Chemo or No Chemo?

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LVFighter_Survivor
LVFighter_Survivor Member Posts: 7
edited December 2016 in Chemotherapy - Before, During, and After

First time forum user... I apologize in advance for any errors I make or if I don't follow protocol. I'm 44 years old and have zero exposure to social media (by choice), so suffice it to say, I'm a novice.

15 years ago I was diagnosed with papillary thyroid cancer, fought it and won. I've been assured by all the doctors that my thyroid cancer has nothing to do with breast cancer.

2 months ago I was diagnosed with invasive ductal carcinoma.

No family history of ANY cancer (so why am I getting it twice? Lol.) BRCA1 / BRCA2 and genetic testing results were negative.

On Nov. 2, 2016 I had a double mastectomy. Cancerous tumor on the left side was 8.5 centimeters. Right side tumors were benign.

2 of 15 lymph nodes positive for cancer.

Oncotype DX result was "12".

I met with my oncologist two days ago. (My oncologist admits to being "old school" even though he's 41). The oncologist is recommending chemo but says ultimately it's my choice. His recommendation is 4-cycles of TC chemo.

Oncologist wants to start treatment the first week of December and I'm having a difficult time getting a second opinion within the given time frame.

Any advice out there?

-confused in Las Vegas

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  • Nfullblume
    Nfullblume Member Posts: 171
    edited November 2016

    Hi there! When I was diagnosed in September, I thought I could skirt around chemo. I read for weeks on what to expect prior to visiting with my MO. I had my surgery right away, because my tumor was very small. Basically, once the cancer moves to the lymph nodes, they normally recommend chemo. Once the lymph system has been penetrated, there is a very good chance that there are cancer cells around the body. A question you could ask your doctor is what % recurrence are you removing by doing the 4 cycles. Because my cancer is already gone, my chemo represents about a 4-6% reduction in recurrence rate. An insurance policy, really. I know the future looks bleak, But chemo isn't the the end of the world. 4 cycles is very do-able. I am doing 8 cycles. I've done 2 and ive been doing really well.

    In the end, it will always be your decision. If your MO can't convince you that the reward outweighs the risk...

    You can visit the October and November chemo boards and see the real life experiences of those going through it right now

    Good luck!

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited November 2016

    LVFighter - you don't say what grade the cancer is, or if you are hormone positive or HER2 positive, or if there is any other treatment planned. If you go to My Profile and fill in the data it will be easier for us to see the broader picture. Without any details, I agree with Nfullblume. If the cancer has gotten into the lymph nodes, you don't know where it will travel. My MO recommended both chemo & rads once I had lymph involvement. Good luck with your decision.

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  • Moderators
    Moderators Member Posts: 25,912
    edited November 2016

    LVFighter, glad you posted here. It sounds as though you do need a bit of additional information regarding your situation, and how much they expect to chemo to reduce your cancer/ future cancer recurrence. Maybe it is worth trying to get a second opinion, even if you have to postpone the start of chemo by a week.

    We're thinking about you!

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  • LVFighter_Survivor
    LVFighter_Survivor Member Posts: 7
    edited November 2016

    Thank you for the feedback. (You are all so kind).

    MinusTwo: I am Estrogen Receptor Positive (97%) and Progesterone Receptor Positive (95%) and HER2 negative.

    I've read through all my test results and pathology reports, I don't recall seeing anywhere that they "graded" the tumor, but if I run across it, I will certainly update my profile. :-)

    I had prepared myself for the possibility of chemo when I was initially diagnosed. I really don't mind the idea of chemo, but I want to know I'm taking it for a beneficial purpose.

    I received my Oncotype DX results (12-low risk of reoccurence). The likelihood of reoccurrence within 5-years by just using Tamoxifen alone is 10%. The likelihood of reoccurrence within 5-years with Tamoxifen and chemo is 11%. (Yes, higher propensity of reoccurence if I take chemo.... crazy isn't it? But I'm really just giving them equal rate in my mind.)

    If they are relatively" equal probability rates of reoccurence, what benefit do I have in taking this treatment?

    My challenge is this: according to the Oncotype DX test I would not benefit from chemo; but my MO (medical oncologist) is encouraging me regardless of the test results but can't give me hard reasons and facts as to "why". This is why I'm reaching out to the forum. I'm also seeking a second opinion from another medical oncologist, but I wanted to see if anyone else had a similar situation.

    My MO indicated he's "old school" and if it's in the lymph nodes they typically recommend chemo; the Oncotype DX test is too new to have a large enough pool on the study subjects to rely on the results.

    I appreciate any feedback.

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  • KBeee
    KBeee Member Posts: 5,109
    edited November 2016

    I think the 10 year rate is distant recurrence and the 5 year rate is any recurrence which is why there's a discrepancy. I could be wrong though. You may consider a second and even a third opinion so you make the best decision for you. The Oncotype is a tool, but doctors consider a lot of other factors too.

    I think thyroid cancer puts people at increased risk of breast cancer and vice versa.

    Welcome to BCO; sorry you find yourself here. My biggest advice is to get other opinions, make a list of pros and cons of doing chemo or not, and then go with what your gut says.......and then never look back and ask what if. Know you made the best decision you could with the information you had

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  • LVFighter_Survivor
    LVFighter_Survivor Member Posts: 7
    edited December 2016

    After many hours of research and calling in favors (friends of friends that are oncologist & genomic experts) - I decided to do chemo.


    Thank you all for your kindness, advice and support in this tough decision. (You ladies ROCK!

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