Chemo before surgery
Hi everyone,
Just giving an update on my treatment so far. I've been having chemo prior to surgery for four triple negative tumours in my left breast.
I've finished three rounds of three weekly FEC and I've now had three rounds of my 12 weekly rounds of Paclitaxel.
Yesterday's ultrasound showed that my three smaller tumours are GONE!!!!!
The largest tumour is also looking unstable and the ultrasound program needed to be enhanced to get a decent shot of it.
I am very hopefully of a full pathological response by the time I go in for surgery in January.
I can also now have breast conserving surgery rather than a mastectomy because the tumours will probably all be gone. They will just use the clip they inserted at the start of the process to map out the tumour site and remove it with a couple of nodes for biopsy. If I can get a report of clear margins and clear nodes I'll be a very happy woman!
My research has led me to UK and USA sites that state a full pathological response prior to surgery (all tumours gone) lowers my risk to the same as that for other less aggressive forms of breast cancer! (breastcancer.org)
The technician that did my scan yesterday also confirmed that when people have surgery first the most common site for recurrence is in the scar tissue.
John Boyages excellent book, Breast Cancer :Taking Control, postulates that the scar tissue may make it more difficult for chemo drugs to reach the tumours due to disruption in the blood supply.
Needless to say I am very VERY happy that I chose this mode of treatment. It was initially nerve wracking because you're walking around with tumours inside you and there's no guarantee that they will respond to chemo, but they keep checking and if they're not responding they go ahead with surgery.
If you have surgery first then chemo is really a case of 'pot luck'. Triple negative is a group of cancers. Not just one form of cancer. There's no way of knowing if chemo is affecting your cancer once the visible tumours have been removed.
With chemo first you can watch them melt, or not. If they need to go early with surgery they can try different chemo post surgically because they will know that what you'd been having doesn't work. Makes sense to me.
The other great advantage of this treatment is that, as we all know, this cancer is very aggressive and notorious for metastasing. Very tiny tumours in other parts of the body won't necessarily be picked up with scans.
Having chemo first means you're tagetting ALL cancer cells in your system, your treatment isn't delayed by surgery and recovery (and the possiblity of having to go back in for more surgery if you don't get clear margins) and you're having chemo when you are at your fittest.
I have coped extremely well with chemotherapy. This is partly due to the excellent protocol at the Mater hospital in Sydney and partly due to all of the various strategies I'm using to minimise the side effects.
I hope this information is useful to anyone else considering this approach.
I'd also add that not all doctors offer this approach and it's worth doing some research before you rush into surgery. The more I read the more it's looking like this decision could be a game changer in terms of recurrence.
Meg
