I have been diagnosed in the past month with secondary breast cancer. The primaries are in both breasts and lymphs, with multiple metastases in my bones (mostly in the spine) and a single small tumour in my right lung.
My oncologist has put me on to tamoxifen and bonefos as I am 8 out of 8 hormone receptive (???).
I am having a second opinion consultation from another oncologist next week, who has indicated that he would rather treat me with chemotherapy.
Does anyone have any advice on which route I should follow – hormone therapy or chemo?
This is all new to me as I only found the lump in my breast last month, so I have not had any prior treatment.
Listen to what the second opinion has to say and get reasons for him/her about why chemo. Also check out why they think that hormones are not the way to go at the moment.
I have liver, lung and bone mets and it is because of the liver mets that I started on chemo first. I am also 8/8 for ER/PR and am now on Tamoxifen. From what you have said, I would personally do the Tamoxifen first as it sounds like your mets are small and not life threatening at the moment. Most oncs will scan you after 3 months to check out how things are going and some women have got to NED (no evidence of disease) on hormones alone.
Chemo is doable but is no walk in the park! You might want to save the big guns of chemo for later which may be what your first onc thinks.
These things tend not to be clear cut and uncertainty, unfortunately, goes with the territory. I think that as long as you are happy with your decision, having considered all the options from an informed perspective, that it the best you can do.
Laurie x
PS: In terms of your hormone score, Estrogen and Progesterone (ER/PR) are scored out of 8 so the higher the number the more hormone positive you are (e.g. ER 7/8 PR 8/8)
Hi Ruthie
I had a similar decision to make when my bone mets were dx in 2008, four and a bit years after my primary dx. I had a local recurrence which meant they also scanned me for any spread, which is when my bone mets were ‘dicsovered’, I had no idea, so it was a huge shock as I’m sure you are going through right now.
My onc suggested hormone treatment, with AI’s as tamoxifen had failed for me, and I am strongly, 8/8, positive for both ER and PR. However as my spread has been through the blood system rather than nodes/lymphatic system I decided to go with the big guns in case there were any micro mets floating around else where. My onc explained that the hormone treatment does do the same as chemo, with less other health risks, but takes longer to show a response. I had not had chemo with my primary as there was so little difference with my (good!) prognosis therefore this was the first chemo I had. After discussing all the issues at length with my OH and onc I decided to go the chemo route, and then followed by AI’s. Chemo is not easy, neither is any treatment that cancer forces you to have, but for me it was the right decision.
I suggest, as Laurie has said, to discuss the options with the second oncologist and then hopefully you can make an informed decision. Ultimately if they both say the same it will be what you want to do, there’s no right or wrong answer. Do check if you are PR positive as well, it does make a difference to how well hormone treatment can work for you.
Good luck, hoping that you are gradually coming to terms with both a primary and secondary dx at the same time. I think most of us with a secondary dx understand exactly how you are feeling right now and all of us seem to cope better once we have a treatment plan in place. Feel free to send me a private message (PM) if you would like to.
Nicky x
Welcome to the BCC discussion forums, I’m sorry to read of your recent diagnosis.
As well as the support you are receiving from the other users you might find it helpful to talk things through with a trained member of staff on the BCC helpline. Here you can share your concerns and questions with someone who will be able to offer you emotional support and practical information. The number to call is 0808 800 6000 and the lines are open tomorrow from 9 to 2pm and Monday to Friday 9 to 5pm.
Sorry, OH means other half, it took me ages to realise on here as I’d been used to another forum using DH, dear husband! We all tend to use a lot of abbreviations on here, it helps save typing the long bits over and over! And there is a part of the forum that explains them, it escapes me where it is but probably on the getting started or help with the forums part. It’s useful for all the medical abbreviations as well.
Nicky x
Ps, it’s in the Glossary part, I’ve just been able to look once I’ve posted this originally, the left hand menu disappears when you are submitting a post.