be telling us here. You don't need to tell us anything.  In your most recent post, you didn't ask for our advice or our thoughts on what you are doing; you told us your decision.  Whether I or anyone else understands your decision or agrees with it or not really doesn't matter one iota.  You say that you have the information you need to feel comfortable with the decision, and that's what counts.  I wish you the best of luck and I hope that you do come back in 5 years, happy and healthy. 

    Please let's everyone remember that the role of this discussion board is not to offer medical advice. None of us are in a position to do that. The best we can do is offer support and information. If someone chooses to share the specific details of her diagnosis, we may be able to explain the different options that are generally available to someone with that diagnosis, and we may be able to discuss the possible implications of each of those options. If the discussion includes recommendations on what this individual should do, I believe that it's going too far. I think it's going too far when we try to influence or direct or steer someone down one path vs. another, when we put pressure on someone to accept a particular treatment, when we challenge them to explain their decision, when we judge someone else's decision, when we tell someone that they making the wrong decision. The way I see it, it doesn't matter if the directing and influencing and judging is blatant or subtle. Saying "I think you should have treatment X" is really no more directive than saying "I had treatment X and it would never have occurred to me to not have it"; the intent of both statements is to influence someone to make the decision to have treatment X.

    Every diagnosis is different from all others and every woman dealing with a diagnosis is different from all other women. No one can know what's right for someone else. That's not to say that we can't help. We sometimes are able to add clarity to the information that someone has received from her doctors. We often are able to provide information that makes upcoming discussions with doctors more informative. If I can do that for someone, that's pretty terrific. Of course, while some of the women who come here want this type of help, there are others who don't.  Some who come here just want emotional support, or perhaps they want to know that they are not alone in going through this experience.  If that's the support that someone wants, that's the support that they should get.  If someone doesn't want to know anything about her treatment options or doesn't want to share information here, that's okay.   After all, we are not here to offer medical advice or to advise someone on which treatments she should have, we are here to offer support. 

    My apologizies to any who are offended by this post. I'm absolutely not directing it to any one individual; this is something that I've been wanting to say for quite a while now. In my 6 1/2 years on this board, I've never seen so many judgemental posts, so much directing and influencing and telling people what they should be doing. I've made comments here or there but mostly I've turned away and shut down the computer and said nothing. But just over the past few days I've seen several of these types of posts, so today I decided to say something and say it clearly.  

    Edited for grammar corrections and typos only.  

  • Infobabe
    Infobabe Member Posts: 1,083
    edited August 2012

     Beesie

    I am not telling Jo-Beth what to do.  I just don't know what she is talking about. 

  • proudtospin
    proudtospin Member Posts: 5,972
    edited August 2012

    one of the things we all need to realize that we get to tell who we want what we want to tell with no obligations for anything else

    Bessie, hope I have not tried to tell folks what to do but only say what I have done

  • Shayne
    Shayne Member Posts: 1,500
    edited August 2012

    We are having a discussion.......which calls for our opinions.......which are based on our own experiences.  Not forcing anyone to do or agree with what we have done, just talking here.  I dont think we need the continuous monitoring.  We are just talking - no one is breaking the rules, name calling or being disrespectful.   

  • Jo-Beth
    Jo-Beth Member Posts: 12
    edited August 2012

    Thank you Beesie, my little earth angel!

    Firstly infobabe on a previous post regarding finding notes, I related info on the post surgery outcome which is all I wish to share. Just for a quick recap, it was 'triple negative' IDC invasive, 2mm clear margins and clear node that was removed. I'm not going to get into size or further details and I don't wish to update my profile so I have this little badge displayed on every post.  Just not me.  I did feel I was being steered quite clearly going down the medical radiation path even after I've made it clear I will not be going down such path.  I think we may all greatly underestimate the human spirit and power of the mind. I've said often going natural for me is not just about diet and excercise they are just the basics - I'm changing who I am as a person, my lifestyle, the way I think, my optimisim and my faith.

    Just by the way I'm Australian writing from Australia.

    Thanks Shayne for advice I will ask for my pathology report to be sent in mail - seems you had a better post medical care experience than me, I'm happy for you. 

    I can only hope to be able to share a post in five years and hope you are all around to see it that's if the world doesn't end 21st December 2012 but that's another story not for here!

    Bye for now :)

     

  • Shayne
    Shayne Member Posts: 1,500
    edited August 2012

    All the best to you Jo-Beth!!  Good luck with everything!  

  • Infobabe
    Infobabe Member Posts: 1,083
    edited August 2012

    Jo-Beth

    I too wish you the very best of luck.

    I was trying to figure out exactly what you have and compare it to my own diagnosis.  I have done what you intend to do but our situations are completely different so I cannot advise you further.  

  • vik11
    vik11 Member Posts: 69
    edited August 2012

    bdavis--



    Thanks for your info. I guess in my little mind I don't like to think of what I'm considering to be reconstructive surgery, although it probably is. All the skin and areola and nipple would still be mine (from what I understand). Just tissue to be removed. I didn't realize how much tissue they do remove. I meet with new plastic surgeon on 9/7 and will get his opinion of what we can consider. Believe me, I am very picky about who will be performing any kind of surgery on me. Right now I believe I only have two options. Bmx or internal rads. Of course, I will look at only "reconstructing" affected breast only, but don't hold too much hope for the end result, cosmetically speaking and asymetrically speaking.



    JoBeth --



    If you are still reviewing posts at this time, I certainly respect the choices you are making and I'm thrilled to see your attitude with it. However, sometimes in life we have to make difficult decisions in order to increase our odds for what we hope will be a cancer-free future. No, I don't relish the thought of messing with a healthy breast, but there are some upsides to it. Obviously, our bodies have demonsrated they can produce cancer cells. Not having to worry about bc again is appealing to me. And, being able to go through the rest of my life with that peace of mind, and hopefully some good-looking chi chi's (as my 5-year-old granddaughter calls them) also appeals to me. Believe me when I tell you I've looked at all forms of recontruction and they all have their issues. Stem cell reconstruction is so new and still many ?? on that being the end all, be all answer. Just my thoughts. I driiled the bc surgeon I believe I will be using, to the point it somewhat embarrasses my husband. I plan to do the same with RO and plastic surgeon. I'm not going into this without all the possible info my little brain can hold!

  • Shayne
    Shayne Member Posts: 1,500
    edited August 2012

    Vic11 - I applaud your spirit and tenacity!!  Remember you are paying these doctors for their expertise.  You GO GIRL!!!

  • Infobabe
    Infobabe Member Posts: 1,083
    edited August 2012

    vik11 

    You are really to be admired.  I am proud of you. 

  • vik11
    vik11 Member Posts: 69
    edited August 2012

    Shayne & infobabe --



    Thanks ladies. It's good to get validation on what you think is the right thing to do.

  • bdavis
    bdavis Member Posts: 6,201
    edited August 2012

    Hi Vik... a little confused by what you mean by reconstructing affected breast only... BMX means bilateral MX (both breasts are totally removed (except for skin, nipple, and aereola if possible))... so with no breast tissue on either side, you would be reconstructing both.... or did you mean unilateral (one breast)?

  • vik11
    vik11 Member Posts: 69
    edited August 2012

    Bdavis --

    You are correct. I did mean I will talk to ps about doing a unilateral. I am still new to this aspect of bc and still learning from you all.

  • Bobbin
    Bobbin Member Posts: 40
    edited November 2012

    BUMP

    This was a very interesting and VERY informative thread and I thought I'd bump it for those of us still struggling with the decision...rads vs no rads. I hope that's ok....

    thanks for starting it Maize. 

    My RO is not very happy that I'm sending my slides to Dr Lagios! Perhaps she takes it as an insult and told me that he isn't going to tell me anthing different in terms of the path.  I felt really rushed yesterday at my appt with her, perhaps I was asking too many questions, but she ran out of time and stood up, which I thought was very rude.  She's also not happy that I'm considering NOT having rads.

    My DX is confirmed.  Pure DCIS, 1.2 cm, smallest margin at the chest wall is 1mm, the rest are about 6mm, grade 2.  I don't want to opt out of rads because I'm afraid of a recurrence, BUT, I don't want rads to prevent having something else crop up because I had rads!  so conflicted!  At some point I need to make the decision.....and stick to it!

    Beesie, you made a very good argument re risks vs benefits.  15 % chance of recurrence, but only 1 % chance of say, lung cancer.  I'm just afraid to make the decision for rads, and then if something horrible were to happen, I can't take those rads back. 

  • Anonymous
    Anonymous Member Posts: 1,376
    edited November 2012

    Maize,

    Once I recovered from the inital diagnosis DCIS grade 3 I pondered about the radiation option. My local doc did 3 lumpectomies to see if we could get clear margins, we didn't.

    I then traveled to a breast center in Seattle and opted for a bmx with reconstruction. I am glad I made those decisions. I am 4 weeks out from my surgery and feel great.

    When I met with the breast surgeon following my BMX they discovered two areas of micro invasive cells. She turned to me and said, " This should confirm your decision."

    I was frightened of the effects of radiation, but in some ways was relieved that I didn't have to really make that choice.

    I was also relieved to not have radiation or chemo that the BMX should have taken care of the breast cancer.

    The relief I have now is amazing. Went in for my yearly mammogram and on July 27 the whole world seemed to shift. The waiting, the reading and the deciding was by far the most stressful time I have had in my 61 years.

    Sending lots of good energy your way to give you strength to get through this trying part.

  • Beesie
    Beesie Member Posts: 12,240
    edited November 2012

    Bobbin, every single treatment we have, including surgery, comes with risks.  

    So the issue is simply whether the benefits from the treatment outweigh the risks of the treatment... and more particularly, whether the benefits outweigh the risks enough for YOU to choose to have the treatment, based on your diagnosis and pathology, based on your level of risk from the treatment, and based on how you view risk and what you fear more and what you fear less. 

    And that's the key.  This is a highly individualized decision. Everyone's diagnosis and pathology is different. Because of that, we each are starting off with a different recurrence risk. Although a lot of women have posted in this thread saying "I'm in the same situation" the fact is that no one is in the same situation. A lot of you may be struggling with the same decision, but every situation is unique. The grade of the DCIS might be different. Or the size of the lesion. Or the margins. Or the focality. Or your age.   

    Then you have to consider as well that the risks from rads is different for each of us.  How much rads might affect your health depends on your age, your health history and other conditions you may have, your family health history and other conditions you might be susceptible to.... 

    As I've said before in this thread, I don't have the same fear of rads that I see from a lot of women.  Maybe it's because I've seen people go through rads with no problems.  Maybe it's because I've been hanging around here for almost 7 years and I haven't seen too many women who've suffered seriously because of rads... but I have seen a lot of breast cancer recurrences. Maybe it's because I've lived with the effects of a MX for almost 7 years, and for just as long, I've been reading posts from other women who've had MXs, and as such I don't underestimate the impact that a MX can have on one's life - for the rest of your life. The risks and side effects of rads compared to the risks and side effects of a MX... for me, it's not even close.  I'd take rads any day. 

    But, just because I don't have a fear of rads doesn't mean that I would necessarily have rads.  If I had just a small single focus of low grade DCIS, and wide margins, for me, the benefit of rads, in terms of recurrence risk reduction, simply wouldn't be worth the risk, even if it is just a 1% risk.  On the other hand, if I'd been given the option of having a lumpectomy, with my 7cm of multi-focal high grade DCIS and my 1mm margins, I would have jumped at the chance and I would have gladly had rads.

    So it comes down to how you feel about your risks.  You mentioned your concern "if something horrible were to happen..." as a result of rads.  How does your fear of that "something horrible" compare to your fear of a recurrence of breast cancer? Consider that your risk of recurrence is almost certain to be higher than your risk of something horrible from rads, and consider that 50% of DCIS recurrences are invasive... which means that in a percentage of cases a recurrence leads to the need for more severe treatments, such as chemo.  If you are going to consider the worst case scenerio for rads, you should compare it to the worst case scenerio for a recurrence, and compare the risks of each.  

    Sorry, that probably doesn't make your decision any easier!

    Edited to add:  Beth, a few points of clarity for those who are reading and may be in a different situation than you.  A BMX does not replace chemo.  If someone needs chemo, they need chemo, regardless of whether they had a lumpectomy or  MX or BMX.  Additionally, some women who have a MX still need rads, if they have positive nodes or if the cancer is too close to the chest wall.  There are a number of DCIS women who've had rads after a MX.  Also, having invasive cancer does not mean that a MX or BMX is more advisable than a lumpectomy.  Most women who have invasive cancer have lumpectomies. I had a microinvasion but that was not why I needed to have the MX.  I needed to have the MX because my DCIS was so wide-spread.  A lumpectomy would have been fine if I'd only had the small area of IDC. 

  • Anonymous
    Anonymous Member Posts: 1,376
    edited November 2012

    Thank you, Beesie, for the clarification !

    Beth

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