No chemo, and I am worrying now after reading others posts on here, please advise.

As you all know mum is under the Marsden and had a partial mastectomy two weeks ago. Her path results came back with clear margins and her nodes were also clear. They have told her she needs radiotherapy, but no chemo. I was quite happy with this, but keep reading about others who have clear nodes but still seem to be having chemo. Just read a thread written my a man about his wife and she is having chemo, even though her nodes were clear. Mum is under the fantastic Marsden and they are the experts, but there is a niggle in my mind as to why is mum not having chemo where others are. Please help me understand ladies, as you are all so good at being caring and also informative.

Love Jules xxx

They like to give chemo if you’re young (eg under 40 , sometimes 50, 40 to 50 seems to be a matter of what the onc thinks), they also like to use chemo if the tumour was large and agressive, eg I had no nodes involved but because I had 2 tumours, both were fast growing and I’m young so have a more active metabolism it makes sense to use the chemo.

a good friend of mine who dealt with BC when she was in her 60s said that the onc explained to her that our metabolisms slow down as we got older so older women have more slower growing tumours and if you’re in your 60’s/70s with a slow groeing tumour then it’s likely that you’ll die of something other than cancer at a ripe old age even if it were still there so why put someone through chemo if they don’t really need it.

In cases like mine they can’t really afford not to chemo me because if something did come back it’s likely to be with a vengeance :frowning:

Does that help?

I’m sure others will have different points of view to share though.

Angiee

Thanks Angiee, it does help. I must admit I maybe very niavely thought that its not in her nodes, it wont spread she will be clear of Cancer. But maybe I am being a bit too hopeful!

But what you said does make sense, so thanks Angiee.

xx

Hi

I was told the same thing - that I wouldn’t need chemo just rads - I am 57 with WLE 3cm stage 2 lump/no nodes affected.

They said that the risk outwayed the gains for older ladies as you can get diabetes/kidney damage/liver damage etc. if you are older and the chances of a reaccurrance are less as you age anyway. So I was happy not to have chemo - tho I have the protection of hormone treatment (Arimidex) as my tumour was er+.

Jo xx

Hi Jules

I am 46 (44 when dx) and did not have chemo. I had invasive lobular and onc said just rads and tamoxifen after WLE as no nodes affected (had SNB) and under 20mm lump) mine was12mm lump and I had no other scans etc. I was pleased at this outcome but then on the other hand would it have been better to throw everything at it. My onc and consultant said that in a lot of cases chemo is not necessary and I do know a lady who had WLE, rads and no medication 9 years ago and (touch wood ) is fine. I feel quite happy to leave things in the hands of my medical team who so far have been excellent.

With best wishes to your mum.

Shorty xx

Thank you Jo. Mum has been told she has to take Letrezole I think for the next five years. I know she is taking something for five years and assumed it was the drug that they put her on before her surgery, does that seem right? She was over the moon not to have chemo, and I was on her behalf, so I didn’t want to pass on my worries to her about not having it, hence I asked you lovely ladies. (her tumour as caused by HRT so was a hormone one)

xxx

Thank you shorty, and mum has lobular too!

I will try not to worry, I just want to believe its going to be gone and not come back. Maybe i am niave or hopeful! lol xxx

Hi Jules

Yes I think that is another name for Femera which is very similar to Arimidex. It is very effective and used instead of chemo to shrink tumours sometimes so I’m sure that would be enough to protect her without the very harsh treatment with chemo.

Jo xx

Thanks Jo,it does help when you get worries and silly little niggles to come on here and speak to the experts. So thank you so much.

xxx

NICE guidelines cover treatment for breast cancer, my friend had a grade 2 tumour which was just over 2 cm and she was given chemo even though she had clear nodes. I had a tumour between 1.5 and 2 cm which was grade 1 and clear lymph nodes and I wasn’t offered chemo. I was very surprised. She was 53 when diagnosed, I was 48. We both had oestrogen receptive cancer I think

Mole

Hi Jules my mum was a similar age to yours and she didn’t have chemo - just rads and as I think I have said before she didn’t have a recurrance of BC and lived another 11/12 yrs and died of something different. Please try not to think too deeply about it all and worry about something that may never happen as you can let it take over your life…just enjoy yoursef and take each day as it comes. In my experience with my mum once she had her rads and got back to a ‘normal’ existance we forgot that she had been dx for the majority of the time though we did spoil her more.
xxx

HI Jules

I’m 64 and had a 2cm tumour which was grade 2ish; I opted for a mastectomy which I had June 24th, , the margins and lymph nodes were clear and I’ve needed nothing else, neither radio or chemo, although am on Arimidex. I’m over the moon and not worrying at all, especially since the surgeon doesn’t want to see me again until next July. I’m sure that they know their stuff, they’ve so much experience.

Love and hugs to mum, I’m sure you’ll look after her wonderfully.

Gandt

Hi Jules,
when I was dx in Jan 2003, I was offered either a WLE with rads or a mastectomy with no rads. Chemo never mentioned, and I chose the former. However, at the WLE, they took 8 sample nodes (SNB not being done at my hospital then) and 2 were malignant. I went back for total axillary resection and one more lymph node found positive. This was the first time chemo was mentioned and I was shocked, to say the least. I asked my bc surgeon why I needed chemo and rads and he said that the chemo would take care of any microscopic cancer cells that had gone through the lymph system, and the rads would be extra protection to the area in the breast where the tumour was. This made logical sense to me. I had a 2 cm stage and grade 2 tumour with associated intermediate nuclear grade DCIS, cribriform and comedo, whatever that means.

He also said that with any tumour of 2 cm and over, with lymph node or vascular spread, they strongly advised chemo. It looks as if the Marsden are following this same protocol and is the best treatment for your Mum. I am not sure if chemo is advised for tumours over 2 cm without lymph or vascular spread. I’m sure someone more knowledgeable than me (JaneRA, Mole, ChristineMH and Vertange come to mind) can advise on this aspect.

It may be a good idea to stop stressing about your Mum’s future treatment, and concentrate on being positive about such a good diagnosis, and prognosis, so you can help her regain her health and enjoy life. The Marsden may now wish to do a bone scan, and CT scan, just to get a baseline, but this is quite the nomal procedure, or it is at my hospital. A DEXA scan may also be ordered, to check bone density, as the aromatose inhibitors do not protect the bones as Tamoxifen does, but they have a much better prognosis for non recurrence. If your Mum’s bone density is low, they will prescribe a bisphosphonate to delay any further bone loss.

Take care - try not to worry your Mum with your concerns, she sounds as if she is doing great, and is under probably the best cancer hospital in England…wish we were all so lucky.

Liz.

Hi Jules

I think the other girls have already given you very good avice. I believe it is generally a question of age, size of tumour and spread and whether ER+ or negative which dictates chemo treatment. In you mum’s case it seems that the size of tumour, her age and status of tumour (i.e ER+) made them decide against chemo. As the others have said, don’t stress too much. SHe is udner the very best of care, so just look forward to the future now. Very best of luck and best wishes for a speedy recovery for mum.

Thanks ladies for taking the time to write to me. I am not really stressing as in neurotic way (HONEST) LOL Infact I do feel like she is cured (or well on the way to being), which is maybe going to far the other way, it was just reading the other posts put a little seed of doubt into my mind.

I will spoil her and make sure I see and speak to her more oftenly as maybe I did before dx, and that is more because having a scare like cancer has made me realise how precious my time with her is, and that you really don’t know what is round the corner so you must make the most of the time you do have.

Hubby and I are off to Mexico (no children going as son going with a friends family as he gets bored at the grand age of 15 with us, and daughter staying with boyfriend and they are off to a lovely cottage in Cornwall for a week!) but we are going on Tuesday and I am really looking forward to it and not worrying like I was about mum now as realise she is in good hands, but just wanted to post my little niggle as I knew you ladies would be able to put my mind at ease, and you have.

Regarding a bone scan etc. They have not suggested one, the only would have done if it had been in her nodes at the Marsden.

Thank you again ladies.

Jules xxx

Regarding the Marsden and her treatment, I am not sure if everybody knows that, as my mums gp didnt know this and my sister found this disgraceful. Anyone can be treated at the Marsden, its a foundation Hospital so anyone can be treated there. My gp said to mum, wow how did you get treatment there as its out of the area, did you pay?!!! Thats shocking that she didnt know that, because patients who could go there are being denied the chance by her ignorance. My mum was being treated elsewhere and the treatment was a bit worrying, hence we asked for her to go to the Marsden. (And yes it is a distance for some people, but if your chances, like poor Paula’s have been reduced by the error or somewhere else, its worth the travel and money for a second chance!)

I think what you need to consider is that there is not a standard treatment in breast cancer - everyone gets an individual treatment plan tailored to their specific case. Yes there are guidelines which the medical profession follow but each case is viewed individually and the plan is specific to the patient.

I understand the niggle cos I felt the same when I was told they were not offering chemo to me … my lymph nodes were negative but I was slightly unusual with my inter-mammory node involvement, the majority vote in my case was node negative so no chemo … basically what they said was that the benefits of chemo were outeighed by the risks involved. I was un-nerved by them taking away my chemo option at the start and did worry about having a higher chance of re-occurrance but then I decided that the oncologists at the Beatson have much more knowledge and experience in dealing with cancer than I have so I decided to trust them.

Obviously no-one can give any of us a guarantee that the cancer will not come back and we all live with the uncertainty but we have to take the treatment that is offered and hope for the best.

I was like Lilac. My lymph nodes were clear, had the dramatic surgery of bilateral mastectomies and my cancer grade was a 2, so it was deemed not necessary for chemo and rads. The cancer was right through the right breast when it came off, but luckily nor in nodes. I was just so grateful not to have chemotherapy. I’d already lost two breasts, I really didn’t want to lose my hair as well, so I was just really happy I didn’t have to have it. It all depend on grades, node involvement and how clear margins are. Like Lilac says there are no guarantees with this disease. By rights you take some sort of adjuvant therapy for five years, and yet people get secondaries years and years later. It is just unfortunately the luck of the drawer.

Julie

Hi, i was given chemo because my tumour was a Grade 3 (more aggressive than other grades) and I was only 38 at dx. I remember the worry I had as a 13 year old when my mum had bc. I try not think of ‘cured’ because cancer can come back. I am NED at the moment (no evidence of disease). My mum is now 74 and NED.

Look after yourself Jules as you are obviously care for your mum a great deal but are a worrier (as we all are with this b***** disease).

Rach xx

Hi

I’ve just had my first chemo 10 days ago. I was dx with 3cms, grade 3 with 3 out of 24 nodes involved. I think it’s the node involvement that determied the chemo treatment. I’m 56. I know 2 other people who have aslo had treament for BC recently. My son’s mother-in-law was nearly 60 when she was diagnosed but no nodes involved and ER +. She had surgery and 5 yrs of Tamoxifen. She has just passed her 5 yrs NED. My colleague was only 38 when diagnosed with an aggressive cancer, no node involvement but chemo, rads + 5 yrs Tamoxifen. She’s back at work and doing very nicely.

Don’t worry. They do what’s necessary.

Mal