Rads before chemo?

Ask our Nurses your questions
1

Why do I not see people offered radiotherapy before chemotherapy AFTER the lumpectomy?

While I wait for my oncotype score to come back, knowing that I’ll be having radiotherapy whatever the outcome, why can’t I start that treatment first?

Then if chemo is needed, that can come after?

I’ve researched online that it’s possible but never read of anyone having that.

Reason for asking:

Had my lumpectomy 2 weeks ago.

Clear margins, but the depth margin was only close (under 0.2mm). 20x13x11mm IDC.

1 cell found in lymph nodes.

Because of the close margin, it was suggested that I have the oncotype test which is a 4 week wait and delay to other treatment.

2

My surgeon told me it was because radiotherapy contracts the tissue, and makes the chemotherapy less effective as it can’t penetrate the cells as well. I’m sure he explained it better than that but that was the jist.

3

Ah, I see. That makes sense.

I thought after surgery it was going to be a linear timeline to radiotherapy and would all be nice and smooth. Now I’m back to a month long waiting game again.

All the waiting is just so frustrating and I’m really impatient!

4

Hi michyb,

Thank you for your post.

It is understandable that while waiting for your oncotype dx result you ask whether it is possible to have radiotherapy before chemotherapy, especially as you have been recommended radiotherapy whatever the oncotype score is.

Waiting for results can be difficult and as you said it’s frustrating and it sounds like you are wanting to get on with further treatment.

Chemotherapy can be recommended depending on the characteristics of an individual’s breast cancer after surgery for primary breast cancer to reduce the risk of the cancer returning or spreading. This aims to reduce local and distant disease recurrence by reducing microscopic disease that could potentially grow and cause disease relapse in the future. Whether you are offered chemotherapy depends on a number of factors including the grade, size and stage of your cancer and tests such as the oncotype dx.

If chemotherapy is needed this is usually given before radiotherapy because it is a systemic treatment (meaning it affects the entire body rather than just one part) and will attack any microscopic cancer cells in any part of the body reducing further risk of breast cancer in other parts of the body. It may help to know radiotherapy only treats the area around the surgery site and reduces the risk of local recurrence.

It would be best for you to get a clear answer to your question by talking with your oncologist as they know your individual case.

Talking to someone who has had a similar experience can often be helpful. Our Someone Like Me service can match you with a trained volunteer who’s had a similar experience to you. You can be in touch with your volunteer by phone or email and they can share their personal experiences to help answer your questions, offer support and listen to how you are feeling.

You can ring the Someone Like Me team on 0800 138 6551 or email them at someone.likeme@breastcancernow.org, so they can then match you to your volunteer.

We offer a range of free supportive services which you may be interested in. They include face to face and online courses and events.

Do call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen, talk things through and signpost you to additional support and information if necessary. Your call will be confidential, and the number is free from UK landlines and all mobile networks.

Our number is 0808 800 6000. If you have hearing or speech difficulties dial 18001 followed by our number and the call will go through Relay UK. Our helpline has access to telephone interpreters if language translation is required.

If you would prefer one of our nurses to call you. Please complete this form ticking the box agreeing to a call back.

Our usual opening hours are Monday to Friday 9am - 4pm and 9am -1pm on Saturday.

Out of hours you can leave a message and we will call you back when we next open.

We’re continually evaluating this service. If you want to provide feedback, please click the link to complete the survey . It should take approximately 10 minutes.

Best wishes,

Helen

Breast Care Nurse

Please read the disclaimer Full details on how we collect and use your data can be found in our Privacy Policy

As we are unable to monitor for further replies, this thread will now be closed. If you have any additional questions or would like to provide feedback, please start a new thread, call our helpline, email us or request a call back.