Shoulld I have Chemo?

Hi
I was diagnosised just before christmas with grade 2 breast cancer. I had a lumpectomy with clear margins. I had 5 lymph nodes removed for sampling which have come back negitive. HER2 is negitive and ER+.
I need to meet with the oncologist next week but after speaking to the consultant/surgeon today and the macmillian nurse I will definitly need radiotherapy and Tamoxifen. Chemotherapy is boredline as it will only reduce the chance of it coming back by 2.5% I guess after speaking to the oncologist I might be more informed.
It looks like I might have to make this decision. Has anyone else been in this postion?

Hiya
I was diagnosed in sept grade 2 10mm no lymph involvement or vascular invasion er+ her- I didn’t get given the choice of chemo but was told I didn’t need it. Not everyone who’s younger has to have it as sometimes the risks outweigh the benefits.
Just wanted to reassure you that if they do say u don’t need it your not the only one xxx

Hi, I was the same, 9mm, grade 2 er+ no nodes, on tamoxifen and about to start rads. Oncologist told me years ago everyone got chemo but nowadays that doesn’t happen. I put my trust in them, good luck xx

Thanks guys
I hope i’ll be told the same on Tuesday. Hope your treatments are going well. I’m not looing forward to the side effects from Tamoxifen, early menopause at 38 is scary. xx

Hi Em
Just to add reassurance I’m also in a similar situation. I’m 44, DX’d in November with Grade 2 IDC in right, DCIS in left. Lumpectomy, no node involvment, ER+.

Chemo was raised by Onc initially but after reviewing the stats like recurrance rates vs chemo side effects I decided to follow the Onc advice and not have chemo. I started tamoxifen a week ago (not killed anyone yet nor had a flush;-) and I start radiotherapy on Monday.

I’m comfortable I made the right decision based on facts & stats, advice from specialists and good old gut feel. Whatever you decide try to be at peace with the choice…we dont need to give ourselves anymore ‘demon head-gremlins’ to deal with. Good luck and take your time time to decide…Zax xx

Hi em,

I was in exactly the same position. After reviewing the stats and a disucssion with the oncologist I decided not to have the Chemo.

I also started Tamoxifen last week with no side effects and start Rad on the 6th Feb.

It is a bit frightening having to make the choice, but do whatever feels right for you…then as Zax says don’t beat yourself up over it.

Lynda

Thank you all for your posts. I also had the same advice from the oncologist about chemo. So I will have 4 weeks of radiotherapy and Tamoxifen for 5 years. It is such a relief however I feel I’m getting off lightly in comparison to those who will have chemo. I’m not sure why i have this feeling of guilt almost. Does anyone feel the same? In saying that I am feeling better these days emotionally and feel i’m getting back to my life, which sometimes feels weird too as if I don’t want to forget. I will start radiotherapy in a few weeks so that will probably be a reminder. Starting Tamoxifen next week too. Best of luck to you all on your journey beyond cancer x

Hi Em
I know exactly what you mean about feeling like we’ve gotten off lightly because we are not having chemo. And I have an over-active guilt gland!!

Without a doubt chemo is a tougher longer harder journey to make and I won’t insult anyone who finds themselves on that road by saying I can come close to understanding what it is like but we all started in the same place; your 4am darkest lonely moments are no less traumatic than anyone else. As someone else said on a post a while ago ‘there is no pecking order with BC’.

I started tamoxifen 2 weeks or so ago and started rads on Wednesday so just about a month ahead of you. All going well so far although I did have an emotional wobbly the first day of rads but as you have already anticipated that was because for a while I could pretend it wasn’t really happening. For me life is currently being managed in bite sized chunks until active treatment is finished and then it’s slowly back to a new-normal life. PM me if you have any questions about rads or tamoxifen or check the rads part of the forum. Keep strong…Zax

Hi Em

Unlike the other ladies I was also given the choice I’m Grade 2 Her 2+ no node involvement had right mx but I decided to go with chemo then herceptin and tamoxifen no rads needed. I had my last chemo at the begining of Jan it was hard but doable I’ve just had my first herceptin and started on tamoxifen and so far so good. the reason I decided to go along this route was If in a few years it came back I wouldn’t be saying “the what ifs” I decided to throw anything offered at this horrible disease.

But the decision must be yours good luck with whatever you decide.

Sue xx

Hi Em - I had exactly the same dx as you - 16 years ago. Unfortunately 16 years later I have a recurrence and had mx in November and about to start a 9 week chemo course. Again, I was borderline and given a 3%-5% improvement percentage but onco told me that if what had happened 16 years ago was happening now, then I would’ve been given chemo - the opposite of what your onco said! So who knows!

Totally your decision of course and I think I have just been one of the unlucky ones.

Don’t worry too much about Tamoxifen - I had no probs and it certainly didn’t bring on menopause (I was 43).

XX

My onc only recommends chemo if there is a benefit of 3% or more other wise the risks outweigh the benefits.

Jan after 16 years even if you had chemo it’s still possible you would have had your recurrence anyway.

I had a grade 1 stage 1 tumour in 2006 and didn’t have chemo… But then got a new primary unrelated to that cancer in 2009 so even if I had chemo for the first one it wouldn’t have prevented me getting the second cancer… And having chemo for that tumour in 2009 didn’t stop me getting a recurrence in 2011.

There are no guarantees with BC unfortunately.

Grade 1 and 2 tumours do not respond to chemo as well as grade 3s too.

Take care

Thanks for your posts. I feel i have made the right decision given the information the oncologist gave me and his professional opinion. I think for me to choose to have chemo would be treating my fear.
And there is a lot of that but I hope with each day that will get less.I started the Tamoxifen today and have my first appointment for radiotherapy screening next week. I just want to get things started now. Good luck everyone x

I also have a grade 2 (with node involvment) and a relative of my husband who is a GP said to me chemo works best with aggressive cancer (we were speaking about a cousin who had a very aggressive from of Lymphoma eight years ago, she was in her 20’ties. She recovered well from this cancer and is fit and healthy now.) I was not given the option of having chemo or not, it’s probably soooo bad they need to throw everything at me :frowning: (3 FEC, 3 Tax, MX, Rads, Herceptin, Tamoxifen). Well, that’s my conclusion. Now I wonder if it only increases my chances by 3-5 %, is it worth it in the end? I thought chemo would do a lot more for me than that.

All rather sad,

Christine xx

Christine - you can ask your onc (or look yourself, but think carefully before doing so!) for your prognosis benefit stats for having chemo. My tumour was grade 2 and my prognosis was increased by 15% by having chemo. But I’d have done it for way less than that…

Sandytoes I haven’t asked for any stats and prognosis. Although I’m quite happy to look at the whole picture of this disease I kind of shy away from numbers. What if they tell me my 10 year survival rate is at about 30-60%? I don’t know if I would want to know that as I’m naturally a pesimistic person, thinking I’m realistic, but it’s probably pessimistic LOL.

Encouraging to know they told you 15%, that’s rather good then, eh?

On a good note I went for my pre chemo clinic app this am and they said they are very happy and ecouraged how the tumour has responded to the 3 FEC’s. I had a mammogram and ultrasound two weeks ago and although it was 7.5cm x 5cm to start with it is now not meassurable anymore! i was asking her regards the grade 2 and not respondin to chemo so well as grade 3 and she said they don’t get too hang up about that at the beginning, it’s more to do with long term prognosis.

Christine xx

Christine I input some of your stats into the nhs predict and lifeath BC tools and you would get a 20% benefit from chemo and survival of about 80% at 10 years… I hope that is better figure than you were worrying about.

As for grade 2 not responding so well to chemo… Her2 tumours respond well to chemo and with positive nodes it reduces your risk of spread to other parts of your body.

Lulu xxxx

Hi

My Onc went on the adjuvant online website with me at my appt yesterday. Without chemo there’s a 20% chance of recurrence in 10 years but with it the percentage drops to 10% so well worth it in my case. I thought the improvement was just a few percent but was barking up the wrong tree so it was a bit of a shock when he gave me those stats differences. Didn’t want chemo again but I’m having it! If it was only an improvement of a couple of percent then it would be a different discussion. Thinking about it now I’m glad to have this ‘mopping up’ after surgery as they said my tumour was actually in bits when it was removed do who knows what ‘got away’. I was upset yesterday but sense prevails today and back in my fighting spirit!

Twinky x

Thanks Lulu XXXX