Chemo followed by radiation? Why?

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Shellshocked
Shellshocked Member Posts: 9
edited September 2021 in IDC (Invasive Ductal Carcinoma)

My surgeon called me Thursday to tell me that my OncotypeDx score is 27, which means that I will need chemotherapy followed by radiation followed by endocrine therapy. Why would I need both chemotherapy and radiation since, as I understand it, chemotherapy is system treatment and radiation is local treatment? I can't find anything that explains why I would need both and can't make a decision on treatment if I don't understand why. I don't see the oncologist until September 14.

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  • 1Greekmomma
    1Greekmomma Member Posts: 22
    edited September 2021

    Hey Shellshocked,

    Found this - Understand Oncotype DX Scores | MyBreastCancerTreatment.org

    27 puts you in the high-risk category, and the younger you are, the more aggressive they will be with treatment.

    All the best!



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  • LeesaD
    LeesaD Member Posts: 383
    edited September 2021

    If you have just a lumpectomy, then radiation is standard of care. With mastectomy it is not unless lymph node involvement. You are correct that radiation is localized. It will try and get any rogues cells left behind or anything lurking in the breast tissue. Also correct that chemo is a systemic treatment. In case any cells escaped and travelled in your blood stream or lymphatic system and is moving to other parts of your body, the chemo is going to go after those. I think on this site there are treatment explanations and how they work. I will look for them and try and link them for you. It's good you are doing your research so when you meet with your oncologist you can go in with questions and concerns.

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  • LeesaD
    LeesaD Member Posts: 383
    edited September 2021

    Here's chemo link :

    https://www.breastcancer.org/treatment/chemotherapy

    Radiation link:

    https://www.breastcancer.org/treatment/radiation

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  • Shellshocked
    Shellshocked Member Posts: 9
    edited September 2021

    Thanks, LeesaD. Those were helpful. I still don't understand why I would need BOTH chemo and radiation. Wouldn't chemotherapy kill all of the cancer in my body, thus making radiation unnecessary? I'd go with chemo or radiation, but to have both seems overwhelming to me. I sure wish I didn't have to wait another week to talk to the oncologist.

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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited September 2021

    Shellshocked,

    A lot of local recurrences arise near the site of the original cancer. By radiating that site (or sites), your radiation oncologist is trying to prevent such recurrences.

    Chemo is about getting cancer cells out of your bloodstream and/or lymph system. Such cells can land elsewhere in your body where they can set up shop. Breast cancer can spread to your bones, lungs, liver, and even your brain. So, chemo is about preventing cancer spread to distant places and radiation is about preventing recurrences close to the original cancer site.

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  • moth
    moth Member Posts: 4,800
    edited September 2021

    Shellshocked, it's because certain areas - specifically the areas around the tumor, need extra attention because there's a higher probability of a single cell migration in that area.

    It's like if you're cleaning a tablecloth and all of it needs cleaning and will have a good soak in detergent but there's an area where you know the sauce got spilled - you will put on additional spot treatment & even scrub a bit on that area. That spot treatment rubbing is your rads.

    And no, chemo will not kill all of the cancer cells in the body. Cancer cells can and do evade chemo through a variety of biochemical processes.

    I had 6 months of chemo and radiation and the cancer cells still managed to hide out somewhere and come back. These treatments all reduce risk, they do not guarantee a cure. The more treatments you layer, the greater the risk reduction.

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  • Shellshocked
    Shellshocked Member Posts: 9
    edited September 2021

    Oh, moth, thank you. Your tablecloth analogy was great! I hadn't thought of it that way, but it actually makes sense to me that the original source of the cancer might need a little extra attention.

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  • ShetlandPony
    ShetlandPony Member Posts: 4,924
    edited September 2021

    Moth, that was a brilliant explanation!

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