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chemo or no chemo
Hi everyone,
I am new to this list. I am 60 and was diagnosed with breast cancer (ER+, PR-, HER2-, Grade 3, Stage 2) and had a mastectomy a couple of months ago. My oncologist recommends chemotherapy followed by hormone therapy. However, I have been reluctant to undergo chemotherapy due to concerns about the side effects, especially the long-term ones. I am curious about how others made their decisions regarding chemotherapy.
I also had a genomic test, which reported a 36% risk of recurrence. Chemotherapy might reduce this risk by around 10%, and hormone therapy could further reduce it by another 10-15%. I am still uncertain, but I need to make a decision soon.
My oncologist recommended a combination of two drugs: Docetaxel and Cyclophosphamide. I wonder if anyone has experience with this combination. I have seen some posts about chemotherapy, but they discussed single drugs administered sequentially, not together. I am concerned that the combined treatment might be more taxing on the body.
Thank you for reading my post and for your responses in advance.
Comments
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Sorry to see you here, @Emeraldgreen ... a 36% risk of recurrence is pretty 'big' in my opinion and personally, I would throw the bus at it! ... Did your pathology show any activity in the nodes at all?
Not all chemo causes hair loss - and wearing a Cold Cap may also reduce the amount of hair loss - and it pretty well always grows back after the chemo stops.
Your Oncologist has your best interests at heart and wouldn't suggest doing the chemo if they didn't think it would reduce your chance of recurrence - You could always see another Onc, for a 2nd opinion ... but be prepared for them to say the same - to do the chemo.
Do you have a Breast Care Nurse? Maybe you could have a chat with her.
Have you talked to your family about this, tho I know that in the end, it is your decision to make.
Take care & wishing you all the best
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@Emeraldgreen, I agree with @arpie in that the specialist would be recommending the best treatment given your circumstances. You have done the genomic test so you have some decent criteria re a recurrence - hair or no hair I'd be accepting the chemo. You are stronger than you think so, like many others before you, you will get through it.
I have also sent you a private message (look at the msg icon next to your profile icon at the top right of the screen).
All the best with your decision. 💖1 -
@June1952 and @arpie, Thank you very much for your thoughtful messages and information. Yes, my recurrence risk is high, with anything under 25% considered to be low. Although no lymph nodes are affected, the tumor size was 2.4 cm, which is not small. My oncologist is very kind and I trust him.
However, I have been contemplating whether the uncertain 10% benefit from chemotherapy is worthwhile, especially considering the side effects. These side effects not only reduce my immune system's ability to fight but also damage internal organs like the digestive system and liver. I guess that I'm struggling with the idea of attacking my own system for an uncertain treatment outcome. If it works, that would be great, but if it doesn't, it could leave me even more vulnerable. I understand that no treatment is perfect or 100% effective, but I still worry. Maybe I'm overthinking it. It is very comforting to receive your kind messages and encouragement. Thanks again.
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@Emeraldgreen I would also be throwing the bus at this disease. I would be doing everything I possibly could. Not everyone gets all the side effects. You get through by putting 1 foot in front of the other. Our minds do go into over drive.2
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@Emeraldgreen When my Dad died he made me promise not to ever get chemo as it was so harsh on him and yet he didn’t survive it anyway. Eighteen years later I got a cancer diagnosis. I have always hated putting anything non natural in my body. However, my best chance of survival was chemo. My Onco assured me drugs had come a long was since I made that promise to my wonderful Dad, who only ever wanted the best for me. So I broke my promise which was so very hard to do. Yes I had side effects, but they were doable. The chemo killed those blighters and is the reason I am alive today. I didn’t let fear of the unknown stop me from giving me the best chances of survival. Sending you big hugs as you make your decisions.6
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Hi @Emeraldgreen
I always ask my Doctors “ what would you recommend if I was your mum ( or sister).”
I figure the medical specialists do years of training and then usually have years of experience so their advice should be respected.
If you don’t have the chemo and then the cancer comes back , you will regret the decision.
In the end it’s up to you but as the ladies have said above - throwing the bus at it seems like the way to go.1 -
Hi @Emeraldgreen, if it's the long term that's particularly concerning to you, I'd take possible side effects from chemo over a possible recurrence of the cancer any day. There's no guarantees in life but having recently had a recurrence 17 years after treatment for early breast cancer (including chemo), I take some comfort in knowing I did everything possible at the time to knock it on the head. Yes, chemo is awful but the cancer coming back is crushing
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Hi @Emeraldgreen, I had a similar diagnosis, stage 2 grade 3, 2cm cancer, 1 lymph node involved, but clear margins for all. A higher risk of reoccurring, about 30%. My oncologist strongly recommended the same chemotherapy plan as you, and told me he would strongly recommend it even without the lymph node involvement due to the high grade cancer. I chose to do the chemo, I don't want this coming back and will do everything recommended to try and avoid that happening. I have just finished chemo, it wasn't a walk in the park, but my side effects were manageable, and 3 weeks on from my final chemo I'm feeling ok and my hair is starting to grow back. Moving on to radiation therapy next and then hormone treatment. The early stages can be very overwhelming, I contacted my local McGrath Nurse who was so helpful and answered all my questions. Wishing you all the best through your journey. Katie2
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Hi @Emeraldgreen
I had chemo nearly 12 years ago, A/C and paclitaxel (the latter is a taxane, as is docetaxel). While I understand the concern about long term effects, I agree with others that the possibility of recurrence may be a greater concern. I was 67 when diagnosed, recent tests have shown that my liver, spleen and kidneys are in fine condition, I have had no problem with digestive issues and while surgery, chemo (more likely the A/C) and my age combined to tip my heart into an arrythmia, I continue free of any side effects, with a healthy heart function on minimal medication. Paclitaxel was probably responsible for peripheral neuropathy, affecting my feet. It doesn't affect everyone, most of those who are affected have a slight impact during treatment and it clears up afterwards.
It's hard to know how any individual will react to chemo. Nausea and fatigue are common and I didn't have either, I worked throughout treatment and felt fine. Two people on the same chemotherapy can have quite different reactions. Like many, I knew nothing about breast cancer when diagnosed and not much about cancer generally. I had (still have) a surgeon and an oncologist I trusted. I followed their advice and have never regretted it. No side effects at all would be great but cancer is difficult, complex and unforgiving. Throwing everything at it has given me 12 more years I might not have had (and hopefully more). That includes some memorable travel, a wonderful project at work for five years, a great deal of learning and two grandchildren. In return I take a few pills and can't sprint. Seems worth it to me. Best wishes for your continued recovery, whatever you choose.5 -
@Emeraldgreen - these are tough decisions to make and sounds like you have a great treating team who are advising in your interests. Chemotherapy is tough but as these other ladies have said not everyone gets all the side effects short or longer term. I am currently on the chemo journey, and your mind does play tricks initially about what am I getting from this. My mantra has been I choose life and I remind myself of this when it is tough going - I make this choice not just for me, for my family and friends - so I am taking all treatment on offer. I wish you all the best in as you weigh everything up and make your decision.3
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Hi @Emeraldgreen, I was diagnosed at 58.5 years old (in 2023).Chemo was initially advised as a ‘maybe’ but my tumor turned out to be twice the size post surgery. My breast surgeon told me ‘I want you to live longer, so I will be referring you to a medical oncologist’.
we are fortunate to be given options, and when making decisions about the options, I don’t want to regret them down the road. My risk of recurrence is extremely high even with chemo + hormone treatment (20%).
I am stage 3 , grade 3. I saw my oncologist recently and he informed me CDK4/6 is now on PBS for BC patients with high risk of recurrence. I would be an ideal candidate but it reduces my recurrence by only 6% and there are side effects ( I may not get them though). We decided to give CDK4/6 a go and if I can’t handle the side effects, I can stop taking the meds. Long story short, only you (+ your partner) can decide what’s best for you.Chemo wasn’t a walk in the park for me and I can totally understand your dilemma. I am still having side effects from the horrible chemo drugs ( AC + Taxols). But I don’t regret going through it as I know I have done all I can to prevent recurrence.Wishing you all the best with whatever you may have decided.
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Dear @Emeraldgreen, throw everything you can at this. If the cancer did come back and you didn't have the chemo, you would be kicking yourself. I did everything I could. I had surgery, chemo, radium, hormone suppression with AI but I unfortunately haven't been successful. I am glad I did it all and I am still dealing with it all again. Do what your doctor advises. You can mitigate any side effects now or in the long term. The only thing I can guarantee is you don't want this thing back.5
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Dear Cath, many thanks for responding to my post and sharing your story despite struggling with your current health issues. I am terribly sorry to hear that the treatment had hicups. But I am sure that the continuing treatment will work well. I wish you great strength and best of luck.
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Beautiful and Lovely Ladies,
My heartfelt thanks for sharing your stories, insights, and caring good wishes. It’s comforting to know that you have successfully completed the chemo process and have managed or are managing the side effects well.
I still have to make up my mind, but when I do, I will be thinking of you. Wishing you all good health and a BC-free future. With Warm regards.
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