Decisions about Radiation.

Hi Ladies

So today I saw a radiation oncologist regarding whether I will have radiation after my chemo finishes.  You see, my breast surgeon feels that I don't require it and my medical oncologist feels there may be some benefit.  I had been happily going along, booked my plastic surgery reconstruction appointment and wham - what about radiotherapy? So off to get an opinion I go.

I have come away from the appointment still undecided - I am in the "grey zone" apparently. I have had a mastectomy and full axilla clearance.  My largest tumor was 2.2cm, I had 2 much smaller ones and a large area (9cm) of DCIS - there was no sign of lymphovascular invasion or or the cancer leading to my skin.  I am hormone receptor negative and Her2+ve.  The cancer was grade 3. 

The usual criteria is tumor of 5cm or more and 3 or more lymph nodes involved.  Apparently the oncologist's concern was the multifocal nature of the cancer - more than 1 tumor despite the others being very small.  The radiation oncologist still feels I am low risk for local recurrence - between 10-15%.  Radiation would drop this risk by 2/3. It would put off any tissue reconstruction by 12 months of more and there is likely damage to the skin tissue (which of course can be rectified later via plastic surgery). It is 25 days of going every day, there are minor risks of heart and lung damage, there will be more fatigue.

I didn't feel it was a convincing argument for having the radiation.  I have a 10% chance of secondaries after chemo - this was considered low so why should I consider radiation for a 10-15% risk of local recurrence?  A local recurrence would be treated with radiation anyway (I have to check on whether I would need chemo - depends on the oncologist).  

So I don't know what to choose.  I am leaning towards not having it and then having radiation if there is a local recurrence (of which the risk is low) - it would be a higher dose and longer treatment of radiation then.  

My husband suggested why not have it to reduce the risk anyway?  I am not that concerned with side-effects - I've dealt with enough already this year, what's a little more discomfort and inconvenience?  I have written the year off anyway.  

I had hoped to have my reconstrution in October and then finish my Herceptin in May next year and just move on with life as if this year was just a blip - having the radiation would stretch this out quite a bit because it would be longer for me to have plastic surgery (I see the plastic surgeon next week to check with him details of how radiation would impact there).

Would love to hear some thoughts and opinions.

As for Taxotere - so far so good.  Hit me day 5 - thought I would end up in emergency - I felt like I had the flu so badly but it passed quit quickly and I just have a lingering fatigue and occasional aching legs.  My nose drips constantly too.  I can feel the cumulative effect of drugs on my body as the fatigue mounts up.  Usually I would be bouncing around this week and I am finding it hard to get out of bed or the house.  I don't feel unwell just lethargic.  I am up for my second Taxotere next week.

I hope everyone is going well today - it's cold here but the sun is shining and the sky is blue so that is great!

Amanda xx