Chemo regimen advise for 88 year old

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katcar0001
katcar0001 Member Posts: 621
edited January 2016 in Stage III Breast Cancer

I am writing for my good friend's mother who just had a double mastectomy Dec. 29. Her pathology showed 7 out of 10 lymph nodes affected. I believe the subtype was ER+--not sure about PR or HER2 yet. The question is--what kind of chemo makes sense for a woman of her age? Is just hormone therapy sufficient? Is there a chemo/hormone therapy combo that would fight the cancer but not leave her debilitated?

Thank you, wise ladies!

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  • ChiSandy
    ChiSandy Member Posts: 12,133
    edited January 2016

    Chemo is usually not given for a woman that age, as the side effects would likely be more dangerous and possibly kill her faster than any leftover tumor cells--even with that much spread to the nodes. At 88, with double mastectomy, perhaps radiation to the nodes--but more likely quality of life for the years she has remaining would be the primary consideration. Even hormone therapy might be rougher on her than what she could otherwise handle.

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  • sbelizabeth
    sbelizabeth Member Posts: 2,889
    edited January 2016

    Wow--88 years old! Bless her! She must be reasonably fit and active, or a surgeon would not have risked the surgery at all.

    My mom is 92 and has had two mastectomies, but her last one was done maybe ten years ago. She had CMF chemo ("chemo-lite") with the first one in 1995 and no chemo with the last one. She tolerated her CMF chemo very well. BUT...everyone is an individual, with their own response to these chemicals. Even at her fit, active 92-year-old state, I would not want my mom to undergo chemo of any kind now.

    Like ChiSandy, I would even hesitate at an AI. I'm 60, and my Femara makes me move like I'm 90. Balancing the risk/benefit of an AI would be hard to do, and should take into account your friend's mom's wishes and state of general health.

    Perhaps radiation treatments, designed by an RO with her age and state of health in mind, would be less taxing on her. Or it could be that just the mastectomy itself will allow her a disease-free survival that will be the same as her normal expected life span.

    You might ask your friend to request her mom's case be brought before the hospital's "Tumor Board," where complex cases are discussed in a multi-disciplinary forum.

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  • rainnyc
    rainnyc Member Posts: 1,289
    edited January 2016

    I'd agree with these comments; I'm even a little surprised that they did the surgery.

    If she's HER2+, Herceptin has fewer side effects than actual chemo. But yes, the hospital's tumor board might be a good idea, as might be a 2nd opinion if there's a way to get that without having her travel if that's too hard on her.

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  • katcar0001
    katcar0001 Member Posts: 621
    edited January 2016

    Thank you for your replies, ChiSandy and Sbelizabeth. I think your recommendations are very sound, and I suppose Tamoxifen would be out too, due to the potential for blood clots. I have passed on your responses to my friend. I think a tumor board is the way to go. This is quite the dilemma, but if I were her, I'd go for QOL. Hell, I'd just about give my left arm to have lived as long as she has cancer free. 88 seems a great age to me. As they say, to grow to old age is a privilege denied to many. Have a nice night!

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  • katcar0001
    katcar0001 Member Posts: 621
    edited January 2016

    Thank you, rainnyc -- we must have been typing at the same time, so I missed your comment. I think she is in surprisingly good shape and came through surgery just fine! Pretty amazing, if you ask me. She is near Seattle, so I am sure there are many places she can go for more opinions.

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