Can someone help me understand this..

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Krysm7
Krysm7 Member Posts: 52

hello ladies.

Got to meet my MO today and hear treatment plan. BRAJDC chemo was suggested. He also said that my survival rate was 84% if all Cancer is infact removed, 88% with hormone therapy alone and then 90% with chemo and hormone therapy. Chemo seems like a big risk for only 2%. What am I missing?? I asked about oncotype number and he said that here in BC Canada, it would be turned down if cancer was in a lymph node.

So confused on what choice to make!!

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  • Ingerp
    Ingerp Member Posts: 2,624
    edited July 2018

    I’m not familiar with BRAJDC but I get that many of us are tweaking probabilities that are already very good. I did a lot of research, got info from some of the super smart women on this site, and asked my MO several questions she coukdn’t answer until she did her own research before I signed on to chemo. For many it’s a peace of mind thing. Like how hard would I be kicking myself if it returned and.I hadn’t done everything I could to prevent a local or distant recurrence. If nothing else, if I had had anything in my lymph nodes I probably would have insisted on chemo

  • gailmary
    gailmary Member Posts: 332
    edited July 2018

    it was explained to me with the benefit so low that the risks of chemo are greater but if you think it will help. . . I passed on the chemo 8 yrs ago cause taking chemo does not guarantee it will not come back . Plus there are improvements all the time in treatments.

  • moth
    moth Member Posts: 4,800
    edited July 2018

    Krysm - hello fellow BC'er! (come join us on the Canadians in BC thread as well!)

    BRAJDC is docetaxel (taxotere) and cyclophosphamide. People on this board usually abbreviate it as TC

    So, one thing you can do is run your own numbers in Predict http://www.predict.nhs.uk/predict_v2.1/tool

    & Lifemath http://www.lifemath.net/cancer/breastcancer/therap...

    You can check whether you get similar numbers to what your MO said.

    I tend to look at shrinking the recurrence size of the bar charts as much as possible & I reduce them to simple fractions because I think percentage increments just don't resonate as well. So your MO is saying that if you throw everything at it, probability statistics say 1 out of 10 women with your statistics will develop fatal metastatic recurrence. If they skip chemo, it's 12/100 which reduces to 3 out of 25. It isn't a huge increase, I get it, but... how comfortable are you with the odds? I actually pulled out a pile of sticky notes for my stats, made rows of possible people affected with little stick figure happy faces & spent time looking at it.

    The lymph node involvement would probably worry me. You also don't say how old you are. The younger, the more opportunity for it to recur.

    BTW, you CAN pay for OncotypeDX or Mamaprint yourself. They will prepare the samples for you and send them out. They won't pay for the Oncotype with lymph node involvement because they say they're waiting for the study validating those results to be published. If you want that extra decision making tool & you have the funds or family who will pay for it, it might be well worth it.

    All the cancer agency management guidelines are here btw if you want to read how they make the decisions.
    http://www.bccancer.bc.ca/health-professionals/cli...

    Staging & management is where they talk about Oncotype eligibility.

    The chemo protocols are all listed here: http://www.bccancer.bc.ca/health-professionals/cli...

    Which center are you at? I'm at Fraser Valley but on the Cdns in BC thread we have several peeps from Vancouver and other places in BC.

    best wishes ~



  • Krysm7
    Krysm7 Member Posts: 52
    edited July 2018

    Thank you so much for all the information!! All those links were so helpful!! Just what I needed.

    I live on Vancouver island. I am 47. I will look for that thread


  • WC3
    WC3 Member Posts: 1,540
    edited July 2018

    moth: Thanks for the links. I do like to fiddle with stuff like that. I have to say though, I don't have much faith I will end up on the majority side of statistics anymore because in my life, I've won a bike, a car, a trip to Hawaii, have a 1 in 100,000 genetic condition, had a cat who developed a rare skin cancer from cat AIDS, and when I got my pathology report back, right above the "highly mitotic, poorly differentiated IDC" bit, it listed my lifetime breast cancer risk as something like 0.4%.

    I've bought a lot of lotto tickets recently :-)

  • moth
    moth Member Posts: 4,800
    edited July 2018

    You're welcome, Krysm. The Cdns in BC thread is here: https://community.breastcancer.org/forum/55/topics...

    WC3 - I totally know what you mean. My risk of bc was very low according to the risk calculators as well. Probability is just probability ... shitty weird, unusual things still happen. I was actually taking a stats course when I was diagnosed. A bunch of our final exam questions were calculations on risk assessments for elevators and harbour ferries (based on real accidents which had occurred) which was kind of scary too lol... those risks are not zero....

    Hey, I won a trip to an all inclusive in Mexico about 10 years ago! I'm not buying lottery tickets though :D

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