Refusing Radiation?
Comments
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To all of you so on the fence, I just want to say that I was against radiation also, without knowing anything about it.
I did it. Initially I could not decide, had two opinions.
The day I saw the second RO (the one I went with), I saw an interview on TV. I looked up some information about the person (she was not being interviewed due to breast cancer, but for an invention of hers). I read about her and she described, in a previous article, how she had bilateral mastectomies and her breast cancer came back in her chest wall.
The RO had discussed with me that morning the importance of the chest wall and that the radiation would "get" that area.
My decision process ended. It was a relief to decide to get going and get done with it. I am not so sure it is something you can always "just do" in the future.
I do not have implants so I cannot comment on that aspect of it.
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I think that is smart. I have a recurrence after 10 years. I saved rads for now. Nothing left to lose. -
So sorry to hear of your reoccurance Lunalin.
I went ahead and refused radiation after discussing it with my oncologist, he listened to all my concerns, we made a pros/cons board, and at the end of the day it just wasn't something I could make myself do... he put me on tamoxifen and cautioned me that if the cancer were to come back I would need a mastectomy instead of the lumpectomy I had this time...
In the end, I think it comes down to how much you are willing to trust your own instinct and how much you are willing to leave to chance...
I'm happy with my decision, now I just hope it was the right one, needless to say it's what I think is right at this time.
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ChaosRains, Did you have any lymph node involvement. I am in the process of deciding whether to do the radiation and have been told I am in the gray area with only one node positive out of 17 for cancer. I had a mastectomy and thought i would be clear for no radiation, but they are telling me its my choice..they aren't telling me I must have it. Tough decision. I am going for a follow up tomorrow to have questions answered. Are there any questions that you asked that may help me with my list of questions?
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ThinkingPositive,
Sorry, I just got your message. I hope you got your questions answered at your appointment today.
I had no lymph node involvement, and my cancer is a very aggressive invasive high nuclear grade, high mitotic rate, high ki67 scores...
6 1/2 weeks of daily radiation would have only changed my "survival rate" by 1.5-2%. To me, that was not worth any side effects or problems that may have arisen from doing radiation. It would have also been radiating my left side and they would have had to hit part of my lung to miss my heart.Questions that I asked:
How much does my baseline survival rate change with the treatment being suggested (make sure you ask for baseline survival rate there are other rates such as change of reoccurrence from oncotype dx etc) ?
What potential side effects can I expect from this treatment?
Can we list the pros and cons of this treatment together ? (had radiation oncologist and medical oncologist both do this)
Worst case scenario if I do not do this treatment? (mine was that I'd have to have a mastectomy, possibly go through chemo again...)
Hope that you are doing well... keep thinking positive
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I totally relate all these posts. I am almost done with radiation. I am having 25 total. I had one lymph node before chemo that was positive that we knew of. I had a complete pathological response to chemo in the breast tumors and in that lymph node.
Still, I was told that due to the nature of my cancer I should have radiation too. My oncologist says that in 35 years, he is never had a local recurrence in a breast cancer patient. He said though that of course there had been other mets.
I am not sure at this point whether or not I'm happy to have done rads. I feel like I was lied to in that I am having an awful horrible burn reaction that was described to me initially as being like a light sunburn. Well, I've had plenty of blistering sun burns and let me tell you if any more of my body was burned like this I'd be in intensive care. It's purple and on the verge of skin breakdown in the armpit area. Very painful.
That being said my idea initially was to throw everything out it and listen to my doctors. I am really at a huge risk of lymphedema now, even more than before. I feel like they have absolutely no consideration for what happens to you after all these treatments. They only care about what they're doing to you at that given moment. There needs to be more emphasis in every practice on quality-of-life After treatment. I get blank looks when I mention these kinds of things.
I think it is very smart for everyone to get second and third opinions even before they start radiation. I wished I done that myself but it's too late for me now. And the best part is, even with this, I can still develop stage 4 later down the road. I don't feel like there's any real guarantee The radiation will completely stop my cancer. It would be easier to take if there was!
Good luck to everyone trying to make the decision. We can only do what we think is right at the moment, for us.
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Bippy625 - so sorry about your skin breakdown. I had it as well. I wanted to give you some hope. Mine started turning fire engine red and purple about Rad #20 (I had 35 rads). But it got really bad toward the end. A week after I ended radiation, my whole breast area (well, I had an MX no reconstruction) peeled. I kept using Silvadene, a script, which really helped the pain.
Within 2 weeks after the peeling, my breast area looked great. I'm 2.5 years out and have had no skin issues since.
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Denise, thanks so much for sharing your experience. It helps to hear from those who are currently going through radiation, those recently finished and those of you well on the other side of it.
Do you have any issues with your chest wall, post-radiation or noticeable changes to the texture of your skin?
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Hopeful8201 - My skin is soft, no issues, just slightly darker like a permanent suntan. For the first year after Rads my ribs were a little sore. That has gotten better. I can still feel it a tiny bit if I really push on them. But no big deal.
One issue - Lung. I've always been prone to getting bronchitis or chest colds. The first cold after Rads was one lot of coughing. One of my doctors (I forget who now), told me that my lungs were less pliable after radiation, so it took more coughing to clear them. That has improved...
Now 2.5 years out from Rads, I have no issues on a day to day basis. To me, it was worth every zap.
My biggest advice is -- make sure you have a GREAT radiation team that is really good at mapping before Radiation. My radiation team was EXCELLENT, and I definitely believe it made a difference. Do your research!
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Thanks so much, Denise. I will admit that it really pains me to think of my skin being permanently discolored, especially on one side, not the other. Sort of a harlequin effect. Most women aren't too bothered by that but I am really upset about all these permanent changes to my body.
I had not thought about issues of lung pliability and will have to talk with them about that. I, too, am prone to bronchitis - I don't get colds/flu readily but if I do it almost always turns into a prolonged attack of bronchitis that nothing will calm, including codeine. This could be a big issue, so I really appreciate the heads up on it. I am glad to hear that yours has calmed down over time.
I will admit that I am really struggling with the issue of radiation - I'm not certain the absolute risk reduction is really worth years of side effects. My proposed team is very rigid in their thinking, too, which doesn't help. I would like to explore other approaches to RT but am limited by our insurance coverage.
Thanks for letting me whine.
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Denise - silvadene finally cleared my youngest son's diaper rash. Good stuff. My poor baby had contracted a diaper rash in the hospital before we went home I battled it for 9 months silvadene finally got rid of it.
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Meow13 - oh so glad Silvadene worked for your son! It really is like a miracle, but I know it has sulpha in it
and if you are allergic to it, not good. But I had no problems and so glad your son didn't either! I kept every last
drop of it in case I ever needed it for something else.
Hopeful8201 - if I had to pick one thing that changed my body the least, it would be radiation. Had a heart attack
from AC Chemo, Herceptin gave me permanent heart valve damage, MX cut my breast off -- so the Rad thing was
no big deal to me. Perhaps that sounds like I am being trite, but I am really not. For me, it was the only decision.
And I definitely understand others who do not want to do it. But if you go looking, you only find that "bad" info
about Radiation. Most women I've talked to that did it, never complain about it after the fact like they do chemo,
for example. But you have to do what is right for you, and only you know that in spite of what doctors might say.
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Hi,
All your posts take a little piece of my heart. I SO wish I had refused Radiation.
My husband didn't want me to do it. I did it because it was part of the planned treatment and the RO was very insistent. Very.
My skin broke down. That side is discolored. The fatigue held on for about three years. I've developed Lymphedema and Thyroid dysfunction and a Necrotic cyst in scar tissue. And have endured three biopsies. It's been over 7 years. I'm thankful to have the parts of me that I do, but rads beat the crap out of me
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Connie07, I see in your post that you now have truncal lymphedema. I have yet to be diagnosed, but I think that I may have it, not sure. I go to PT for lymphdrainage massage and exercises to hopefully prevent. Saw a physician who said she didn't think I had it, but sent me for PT just in case to hopefully catch it before it develops. How do you know you have truncal lymphedema?
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ThinkingPos,
It's interesting how I know that's what I have now. No doctor has diagnosed it, yet. My BS mentioned it like, you may have a little LE, but never measured or sent me for eval. Reading these boards and asking real patients led me to ask my PCP to send me to PT where I was measured, treated and was taught how to do massage. ... It never quit hurting. That Breast remained uncomfortable after treatment. And the swelling was obvious. My arm felt heavy and I had what I thought was an itchy spot on my back. My LE therapist said it was unusual with no nodes removed but indeed I have it. Thank goodness for her. I live in the hot, humid coastal south where wearing a compression garment feels like torture. Swimming is the best relief of all. I know I have it, I know the BS saw it and ignored it. And my rads team just denied it. So I had to fight for treatment and write letters to ins for coverage. So glad I followed my instincts and advice found in here
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Connie07
I actually saw a Lymphedema Physician and she said she doesn't think I have it. But there is a little bit of swelling in the back area near the underarm. The underarm area is also a bit swollen, but they all attribute it to mastectomy even though it was 4 months since. They all say it could be from the surgery still. But after each fill I get ( I have tissue expander) my arm becomes tighter and feels a slight numbing sensation. I do have cording which is why the physician sent me in the first place to PT, but I have been going since end of January and still don't feel like the cording has gotten any better, or less.. and the swelling in the back area is still there, no less. So you start to wonder do the PT's know what they are doing? I see two different ones, both certified in LE. One told me to get a camisole that has a little bit of compression to it, right now I wear a sports bra that hooks up the front.. Can't find a camisole that I can get over my head as they are all so tight. I even went into much larger size but can't get into it. Even my plastic surgeon said good luck with that! Thats one of the reasons that I am having such a difficult time making a decision about getting radiation. I am in a gray area for radiation, had only one node positive. So I continue to struggle.
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When you refuse radiation, the doctors do not like it...
"Standard of care" is basically what is usually done in a situation, survival rate changes by 1.5-2%, reoccurances usually don't happen in the same location and more people die from side effects of treatment rather than breast cancer itself...
I stand by my decision not to have radiation
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Hi Chaosrain- we were on the July chemo thread together. I know you've made up your mind about radiation and just wanted to mention of few things I heard along the way. My RO said radiation reduces reoccurence by 50 % - that's a lot in my book. Also my breast surgeon told me she had a patient who didn't do radiation and the cancer came back in 2 years. I am doing radiation right now and I haven't had any problems. Yes I know maybe I will somewhere down the line, but hopefully not. I wish you the best. Come back to the July chemo thread - a lot of us still chat over there.
Hugs
Nancy
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I had rads I was told I had a 45% of it coming back. Had some fatigue and some redness. It's all cleared up. You can't even tell I had anything done. It might depend on how much they are giving you. I was afraid before I got started but it's done and I'm fine. Hope this helps some
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Nancy,
I'll have to hop on over to the July chemo thread!
I have a 50% chance of it coming back even WITH radiation, but that is not why I decided not to do rads.
Any one of you can ask your RO "how much does having radiation change my baseline survival rate?"
survival rate to me was the number I was interested in... how much longer can I hope to live if I have this treatment? The answer my RO gave me, and everyone's cancer is different, is that 6 1/2 weeks of radiation would change my survival rate by 1.5 or 2 % which to me personally, is not worth the side effects, etc from rads.
I would never suggest just not doing radiation, you must get information specific to your cancer, speak with your doctors and make a decision that you can live with in that regards. I have friends that have been through or are going through radiation, I think they made the decision that was best for them. My choosing not to have rads was the decision that is best for me
Shan
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I had radiation and regret it............I have not had a day of feeling comfortable since and am left with constant discomfort escalating to pain some days...........pre radiation I had healed well and felt normal.........my skin recovered fine its the tissues underneath ................
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hi Shan - I think the most important part is that you've made a decision that YOU feel comfortable with. That's really what matters. I also see you would be radiating the left side and that would worry me too. I am glad you are doing well. I was worried about you there for awhile.
Lily I am sorry you have discomfort. That stinks and I truly hope it gets better for you.
Hugs ladies
Nancy
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Hello everyone. I only joined this board today and what I'm reading in this thread has made me feel like the earth is moving under my feet (and not in a good way).
I've never been sick, never been hospitalized or had surgery (except when I broke my ankle after falling off my platform shoes seven years ago). Then about seven weeks ago had a wonky mammogram, biopsy, and just over two weeks ago, a lumpectomy. I feel like I've been swept up in a tornado.
I'm 67 years old (a widow and childless), IDC in left breast, about 3 cm, grade II, estrogen+. The surgeon told me she gave me "good margins," and all five lymph nodes that she took were totally negative.
I've already seen the radiation oncologist twice and I know he is strongly recommending radiation. But do I need it? Will it increase the likelihood of no recurrence in my left breast enough to be worth the side effects--and I know I will have side effects. I'm not a stoic when it comes to medical matters--I'm sensitive to everything, a regular canary in the mine shaft.
I feel like I've been sucked into a vortex called the Cancer Treatment Machine. And as you all know, it's NOT straightforward! In the end, you have to do your own research and make your own decisions. I second what was said earlier--that the doctors will tell you some things--from their own points of view. But much of the awful stuff you will have to find out on your own, or mercifully, from others who have been there (like on this board--bless you all!).
Has anyone with my profile opted out of radiation all together?
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Welcome to BCO JaneQPoppy, it is a time of very complex and long term decisions - not easy. However, talking with others from these forms should give you a full spectrum from those who have "been there and done" your options. As much as you may form opinions based upon the valuable feedback here, please also consider that your doctors and surgeon have actual hands-on assessments with all the scan data, so please consider their advice along with supplemental advice and experiences gained from here.
Yes, it is hard, when you are of the type where you are more sensitive to treatments than others seem to be, to consider the many treatments often required, but consider at least trying any your Doctors suggest. We wish you the best, with little side effects to any treatments you need to have.
The Mods
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I had RADS only because I had a positive node. Without that I think I would have passed, but I also had a very low grand and small tumor. My RADS experience was not good: my skin oozed and peeled, leading to cellulitis (a bacterial infection of the skin) which lead to an abscess of the seroma in my breast. Emergency surgery on a Saturday with a regular surgeon not a BS was needed to drain and clean that thing out. The wound, an incision beside and just behind my lumpectomy scar was left open to drain. Now I have a hole in my breast that will require plastic surgery to close. Things really can go very bad with radiation. My breast is a pretty big mess.
That "sunburn" stuff is such a crock. But even with all this, due to that stupid positive node, I'd probably do the RADS again. However, I would have found an RO that was more caring, less cavalier about the treatment even if it meant driving farther. I was never comfortable with my RO, but choosing another center would have meant driving either 1/12 or 2 hour each way everyday or getting an apartment in Nashville or Knoxville and staying in the city. Because I was only going to have a bit of a "sunburn" I'd hoped to work thru RADS. As turned out , with all the complications, I wasn' t able to work anyway and I could have and wish I would have interviewed another RO and done the traveling. I interviewed 3 surgeons but just chose the only really convenient RO not considering that the choice of an RO, if you are having RADS, might be as important as the surgeon you choose.
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Jane, I am >90% ER/PR+ so I decided to give surgery plus tamoxifen a chance to prevent a recurrence by foregoing rads and chemo at this time.
I had recovered not long ago from a bad ladder accident (painful 6 mo recovery) and simply couldn't handle being a "patient" again so soon. The thought of 30 rad treatments was too much to handle and almost sent me spiraling into a deep depression. Refusing rads and chemo at this time gave me peace of mind. If my cancer comes back, I know I won't regret my decision as it was the only decision I could handle at this time. If circumstances were different, I might have chose differently. In addition, I have totally improved my diet, basically have given up alcohol and am exercising more than usual.
You have a choose a treatment plan you are comfortable with for your currentcircumstances and that you will not regret later. Wishing you all the best!
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in addition, my MO told me chemo only helps 2 in 10 patients, and my RO told me I had a 50% chance of my cancer recurring in the same spot. I took that to mean I had a 50% chance of it NOT coming back.
As has been stated on these boards many times, recurrence or no recurrenceis based on luck.
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I've always wondered what percentage of radiation patients have favorable versus unfavorable experiences. In no way do I discount the unfavorable experiences. They must be hell. OTOH, I've had radiation twice--once whole breast after a lumpectomy and had nothing bad happen. So, when I had mets to my hips and spine, and they could get all three places in one field, I decided to zap those too. Boy, the discomfort I was feeling was gone within a few months and I'm sure glad I did it.
The second time, I had some skin deterioration right at the tailbone, but with 'baby butt cream' and patience, it healed up fine. I am just about the whitest person on earth and didn't burn (I did use a radiation cream, but don't remember the name of it).
If everyone had the experiences that I've had with radiation, there would be people lined up around the block for it. I hope that's the normal, but I really don't know the statistics.
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Jane, I was a few months shy of 67 when diagnosed, 1.5cm IDC in left breast, grade II, er 100% positive, negative nodes and good margins. My RO actually kind of talked me out of radiation, citing studies done on ladies over 70 who had good results without it. With my high % ER pos, I fully expected hormonal treatment to be my big gun, but unfortunately couldn't take either type. It's only been 2 years, but I'm still OK. I opted for QOL now and will deal with the repercussions later if there are any. My MO said my chance of being cured by surgery alone was around 70%, so I'm happy with that. Took me over a week of reading research papers to make my decision though. Good luck with whatever you decide. ( BTW, my MO wasn't pleased with my decision, but respected my right to make it )
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Thank you all so much for these prompt (!) and informative replies, everyone.
Micronancy and Fluffycats (love your screen name, as I have three myself), I couldn't tell from your signature blocks if y'all's lymph nodes were clear. Not up on all the codes/abbreviations yet, i.e., "0/1" and "5/19"-- what does that mean? My surgeon took 5 nodes and they were all clear.
I would like to opt out of radiation all together. From the hasty research I've been doing in the last couple of days, am I correct that if I don't have radiation now, and I do have a recurrence, then I could have radiation later...but if I have it now and have a recurrence, I don't have that option and a mastectomy would be my only option?
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