Mom's Choice

Kikiinct · October 2007

Hello Everyone:

My 82 year old Mom recently had a lumpectomy and had her first appointment with the Oncologist last week. He is suggesting that she undergo Radiation Therapy as well as Hormone Therapy.

The problem is my Mom's pre-existing medical conditions. They include: Very High Blood Pressure, Osteoporosis, Arthiritis, High Calcium and a HyperParathyroid.

After hearing so many horror stories about the effects of drugs like Femera as well as the stories about radiation, my Mom as decided not to have any therapy for her cancer.

She is almost 83 and is very active at this point. Does anyone have any info on Breast Cancer in elderly women who do not go through therapy? I would appreciate any info you can offer.

Thanks

Beesie · October 2007

The question of how necessary radiation and drug therapy is for anyone who has breast cancer, and particularly for an older patient, depends very much on the pathology of the cancer. So it's impossible to answer your question without knowing more about your mother's BC. What stage was she? How large was the tumor and what grade was it? How large were the margins after surgery? Was there any lymph node invasion? How strongly ER+ was the tumor?

My mother was diagnosed at the age of 80. She had a lumpectomy and because the margins weren't clean, had to go back for a re-excision, a 2nd surgery. But that was it. Once the doctor had large, clean margins, because her cancer was early stage and there was no lymph node invasion, and because of her age and the impact on her quality of life, neither radiation nor drug therapy were recommended. However, had her cancer been more advanced, I suspect that the treatment recommendations might have been different.

JoelKM · October 2007

Allot of the treatment recomendations depend on the pathology report and possiblythe OncotypeDX if they decided to run one. I doubt seroiously that they would want her to take chemoather age. Radiation along with an aromatase inhibitor sounds realistic though.

Kikiinct · October 2007

To be honest the Oncologist did not offer too much info on my Mom's pathology results. The surgeon did NOT check the lymph nodes because he said he would have to put her out totally during the operation and he didn't want to do that because of her age. So at this point he said that he doesn't THINK her nodes are involved. And that the tumor was 2.1 in size and about a stage 1. He said the margins were pretty good in size. He also said it was ductal cancer. Should I ask the surgeon for a copy of the pathology report? I really don't know what to do at this point.

Thank you for your informative support.

Beesie · October 2007

Yes, I'd suggest that you get a copy of the pathology report. It's good news that the margins were good and based on the size of the tumor, it's an early stage cancer. The other important question is what grade the cancer is. If it's grade 1 or even grade 2, then it's not the most aggressive. My opinion only, but I'd say that for someone 82 years old, if the cancer was fully removed with wide margins and if the cancer isn't overly aggressive, then further treatment might not be required, particularly if the treatment could be dangerous (given other health issues) or would affect quality of life.

You may also want to ask the oncologist specifically why he is recommending radiation and drug therapy for someone your mother's age. What does he believe to be chance of recurrence, with those treatments, and without those treatments? How much benefit would your mother get from radiation? How much benefit would she get from drug therapy? The oncologist should be providing more information to help with this decision.

Good luck!

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