I was recently Dx with invasive ductal carcinoma 13 mm grade 3 ER & PR + Her -
I had WLE/SNB with clear margins no lymph nodes involved.
Saw Onc yesterday he went through treatment options with me, he has suggested Radiotherapy & Tamoxifen as a must (no problem with this) but chemo he has left up to me decide.
Am so confused !! he has given me my Adjuvant print out which shows 89.6% chance of all being well in 10 yrs just with Tamoxifen & 93.5% if combined with chemo.
Although a very nice man, he didnt give me any real indication as to how i make this decision apart from saying that all results to date look very promising & that they are very pleased & chemo could possibly be an over treatment but if i decided to proceed with it I would be having 6 x Fec every 3 weeks but no Tax as studies have shown it is not required with my type as Se worse than any effectiveness, not sure what that means as i thought the 2 always went together, anyone else out there who has had Fec no Tax ? ?
Any advice gratefully received even if only to point me in the direction of somewhere i can get a clearer picture of benefits/ V risks.
Hi there Sarah
My results much the same, but I was recommended to have FEC x 6 but at a reduced dose of 75% (hence probably not as bad side effects as some others have). Essentially, it was my decision, but I felt that I wanted to throw everything at preventing this c**p ever making an appearance in my body again. To go through all this once, is one thing, but again - not if there is anything at all I can do to prevent it.
Before my appointment with onc, I was in bits at the thought of chemo for all sorts of reasons, but I had a long discussion with the onc and felt that he was recommending it for the right reasons.
Not much help I know… but I do know that I don’t want to go through this again and if there is anything at all I can do to prevent it, I will. I don’t want, down the line, to say I wish I had…
Hi
This is a very personal decision. For some people Chemo is just a step too far and they have commitments that make very difficult to manage. They are aware that the op, tamox and rads will do them the most good and Chemo is a back up.
For others they want to give themselves absolutely every single percent advantage and are prepared to go through Chemo as that back up, even if it is just for 4 %.
It depends on the sort of person you are and hw you weight this up. Will you beat yourself up and worry more if you don’t have the Chemo, or will you be satisfied that you have done the treatment that gave you the most advantage ( op, tamox, rads) and get on with your life.
6 fec is often given to er+ node negative bc.
Some oncs would say that as a young women and grade 3 that Chemo was a good option, as you have a long life ahead of you where it might come back. But as you see, for some types of cancer it is not always necessary.
Good luck with your decision… I had Chemo and am 39, I had no real choice as her+ and node positive. I have two small children. We managed and the kids are fine. Please don’t feel you have to do Chemo, it is not always necessary, but make sure you are comfortable about your decision long term.
I would talk all of this through with you BCN. Then you can go through all of your personal circumstances and worries.
Sarah,
I totally agree with debs post, my onc didn’t recommend chemo as my bc was grade 2 and small (12mm) no nodes, so I went with his decision, it is hard as people on here keep saying oh you have chemo cos your young ( I’m 36), so I do worry that maybe I should have had it.
It is a very tough time for you, but wish you all the best whatever decision you make x
Hi Sarah,
A difficult decision, and I was in your position last May, with almost identical results to yours. My Onc gave me the choice, too, but brought up the fact that my Mum hadn’t been able to have Chemo years ago, and she had a recurrance 10 years later, so I knew how he really felt. In the end I opted for the chemo, as I wanted my family to know I have thrown everything at it. A personal choice, and good luck with weighing it up.
Hugs,
Heather.xx
thank you so much for your feedback, have just spoken to BCN nurse which was helpful also although still left with the “at the end of the day” its your decision, aaagghh.
Have an appointment later this morning with the Chemo Nurse so BCN has advised that I have a chat with them too, which i will do, she also mentioned that if i dont have chemo now & in the future I was unlucky enough to have a reoccurence they would have the option to use chemo as i hadnt previously received any (thought they could do that anyway)
Will let you know how I get on & thank you once again for all your advice.
I had the same choice as you but with EPI and CMF over 28 weeks, decided to do it but I went round and round trying to decide first, but once I’d made my choice I must admit I felt more at ease, I chose to throw all they were offering at it and it have me 96% chance of all being well,
Good luck with your choice, maybe speak to one of the bcc nurses on here for an independent opinion ? hugs to you,
Would it help to bounce things around with the Helpline? Putting things into words in writing, as you have done, helps, but you might also find that saying it out loud to someone who is NOT directly involved but who understands might be that extra help you need to decide how you feel.
Good luck on your decision-making, and I hope you do manage to get a bit of sleep over this weekend without The Decision keeping you awake all night.
I would put a vote in for doing it. For me, chemo was not nearly as bad an experience as I had feared, and I carried on with most of my normal life throughout. I had no choice about doing it - if I had I might have decided I had too many commitments at that time, probably not a good decision.
Good medical care can sort out most peoples SEs. If it turns out you find it difficult to deal with the chemo you can always stop.
best wishes
Sarah
Hi i was 32 with idc 2cm, er positive clear nodes. I was told chemo would make about 8% difference and told in no uncertain terms i needed it because i was young.
My breast care nurse said any percentage over 3% is worth having. Chemo makes sure any stray cells which maybe there are killed and with a 2 and 1 yr old it was an unfortunate necessity.
I wont lie, its bloody hard work but it went so fast and at least i feel i have done everything in my power to live a long life for my lovely children.
Hi 021210 i have pm you with my reasons for decision just dont be swayed by fear of chemo do what you feel is right for you .chemo gave me a 6% benefit a benefit i thought was worth taking you are also younger than me i was 48y but my lump was slightly larger at 2.6 cm and grade 3 stage 2 no nodes ,clear margins . hope my message helps xx Julie
I had to make the same decision you had to over three years ago as I was borderline for chemotherapy. The single most helpful thing was being told that - as I was borderline - there was no urgency in making the decision and that I could start on Tamoxifen while I thought about chemotherapy. It’s a very personal decision (and the fact that I wanted to preserve my fertility played a huge part in it) but in the end I chose what was described as a middle way by opting for Tamoxifen and Zoladex instead of chemotherapy.
Today I don’t regret my decision at all (although the Zoladex wasn’t easy…) but the thing that I really appreciated was having the time to think about it and seek second opinions. By the time I made the decision I was really comfortable with it. Do PM me if you want to know any more details…
Hi just wanted to add that it is normal just to have FEC. Tax tends to be used when there are lymph nodes involved. Good luck with your decision - and as the others have said don’t be put off by the idea of chemo if you are leaning towards having it - it’s only for a very short time in the great scheme of things. And should you need it later, there are plenty of chemos left in reserve.
fintyx
Thank you so much for your advice, I have been to see Chemo Nurse today & tried to explain my worries but was met with lots of sympathetic nodding of the head, no words.
Whilst i appreciate only I can make the decision I guess what i was trying to get made clear from the hospital is that yesterday I got the distinct impression that the Onc felt that there was no requirement for Chemo & it could even be considered an over treatment but at the same time he produces a sheet of paper that raises my chances by nearly another 5 % so would the the risk of any potential long term side effects outweigh the benefits, am truly not worried about short term side effects as like many of you I am prepared to do/take anything for a future with my family.
I just feel from Dx they have told me everything that I need doing, i:e surgery, rads, tamoxifen but when it comes to chemo am met by stares & nodding heads & no one will commit one way or another, just keep saying its up to me.
I also feel that since Dx when the whole thing of getting Breast cancer seemed very serious etc (which it is) that now i have had such pleasing results from surgery that I should be “on my way” with my bottle of pills & that i have had nothing more than a minor Op.
Feeling tearful, confused & frustrated, really want to do whats best, apologies for the rambling.
Who wouldn’t feel tearful, confused and frustrated, Sarah? I think I would phone my BCN or the helpline here just to talk it over with someone informed. I don’t suppose they will say ‘do it’ or ‘don’t do it’ but they might be able to explain why you don’t seem to have been given clear advice.
I hope you can find the right person to talk this over with.
Oh, you poor thing. I remember wanting the same sense of guidance from my doctors and not getting it. I spent a couple of months asking everyone for their point of view (including my accountant… Actually, his statistical take was really useful) although I did assure my oncologist that I’d always take her advice over his.
The trouble is that survival statistics are always about 5-10 years out of date - for instance, since Zoladex is a new(ish) treatment, there isn’t much data on how it increases survival (the figures you would have been given comes from something called Aduvant Online (or some spelling like that). In my case I had to be offered chemotherapy because NHS guidelines said that anyone with a tumour over 3cm should - but 3cm on someone under 5ft and six stone is very different to someone who’s heading towards 6ft. I have no idea what treatment choice I would have made if I’d had children but if you can cling onto one thing whilst you go through the whole hideous decision making process, having an 89-93 per cent chance of surviving is a really good start to your treatment. My statistics were almost identical to yours but at the time it didn’t stop me being extraordinarily worried and tearful. I thought I’d never be able to decide but I was eventually.
