Stage 2 breast cancer - some doubts in my mind

[Ccmenon]

My mother ages 67 years was recently diagnosed with stage 2A breast cancer in the left breast after a lumpectomy.. there was also metastasis to 3 out of 6 lymph nodes studied. She has undergone a radical modified mastectomyincluidng removal of all the lymph nodes in the area. The doctors say she will have to go in for chemo and radiation. Is it preventive or curative? What are the options - tablet or intravenous? Will she regain her health after all this.

[sumeet_shah Administrator]

If three nodes are positive, this will be stage 2B.

She will need both Chemo and radiation.

Our aim is definitely curative.

This is infra venous chemotherapy. You may consider PORT insertion. Ask your doctor for details about same.

She will definitely regain health, don't worry.

Just go ahead and do what your Oncologists tell you to.

[Ccmenon in reply to sumeet_shah]

Thank you for your kind reply. I think they have put us as stage 2A because the turnouts are less than 1 cm in size. However the lymph nodes have been affected so is that the reason it is 2b? Any advantage of port insertion? Taking tablets is not an option then? We fully trust our doctors but so worried and want the best possible recovery for her.

[sumeet_shah Administrator in reply to Ccmenon]

I understand your situation. Don't worry.

The above questions have been asked umpteen number of times on this board I request you to please see the sections on PORT and chemotherapy and read through them. It will be of help to you.

The best person to ask all above questions is your Oncologist. Talk to him in details. I am sure they will help you out.

Also ask your Oncologist to explain to you the staging. So your doubts are clear.

[kaarenorgaard in reply to sumeet_shah]

Stage 2A includes the option that up to 3 lymph nodes are positive:

breastcancer.org/treatment/...

[roxboxfox RadiationOncologist]

Sorry to know that your mother has Stage IIB Breast cancer.

This is still cureable.

In view of 3/6 Lymph nodes being positive she is indeed at high risk of relapse if nothing further was done.

As rightly mentioned by Dr Sumeet, your mom would need Adjuvant Chemotherapy and Adjuvant Radiation as the minimum to further reduce the risk of cancer.

If she is Her 2 positive, Herceptin for x 1 year is also recommended.

And if she is ER/PR positive, Hormone Therapy for at least 5 years will also be helpful.

You seem to be on the right track so far so just continue with your Oncologists advice

All the Best

Dr Rohit Malde

[Ccmenon in reply to roxboxfox]

Thank you doctor. Very nervous about the adverse side effects of chemo such as heart damage, bone weakening etc. Right now she looks so normal and fine, its hard to tell what is inside. Feel like we are writing off health once the chemo starts. Also, there's not much information online on what the experiences are with Chemo for a woman of her age. The fact that the tumour was only 0.4 cm but still reached lymph nodes may be the reason they feel she requires aggressive treatment like Chemo. Do you think so doctor? HER ER/PR status we will know in a few days as mastectomy was just completed. Wish that someone would say she is going to be 100% OK.

[Richa25]

Mr Menon...please dont be scared of anything....it is at a very curable stage and side effects might or not happen....we are all there to support and share our experience

Much regards and best wishes

[Ccmenon in reply to Richa25]

Thank you Richa... So thankful for this group even though I have just joined. I have left my 4 year old daughter and husband in NYC and taking care 24/7 of my mother and want to make her get well and stay well for a long happy life. Sometimes, reading information is of no help but a human connection makes the pain much less.

[Delhiresident]

I also had Breast cancer stage 2a in the right breast last year.My tumour was almost 3 cm but lymph nodes were not affected. My Doctors suggested lumpectomy followed by aggressive chemo and radiation. I went through it all and currently I am on hormone therapy. I can say from experience that it is curable and suggest that your mother should go through the complete protocol for the best outcome. I feel much better and feel completely normal now and actually feel physically fitter now because I have been doing exercises like yoga, walking, meditation religiously every day.

Ask your mom to have faith in her doctors and keep a positive outlook. As a care giver, keep her surrounding cheerful and she will be fine and will come out of it completely cured and healthy.

[Ccmenon in reply to Delhiresident]

Thank you for sharing your experience! So happy to hear your outcome. Very reassuring. Would you be willing to tell me more about what the chemotherapy was like for you and what the hormone therapy is like.

[Delhiresident in reply to Ccmenon]

Hormone Therapy is for those with ER/PR positive diagnosis. You have to take one tablet a day prescribed by your doctor for a period of 5 to 7 yrs post treatment. Also you should go for periodic checkups say once in every 3 months for the first 2 yrs and once every 6 months after that.

As for chemotherapy, each person respond to the chemo treatment differently and it is difficult to generalize. Chemo is a combination of drugs given intravenously. Best to have chemoport otherwise you can damage your veins. However some of the common side-effects of chemo are hair loss, taste changes, fatigue and tiredness in the week following the chemo. This is because the drugs not only affect the cancerous cells of the body but also healthy cells. These side-effects will go after you complete all chemo cycles.

[Pakhare in reply to Delhiresident]

Similar case is with my wife. Tumor 3.0CM, no node involvement, her2±, ER ±, placlitaxel chemo completed in July 2018, Herceptin completed in April 2019. But still tingling and numbness prevail in legs. Is this remains or in how many days it will subside. What is your experience.

[SiaK]

My mom was also diagnosed with tumor in left breast. She had to undergo 4 cycles of major chemos followed by 12 minor weekly chemos and now 2 weeks back she had her surgery. I have come down from California to be with her. Just don't wry and u will have to be very very patient with evrything. Just think positive and always talk positive with your mom. Positivity is the key to fight against it.

[Ccmenon in reply to SiaK]

Thanks for your reply! I would like to know more about her experience with the chemo, how the cycles work etc if you don't mind. Is there a way I can email you? Wishing your mother a speedy recovery.

[Sango]

Hi there , Your mom is not alone . Umpteen no of people are going through the same and do come out cancer free . Im currently undergoing chemo too 5th cycle over and from my personal experience its different for everybody. Few suggestions would be :

1) Get a chemo port inserted after discussing the benefits with the Docs as its hardly palpable and will prevent surrounding cells from burning.She wont feel any pain too.

2) Hairloss is the prominent side effect - hence suggest to get the hair trimmed prior as it saves from the impact of losing hair in clumps which is not a very pleasant sight. You could shop for a wig after the head shave which fits her best.

3) Taste changes are common in the initial days after therapy. Im on a complete neutropenic diet probably wil be the same for your mom too.This is the avoid infection from raw foods. Encourage her to eat and one needs to cook keeping in mind her taste preferences. Fluid intake has to be increased.

Be positive detox 3 days before and after chemo and would recommend turmeric , garlic and vit D in the diet, Eating healthily avoid sugars and have Korea of stir fry veg and fruit smoothies (pl take Docs suggestion too) . Take care the journey will be calm if you remain positive .

4) If she feels healthy slight excercise - even a walk in the park or maybe few breathing exercised - Pranayams realy work.

It is very important to keep a positive attitude and ensure to surround her with people who can boost her morale. I can send love and hugs your way, if you have any questions, don't sit worrying, post it, I'm sure someone on this forum will have an answer for you

Sango

[kaarenorgaard]

If it is stage 2A, then the cancer tumor is less than 2 cm with some positive lymph nodes, and no remote metastases are recorded (only in the lymph nodes).

Radiation is necessary in the under arm, because lymph node positivity requires it. There may be other cancer cells in the area, which will get killed by the radiation.

Furthermore, if the breast is partially conserved (lumpectomy, no full mastectomy), then radio therapy is done to the breast as well. There may be cancer cells in the vicinity that have to get killed.

The chemo cure is to kill any cells in other parts of the body. But here it is interesting to know, is the cancer hormone receptor positive (HR+: either estrogen receptor positive - ER+ - or progesterone receptor positive - PR+?

If so, in e.g. the UK they would test whether chemo therapy is necessary, or whether the anti-hormone medicine devised for HR+ can do the job alone of killing any cancer cells in other places of the body.

If it is hormone receptor positive, do read this link, which is valid in the UK:

breast-cancer.oncotypedx.co...

and then we can make it cheaper together with your hospital, because the test is USD 4,000 and might not be covered. by insurance.

It is also important to know if it is HER2 positive. If so, your mother may need Herceptine (but only in the 18% likelihood of HER2+).

Generally, the chemo therapy is needed (unless if HR+ and the test shows it is not necessary).

The radiation and the medicine (depending on the receptor positivity, which I hope you will share) are all needed, but due to these procedures, the mortality of breast cancer has gone dramatically down, so your mother will most probably be fine, surely in the short run.

You can use our site for free and anonymously and key in data and retrieve the appropriate treatment plan and the outlook or prognosis - or tell me, and I can do it...

CureGPS.org

Best wishes

Kaare (in Denmark)

[kaarenorgaard in reply to kaarenorgaard]

I now read all the other replies. It is very important to know that breast cancer is not one disease, it is often said that every disease is different. So it is dangerous to infer decisions from other diseases regarding choice of chemo therapy, if they were very different (like no lymph nodes involved, and hormone receptor positive, if the disease of your mom isn't).

In breast cancer the stage is not very important for treatment decisions, like in other cancers.

If it is hormone receptor positive, do conduct a gene test (genomic test) to tell if chemo is necessary. Because you are right, it is mostly a pain to go through, and it deteriorates the health in general.

But if this test tells you to use chemo therapy, or if it is hormone receptor negative (or HER2 positive, but the test will capture that) - then you must go through chemo therapy. It saves lives in all of these situations.

It is not important how you get the medication.

If it is HER2+, and they add Herceptin to the chemo therapy, then be sure to check that they monitor the heart strength during that year of treatment. The so-called LVEF measurement. If she has other heart problems, you may also choose to omit Herceptin.

Be ready to send the data immediately after the surgery - and I will be ready to help. I would like to be in contact with oncologists, if you want.