Choice of taking radiotherapy or refusing

As I am 67, and a study saying over 65s have similar long term survival whether or not they took radiotherapy, I have been given the choice. Local recurrence 10% without, under 2%with radio.

I had a lumpectomy, 9mm, Grade 2, clear margins, clear nodes, estrogen 8/8, progesterone 8/8.  Told excellent prognosis. No chemo. HT strongly recommended.

I started the HT, but I don’t see myself doing the 5 years. I therefore feel I should accept the radiotherapy, as if I stop HT, I will have had no adjuvant treatment.

Any other over 65s offered a choice?

Why are you considering not taking the AIs ? 67 isn’t old . Of course you should have radiotherapy it’s painless - and also take the hormone therapy . Truly do not understand why anyone would not and I’m on Letrozole for 6 more years started 2019 . 65 and aiming for another 20 years throw everything at it 

Hi mermaid

This is an interesting dilemma. It’s excellent that you have had a straightforward experience so far and your prognosis is good. One thing I have learnt during my 4 years in Cancerworld is that statistics in the end mean little. We are individuals, not statistics. You seem to be predicting your future based on others’ experiences - anticipating side effects from Tamoxifen (surprising to be given Tamoxifen post-menopause, usually we get anastrozole) because presumably you are expecting to have a bad experience and not last the course. It’s a possibility but you won’t know till you’re in there. And there are alternatives to tamoxifen if it does not suit you.

I was told by one oncologist that, of all the adjuvant treatments, radiotherapy was by far the most successful. Why would you not have it? 15 days of a painless treatment (unless you are one of the very unlucky ones), some tiredness and maybe some later soreness is a small price to pay for peace of mind. It’s all very well the statistics saying that the chance of local recurrence is negligible but you don’t know if you’ll be in the fortunate 90% or the unfortunate 10%, do you? And there’s no test to increase the certainty. I guess you’re taking a calculated risk if you let the statistics lull you into what may be a false sense of security.

Thinking from my current position, I look back and detect a degree of naïveté at the potential breast cancer has for wrecking lives. I’m glad because it brought me a period of peace of mind - I’d done the whole adjuvant therapies programme and was clear. I don’t think I’d have had that peace of mind had I skipped one of the therapies. Everyone has doubts about some aspect of treatment, some based on past experiences, some based on fear, some based on ignorance. Your doubts are certainly not ignorance, so what exactly are your doubts? Risk? negligible - they have it down to a fine art now. Pain? It’s not usual to experience pain. If you do, you can stop the treatment. Aversion to medical intervention? Understandable but this is cancer we’re talking about. Just wanting to be out of this awful circus? Again, understandable but you’ve had a relatively straightforward experience so what are a few more weeks?

Btw, your cancer was highly hormone-receptive. You are going to need those AIs, whether you like the idea of a hormone-free future (not necessarily easy) or not. The fact is, you have had a life-threatening illness. Surgery has removed the threat and you are at low risk of any metastasis or local recurrence. But cancer can be insidious and gambling with it without sound reasons seems to me a bit reckless because it can come back to bite you. Ultimately (obviously) the decision is yours to accept any of the adjuvant therapies but please don’t base it on what you’ve read or been told about them because we’re all different. Go by what feels right for your peace of mind. Good luck x

3 Likes

Hi folks

Any thoughts or similar experiences appreciated

Am 65

Intermediate DCIS left breast diagnosed July

surgery in August, not clear margins, surgery again in Sept and again in October

finally clear margins

Radiotherapy now scheduled for 5 days in March

Given the amount of time since first operation in August, 8 months ago, seems that any stray cancer cells could be anywhere in my body by now

So wondering-given the horrible side effects-what is the point of having the whole breast radiotherapy 

Could have chosen tamoxifen instead, but it seems to be associated with toxic side effects also

But-Does tamoxifen treat the whole body or just breast area? 

Statistically, radio seems a bit unconvincing- 3%?

Especially weighed against the ruination of health, it can cause, and the time elapsed since the first operation

Any similar experiences- or doubts?.

Hello, Yes

Was offered a choice of radio or tamoxifen in a similar situation, age 65

Reluctantly choosing radiotherapy, but have yet to go-

but the statistical difference between radiotherapy or none in stopping returning cancer in the breast seems so small and radio has such damaging side effects, really struggling with going forwards with it

I am quite some months after surgery in August

Also, if secondary breast cancer can in fact appear anywhere in the body at any time, is the radio in the affected breast after all clear in surgery a sort of in case/maybe? 

Seems odd there is no annual body scan to check 

Found it easier to be brave for surgery, which was at least finite 

Seems harder to face these choices

Hope you improve and do well with your treatments,

maybe radiotherapy is at least shorter than chemo,

although the side effects are often long, people have said

Good luck

My situation is similar with non-invasive DCIS detected, progesterone and estrogen positive 100%. LCIS was detected as well. My cancer was detected in my annual mammogram.

As I was told radiation takes care of any microscopic cancer cells the surgeon could not see. She said with radiation therapy my risk for reoccurrence was cut to 10% and with hormone blocking therapy chance of recurrence is cut down to low single digit percentage.

I opted for radiation therapy which I started 3 days ago…so far so good. I will have 16 sessions total. I will start hormone blocker- likely Tamoxifen after radiation and take it for 5 yrs. I recently had a bone density scan that says I have osteopenia, which is why Tamoxifen might be a better option. I meet with my medical oncologist at the end of the month to discuss.

Blessings and best wishes to you and whatever decisions you make. I know this is hard. I never thought this would be a part of my medical history.