84 yr old Active Mom Looking for Advice

ktsparkman · March 2020

My mom recently had mastectomy of left breast. Tumor was 3.5 cm. Doc has told her that she's Stage 2B. PET scan was negative and margins around tumor area were clean. Advice is 1) Port> Herceptin combined with other drugs (possibly radiation of breast bone area) 2) Port > Herceptin-only for a year 3) Radiation only of breastbone area 4) Do nothing and monitor.

She is still living independently with a cat and dog, does not have dementia but has some cognitive issues including memory loss, forgetfulness, etc. She is mobile, does some gardening and a little volunteer work in her community. She has friends and family to help. She has no other major medical issues (heart, diabetes, etc.)

She does not want to do chemo. She cancelled placement of port and doc said to they'd regroup in a few weeks. She's quite concerned about the impact that chemo would have on her overall health and well being, and doesn't know if it will buy more quality time (of course, nobody knows the answer). In other words will the treatment potentially accelerate her decline or aging and lead to other health issues or loss of independence quicker or are her concerns about effects overblown?

Anyone out there have similar experiences or insight??

I know there's no single answer to the questions above, but feedback is appreciated.

I will be sharing all comments with my mom. Thank you.

AliceBastable · March 2020

My mom was an active 85 when she was diagnosed. She had a lumpectomy and the long course of radiation (33 daily sessions). She had to drive to another town every day for radiation, which was tiring, but what really had an impact on her was the positioning for the zaps. You have to be able to stretch out on the table and hold your hands far above your head. In the smallish facility she went to, they were still using molds, which are fitted at the set-up appointment and keep the patient rigid. The larger hospital I used just had us hang onto a ring to keep positioned. Either way, it's rough on the shoulders. She lost use of her shoulder on the BC side (her right), and had to use let left hand to lift her right for just about everything. Her improvised method for starting her car was quite a sight, but the DMV kept passing her on driving skills every year until she was 97, the age when she died.

I don't think my mother could have gone through chemo. She'd have probably survived it, but I doubt if she'd have been her fiercely independent self after it. Remember, unless a patient already has mets, the chemo isn't to kill off any specific cancer cells, it's a "just in case there are any microscopic particles floating around that MIGHT metastasize" scenario. At her age, with no mets, I'd be firmly in the NO to chemo camp.

Give your mom a hug from me, if she's the huggy type. I lost mine a few months before my own bout with BC, and I sure miss the occasional hug.

Cowgirl13 · March 2020

If I was me, I wouldn't do everything. I wouldn't want to accelerate the process of what happens when we grow older (I am 74). I am grateful of what I have been able to still keep in terms of health.

hapa · March 2020

Out of those options, I'd pick Herceptin only. It is not that hard of a therapy. Ask if she can get it subcutaneously instead of getting a port.

MinusTwo · March 2020

What kind of numbers is the doc giving her about recurrence? If she really had clean margins and it wasn't in any of the nodes, those numbers might look OK w/o further treatment. If it's a low percentage chance over 5 or 10 years, that's a major thing to consider.

Since she is HER2+, that is fast growing. On the other hand, wait & watch is not a bad decision at 84 AND it needs to be totally her choice. As much as we love our parents, we must let them make their own choices. If she's on board with 'whatever comes', more power to her. BTW - that would be exactly my personal decision about no 'full on' chemo at that age - as long as I knew the pain would be controlled down the road

What does the doc say about Herceptin only? I know it usually takes taxotere or taxol to give it the starting boost, but I've read lately that some patients are forgoing that. Personally, I might try that. Notice the MIGHT.

Is she totally opposed to radiation? Since the doc seems to have thrown that into the mix, maybe she could do only that? I had no side effects for 25 treatments except for fatigue. That and the fact that driving for treatment every day took longer than the actual zap. I was at MD Anderson and did have a mold but did NOT have to hold my arms over my head. But there would probably be some positioning differences to protect the heart since her tumor was on the left side.

Please tell your Mom I'll hold her in my thoughts.

Salamandra · March 2020

There was a woman your mother's age at my treatment center when I was getting radiation. Radiation seems like possibly a good middle ground to me. The older she gets, the harder that surgery alone can be on a body, let alone other treatment, so the benefit in prevention of local recurrence is very real. I think it's at least worth discussing with the radiologist and finding out the position she would be in, how comfortable it could be for her, etc.

MissouriCatLady · March 2020

I just wanted to add, when I was struggling through all this, my doctor told me of an elderly lady who got up and rode her stationary bike every day. Sometimes older folks can kick cancer's butt! Best wishes to you and your mom, thank you for looking out for her.

ktsparkman · March 2020

Thank you to all have comment. Very helpful insights.

ElaineTherese · March 2020

I'm with hapa. Herceptin only might do the trick. I found Herceptin alone to be much, much easier than chemo.

Your Mom wouldn't need a port to do Herceptin if her veins are in good shape. I got a port, but I was doing AC, and my MO strongly suggests a port for that chemo.

Good luck!

84 yr old Active Mom Looking for Advice

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