Just Diagnosed: Chemo first

There is another lady who is asking for such insight that you are right now. "Raisin Angles" is her screen name.

She has a thread going on In the "Chemo, before, during and after" forum that you may find helpful and that you may want to add your questions to.

I was diagnosed HERS2+ in September 2017.  My oncologist had me start my journey with Chemo first.  I have had 5 Chemos to date - one chemo left at end of January.  The plan is to shrink the lump followed by a lumpectomy and then radiation since cells were found in two lymph nodes.  Other test results, body scans, etc., are clear and indicate that the cancer has not spread anywhere else in the body.  I was diagnosed as Stage 2B.  The Chemo has been successful in reducing the size of the lump.  I can no longer feel the lump which started out at 3.5 x 3.0 x 2.5 in size and could be felt by touch.  Doctors are pleased with the way the lump has shrunken and they too can no longer feel the lump.  I am scheduled for a follow up MRI and Mammogram and Ultrasound this week so see where I am at.  I'm glad in a way that I am getting the chemo out of the way first.  It's been somewhat miserable for me.  I go every 3 weeks for an infusion.  The 5th and 6th infusions were delayed because I became neutropenia (which means my white blood cells or neutrophils (a type of white blood cell that fights infections) dropped dangerously low almost non-existent) which resulted in a short stay in the hospital.  Insurance company is to blame as they would not pay for the Neulasta shot as precautionary which increases your white blood cell count (typically given within 24 hours of an infusion).  But they (insurance company) are paying for it now after having to pay the ER and Hospital for my short stay.  Mentally I am still in denial - I still don't believe that all this is happening to me although I am going thru all the motions.  In some ways, I feel better about having the lumpectomy vs mastectomy.  The lumpectomy doesn't seem as radical and seems less traumatic to both my mind and my body.  I've done a lot of reading and asked my doctors lots of questions - from what I have read and have heard from the doctors having the chemo, lumpectomy and the radiation for the HERS2+ has very similar results as having the mastectomy in terms of re-occurrence.  In other words, your chances of re-occurrence or non-re-occurrence and longevity are basically the same.  So why take the radical route?  That's what I tell myself.  Again I am glad to get the Chemo behind me.  I am sick and tired of being sick and tired.  Not having this constant queasy feeling and feeling of weakness - being constipated to having diarrhea - and not being able to eat - along with the body aches from the Neulasta shot.   It will be pleasure to have Chemo completed sooner (first) rather than later.  The surgeon will perform the lumpectomy about 5 weeks after the last chemo so that my body can recover.  End of February or early March is when I will have the surgery.  Radiation will follow 4 to 5 weeks after the surgery.  So far to me it seems that Chemo is the worst of it all although I am not looking forward to the radiation especially after being told that there will be some scarring of left lung from the radiation.  All very scary stuff.  Stay strong.  I'm rooting for you.  Do your homework - ask lots of questions.  You are in my prayers.           

BeyondBlessed,

It's not unusual. Back when I was diagnosed (2010), this order of treatments had not yet been proven to be as good as doing the chemo after surgery, but a study came out just after my treatment that supported it. One advantage is that if the tumor shrinks, you may have more surgical options, like lumpectomy instead of mastectomy, or mastectomy instead of being unresectable. I would definitely have been offered chemo first because my tumor was too big for a lumpectomy.

No matter what, you for sure would meet with an oncologist first anyway. They've got to do an assessment before ordering the chemo, and that will be your opportunity to ask questions. I'd schedule first appointments with a couple docs in case you don't like the first one. That's what I did, but the first one was great so I just cancelled the other. Good luck to you.

From what I have read on this site, if you are HER 2+ they generally do chemo first. Best of luck to you!

M

y daughter had a rather large mass so chemo first was recommended. It shrunk her tumor by 70%. We were told that typically chemo first if the tumor is large. Hers turned out to be 10c.

I had an ultrasound today showing a small tumor. Unbelievable. I am waiting on a biopsy.

Wishing you the best!