To Do or Not To Do chemo??

amctanase · November 2014

Hello everyone,

I am starting a new post in the hope of finding some guidance on the very hard decision of whether to do chemo or not. I know that for many that is not a choice, but in my mother's situation it seems the oncologist has made a recommendation (chemo not strongly recommended) and left it up to her.

My mom's particulars are as follows:

Invasive Lobular Carcinoma, 1.8 cm, Grade 2, no lymph node involvement (well, 2 lymphs were removed, one was completely clear and the second, when they performed some non-standard test on it, showed isolated cells, but on the report the oncologist wrote node negative). Her oncotype dx is 10. No mets.

Treatment so far: Mastectomy of the affected breast (left one). On the other (the right) she had breast duct removal for biopsy because she had a bloody nipple discharge from there, and although the mammo, ultrasound, and mri did not show anything, the doctor removed it - no cancer found, just a dialated duct apparently...though we are still worried about that breast as well!

When we met with our oncologist, she said that chemo is "not strongly recommended" in my mother's case, but estrogen blockers are. Of course we asked if it would not be better - preventive - to do chemo anyway. She then explained to us the array of side effects from chemo, and that it would decrease her risk of recurrence by only approx 3%, and that finally it is up to my mom if she wishes to have it. We asked for a week to think about it, and here we are no closer to making a decision.

So what would you do ladies? Were any of you in a similar situation? what did you choose? are you happy with that choice?

My mom if terrified that if she chooses not to have chemo she will regret that she did not do everything in her power to end her illness, especially if she has a relapse. At the same time, chemo is not something to really do for 'prevention' and we are aware of how hard a treatment it can be...we are absolutely, hopelessly confused as to what to do. Also, it is just the two of us working on this, my father passed away last year from cancer.

Any experiences and opinions would help us shed some light on the questions we have...

Thank you all.

Ana and Camelia

WinningSoFar · November 2014

Your decision sounds like a personality decision. If your mom is too scared to go without chemo, and feels she might regret it, then I'd say go with chemo. I had the same decision 14 years ago and decided not to do chemo and I haven't have a recurrence (I have another primary in the same place, so go figure). There's no way to predict the future, all you know is how you feel today. That's why it's a personality choice. Either choice is right, it's just which one allows you to sleep at night.

rozem · November 2014

hmmm tough one as always, her Oncotype is low at 10, her cancer is grade 2 and ILC which from what I read doesn't respond like IDC to chemo (someone correct me if im wrong) - all points against chemo

her tumor is 1.8cm which is probably the only reason it would be a consideration - 2cm puts you in to stage 2. There are studies showing that as a tumor approaches 2cm there is a higher likelihood of cells escaping - which is why you jump stages at this size.

3% benefit is big to some, tiny to others so I don't know if this is a help to you

is she hormone positive? if yes, what percentage? if she is highly hormone positive she may derive the biggest benefit from hormone therapy not chemo
was LVI present? Lymphovascular invasion (cancer cells found in the lymphatics) is considered a positive node by some MO's and another factor for considering chemo

SoCalLisa · November 2014

I am one who wishes she hadn't done chemo. To me the side effects have seriously effected my quality of life even 13 years later.

BrooksideVT · November 2014

I also had isolated tumor cells in one lymph node (statistically this is still technically negative) and about a 3% predicted benefit from chemo. I decided to trade the down-the-road risk of a possible recurrence for nixing the immediate issues of chemo, along with potential long term side effects from the treatments. I made this decision after many, many hours on the breastcancer.org website, these discussion threads, and published statistical outcomes. The bottom line, however, is that if after reflection, your mom feels she needs to throw the kitchen sink at it, then that's what she needs to do.

She might feel more informed (both pro and con) if she were to read some of the "Starting Chemo" threads here. I think there is already one for those starting in December. She (and you) might learn more from older threads.

Lily55 · November 2014

I had ILC stage 3 grade 2, I refused chemo, if I was your Mum I would definitely say no.........but I would persevere with hormone treatment, but your Mum needs to be comortable with her deision.......

Tomboy · November 2014

hi. if she needed herceptin i would say go for it. but for hormone positive, the anti hormonals are very strong medicine that they even give to stage 4 ladies, and it does a very good job of taking care of cancer they might not be able to remove surgically. ten is a very low score. if she didn't do chemo now, she would be chemo naive later if it ever came back. that is a good thing. If you trust your onc then i would go with what he prefers to do, they really don't want to steer you wrong. a 3 % reduction risk is next to nothing. plus, she is only grade 2, when chemo works best on grade 3 tumors. Yes, read around, and gather info to help you decide. chemo does have lasting consequences, like socalisa and brookside vt said, and if it ever came back she could just do it then. Wishing you and her the best of all possible outcomes.

To Do or Not To Do chemo??

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