I have a few questions I hope someone could help me with. My mum was diagnosed with breast cancer 2 weeks ago, infiltrating ductal carcinoma, grade 2 ‘at least’, sentinal lymph node positive,20mm, possible vascular invasion.
She will have a mastectomy next week, 3 weeks after diagnosis, and has been told her chemotherapy will start approx 6 weeks after the operation - my question is, why the wait? If the cancer is in the lymph nodes, and potentially in the blood, why not start the chemotherapy more quickly?
Hi Jorge
I think they have to wait 6 weeks after the op because you have to make sure everything has healed up well. Chemo can heighten the risk of infection so if they started it any earlier it could be dangerous.
Hope your mum does well
Debs
x
I was given a 12 week maximum time limit to start chemo and I was a Grade 3. I had surgery but because I was pregnant at the time they delayed my chemo so that baby could be induced. All in all I started chemo 9 weeks after surgery (2 weeks after birth).
Jorge, Debs is right - your mum really needs time to recover from her op before undergoing an arduous chemo regime. And don’t forget the tumour and lymph nodes have been removed, so even if there are a few stray cells lurking for the chemo to deal with, it would take much more than a couple months for them to form another tumour. Cancer is a disease that gains momentum, but at the initial stages of individual cells it actually progresses very slowly - and the chemo will find and destroy those cells.
Presumably your mum will be having her lymph nodes removed, so the tumour and nodes will be gone after surgery.
The body does need time to recover from this surgery which is major. Far better to recover from that and go on to have chemo without problems than to start chemo too soon.
Chemo affects the blood too, it lowers red and white cell counts. This means you feel more tired and can eveen get slightly anaemic. With a lowered white cell count the body finds it much harder to fight infections. All good reasons why the body needs to be healed before embarking on the second and often most gruelling part of treatment.
When I was having my treatment I panicked at any delay but in the scheme of things a week or two or three is not going make much difference. I didn’t start my treatment until 4 weeks after diagnosis and two months after first seeing my GP with symptoms.
The most important thing is that your mum is starting treatment.
I would really urge you to keep calm for her. Your support will be invaluable over the coming months. Breast cancer care do some great information leaflets and if you give the helpline a ring, they can send some out to you.
Just to add - it’s always good to ask though! Sometimes the doctors don’t give us enough info or we can’t take it all in. This site is great for getting advice and info. Elinda x
Hello there,
I agree with all the lasses, the main reason for delay is infection prevention, but you know what, as well, your mum might need a bit of a break after her operation, and time to get her head around it a bit. Then chemo does demand a fair bit of resilience - at least it did from me. I had a 5 and a half week gap between mx and chemo - they got me in early cos they had some gaps at chemo unit, and it felt like that was certainly the soonest I’d have liked to have the chemo start.
Your mum is lucky to have you alongside her, best of luck to you both,
Nicola
I’ve had an even bigger gap - diagnosed late October 2010, postponed surgery (WLE and sentinel node biospy) until early December to fit my wedding in first (with some tamox to keep me ticking over). Then needed further surgery (lymph node clearance) in early January as some of my lymph nodes were positive, which meant I would also need chemo. But needed to get some fertility treatment first in case the chemo (or the delay) makes me infertile. So my chemo isn’t starting until late February. Oncologist seems happy with that as they normally leave 6 weeks after surgery anyway. So i’m sure your mum will be fine and all the better for having recovered properly. Good luck to her, and you.
Al x
Do remember that chemo compromises your immune system and slows healing/reduces resistance to infection.They have to ensure that you are as fit as possible before chemo.
Many thanks for all your comments, I guess I do feel slightly more relaxed about the time-scsles now, just to hear people discussing things in a matter of fact way is of some comfort. She is having a mastectomy plus all nodes removed this week. it is just so horrible waiting for results!
Jorge, The Waiting Room is completely the pits, and unfortunately we all spend far too long in there whether it’s waiting for initial results of scans, path reports on bits that have been cut out, scans… well everything really. We always seem to be waiting for something and it’s a big strain. But knowing that she has someone with a shoulder to lean on will give your mum a lot of comfort.
Hi Jorge,
Great kudos to you for helping your mum find information!
I was advised that, because the chemo basically wipes out your immune system, your wounds need to be healed before it can start. What they don’t want is to start it before your mum has healed and had a recovery period from the surgery, otherwise she would be far too vulnerable to infection.
Good luck to you both, your mum will really appreciate your support.