How do they decide who gets chemo?

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lahela
lahela Member Posts: 515
edited June 2014 in Chemotherapy - Before, During, and After

My oncologist says I don't need chemo, but I don't understand why and his "explanation" was basically a dismissive wave of the hand. My mother, sister and aunt all had chemo after BC and MX, I had cancer cells found in my sentinal node, my sister has mets and I had another aunt who died of lung cancer. I would have thought this made me a candidate, but my onc isn't even ordering a chest x-ray or bone scan and says that Tamoxifen will do. I want to do everything I can to reduce my chances of recurrence, so should I be looking for a second opinion? Or am I just being overly paranoid?

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  • mdg
    mdg Member Posts: 3,571
    edited September 2013

    What is your diagnosis?  YOu may want to check the NCCN websites for the chemo guidelines.  That outlines pretty well who gets chemo.

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  • coraleliz
    coraleliz Member Posts: 1,523
    edited September 2013

    You might get a second opinion. You mentioned "cells found" in your sentinal node. That might not be considered positve. To have a positive sentinal node, it needs to be 2mm or greater. You also might want to ask for the Oncotype test. http://www.oncotypedx.com/en-US/Breast/PatientsCaregiversInvasive  there are several threads addressing this test.

    I had 2 positve nodes(3mm), but I was grade 1. I eventually had the Oncotype test. The chemo decision was left for me to decide. I declined it.

    Seriously consider a second opinion. It sounds like you need & want more information. A dismissive wave of the hand would piss me off.

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  • Cowgirl13
    Cowgirl13 Member Posts: 1,936
    edited September 2013

    I'd definitely get a second opinion, especially if this onc can't explain things in a way that you can understand.  It's too important not to understand completely.

    Good luck.

    Liz

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  • Moderators
    Moderators Member Posts: 25,912
    edited September 2013

    lahela, if you decide to pursue a second opinion, here's more information on how to do that, from the main Breastcancer.org site.  Also, the section about Who Gets Chemotherapy? may help explain some of the factors that go into the decision about these treatments.

    • The Mods

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  • lahela
    lahela Member Posts: 515
    edited September 2013

    mdg - sorry, I forgot my diagnosis wouldn't show up in my signature. It should be here now. BTW, I'm premenopausal.
    coraleliz - my BS called it positive, but the path report says micromets, so I'm not sure. I don't think they do the Oncotype test here in Switzerland.
    I'm definitely going to get a second opinion - I feel really uniformed about this and it's such an important decision but I feel like I was left out of the process. Not to mention the language divide - the current Onc doesn't speak English and my French is very short on cancer terminology, funnily enough! If the other doctor says the same thing then at least I'll be reassured.
    Thanks, everyone.

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  • Rose_d
    Rose_d Member Posts: 144
    edited September 2013

    Definitely get a second opinion, it's a good thing to do regardless. You don't mention your age but I think it's an important factor.



    I had one positive node (2.5mm) and a 1.7cm tumor and my onc wouldn't even order the oncotype test. Said the combo of my age and the positive node meant I needed chemo. I was 39 at diagnosis.



    I also would think given your family history they would be doing genetic testing and at least discussing the implications if that for you.



    By the way, I have been treated at memorial Sloan Kettering in New York.



    Best of luck,



    Rose

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  • ruthbru
    ruthbru Member Posts: 57,235
    edited September 2013

    If you are stage 2 & have a positive node, chemo should definitely be considered. (I was stage 2, without nodal involvement and did the chemo which was highly recommended by my doctor). Hurry and get a second opinion!!!!!

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  • mdg
    mdg Member Posts: 3,571
    edited September 2013

    I got a second opinion on everything which I am glad I did.  The first one did not mention the LVI in my pathology and had me dx as a grade 1.  When I got the second opinion, they dx as Grade 2 and LVI was present in pathology.  Did you have the oncotype test?  I found that helpful in deciding on chemo.

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