How can you figure out chemotherapy benefit?

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Fallleaves
Fallleaves Member Posts: 806
edited November 2016 in Stage III Breast Cancer

Hi all,

A family member of mine was just diagnosed as Stage III. She had a mastectomy a couple of weeks ago, and is slated to have 4 rounds of chemo three weeks apart, and then 6 weeks of radiation. She doesn't know yet what the characteristics of her cancer are (hormone receptors, HER2+, KI-67 level, grade, etc) She just said the doctor told her she could expect " a 75% cure, a 100% cure at that stage is not likely".

My family member is in her early 80's, and I'm a bit concerned about the impacts of chemo on her, and wondering if it is absolutely necessary. Is there any way of determining the benefit of chemo for HER specifically? I know with hormonal treatment you get an Oncotype dx score and based on that an estimated risk of recurrence, and then the doctors can say taking tamoxifen or aromatase inhibitors will lower it by 50 to 60%. And with radiation you can also get an estimated reduction of risk. How does it work with chemotherapy? Can she get a solid number that estimates the reduction in cancer mortality from chemo, based on her specifics? How important is chemo relative to hormonal therapy (provided her's is positive) and radiation? Just looking for a concrete way for her to weigh the risks and benefits.

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  • TectonicShift
    TectonicShift Member Posts: 752
    edited July 2020

    .

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

    “75% cure” and “100% cure” are misnomers. Either you’re cured or you’re not. And with breast cancer, you’re never really “cured:” what varies is the likelihood of local or distant recurrence, how far in the future that’s likely to happen, and your “overall survival” chance (how long you’re likely to live before you die from any & all causes, not just breast cancer)—all just statistics. Instead of “cure” or even “remission,” for breast cancer we use the term “NED,” for “no evidence of disease.” We can all point to examples of patients with Stage IV disease who are still alive & kicking a decade or more after diagnosis.

    In her 80s, your relative is unlikely to be recommended chemo or radiation, as even if it would extend her life, it would most likely make her remaining years more difficult. If her tumor is ER+, she may or may not be prescribed an aromatase inhibitor—but both those & tamoxifen carry risks of precipitation heart attack or stroke, both “events” that are likelier the older we get anyway.

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  • Fallleaves
    Fallleaves Member Posts: 806
    edited October 2016

    ChiSandy, I thought that 75% cure and 100% cure stuff was weird, too. Maybe something got lost in translation? We live in different states, so I'm getting everything second hand. I'm pretty sure she's already scheduled for chemo and radiation, though. I found it a bit odd that she was told that before she knew the specifics of her cancer, but maybe the doctor knows and just hasn't told HER yet. She's in pretty good health otherwise, but I worry about the impacts of treatment on her quality of life.

    TectonicShift, thanks for the information on the CARIS report! I will definitely check and see if she is getting that.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited October 2016

    Much to my delight, my onc thinks I am "cured" as I had just passed 7 years out from dx. I Like that assessment and try to remember everyone is not the same even if we may have same stats. My oncotype was 11. The doc said that was good but then I ended up Stage 3 after mastectomy. :(


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  • juneping
    juneping Member Posts: 1,594
    edited November 2016

    at the age of 80? i wouldn't do anything and focus on enjoying my life. eat what i want, drink what i want, travel....enjoy the last bit of life and not dealing with any side effects.

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  • Kicks
    Kicks Member Posts: 4,131
    edited November 2016

    IF I were to have a recurrance of IBC when I am 80 (only 10 yrs away), I will do everything possible to fight (and beat) it again. I will fight in anyway I can for every day I am blessed to have here on this planet called Earth.

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