Refusing radiation therapy at age 72

My mom had BC when she was 85 and did seven weeks of radiation, 5 days a week. Except for getting tired (some of that was from driving to another town every day for treatment), she did fine with it in spite of having had lung damage and mild emphysema due to an infection years ago. I smoked for 49 years and finished my radiation in December with no problem that I know of. The beams are programmed to go around your lungs and heart in a curve, like string or wire art using geometric shapes to turn straight lines into curves.

I was DX in my late 50s so while there is an age difference I did do radiation. I didn't have a choice - it was prescribed by my MO. I could have refused but frankly I was afraid to do that. Radiation has improved drastically over the years by targeting only the affected areas. Of course it isn't foolproof but it's better.

I did have early stage too. IDC - Stage 1b, Grade 1. I had a lumpectomy and 33 radiation treatments. I was a long time smoker too and I was aware it could cause lung scarring but I felt I had to as part of my treatment plan. I dodged chemo because of a low Oncotype score which was 11.

I am 7 years out last August. Several years ago a chest X-ray showed lots of lung nodules but that turned out to be nothing. The radiologist said the Xray was normal. Lots of people have lung nodules. My sister had one and she never smoked. Ditto my brother. Where I live there has been an outbreak over the years of lung nodules and the carrier is a bird virus.

It's a gamble but it's your call. You should always do what's best for you. Don't second guess yourself now. There aren't any guarantees either. Did your MO recommend radiation?

Time will tell if you made the right choice. At least you are taking meds. I know ladies who refused those. Who knows if that was the right decision either?

Diane

We all have choices, but I generally base my decision on the medical expertise of the professionals rather than my uninformed emotions. Opinions and facts are not the same and I get really tired of hearing they should be treated equally.

Old bat rant of the day.

I met an older lady while I was doing radiation, she was almost 80. She had refused hormonal treatment but her doctor insisted on rads and she went along with that. She was willing to do something for a month, but not commit to a pill every day for years.

We stayed in touch. She had typical SE (fatigue etc) but seems to have come through fine.

I saw those 70+ studies too. I don't think they are standard of care yet, and I guess it varies a lot among doctors.

I think that the radiation has enough short term positive impact on recurrence to make it worth considering even older. I mean, this whole thing is such a pain the ass. Even if you have a best case recurrence scenario (local, small, etc), do you really want to go through this all again in 5 years? Thinking about that was part of what got me fully on board with radiation.

That said, you know your own life, lifestyle, anticipation about life expectancy, etc. Some 70-ish year olds, like my dad, are convinced they've already outlived their expiration date - he has a very low bar for refusing medical interventions. Others may feel fit and healthy and happily anticipating another 20 more enjoyable years, or more.

I think that being retired also can make radiation lower impact/less stress, and worth trying even if the marginal benefit is slightly less.

Alice, I hope you weren't referring to my post, as I form decisions based on research and recommendations, too.

NCCN Guidelines Version 2.2014 Senior Adult Oncology: "In patients 70 years or older, omission of RT can be considered for patients with stage 1 estrogen receptor-positive breast cancer who undergo a lumpectomy with negative margins and who are likely to complete 5 years of endocrine therapy."

My mom was 80 at diagnosis for Stage 1 BC - 1.5 cm - ER+ PR+ Her2 Neg Lumpectomy only. I made sure to take her to my NCI Designated Comprehensive Cancer Center. It was her decision, but the experts said Rads would help her an additional 3%. She made the decision not to do Rads, and the experts were happy about her decision.

She took an AI for 2 years, but had balance issues so had to quit.

She is now 5 years out and doing well.

I do think part of the issue is that it's one thing to plan to do endocrine therapy for 5-10 years. But the compliance rate is lower than it should be because some women have intolerable side effects - and you don't know if you are one of them or not until you try it. Doing radiation can be good in case the endocrine therapy doesn't work out for you for whatever reason.