A close relative of mine has undergone a Lumpectomy of her breast and the biopsy reveals that it is a Infiltrating Ductal Carcinoma - Grade II of II and Axillary Lymph Node Metastasis (32/39) (pT2; pN3a). All resection margins are free of malignancy. She is really petrified to undergo any kind of Chemotherapy. Can she be treated with only hormone therapy and radiation therapy to prevent any future recurrence? I would really appreciate it if Dr. Sumeet Shah or some equally qualified Doctor in this group could give me some words of advise which I can pass on to her.
Thanks a Ton in Advance.
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Krishbengaluru
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Oh Ok. She is really petrified about undergoing Chemotherapy. After how many days after the lumpectomy, is this treatment usually started. Can it wait for at least 8-10 weeks? I have been reading that only radiation therapy may suffice. Is this true? Can chemotherapy be given after radiation, if the radiation treatment is inadequate?
Thank you so very much for your prompt advice Dr's. I will do as you advise, take her to meet up with the Oncologist and do as he advises. The other results like ER, HER2 etc are still awaited.
Chemo is a must for her. Tell her not to listen to people. Let her come to this forum and see so many people have undergone chemo. Or ask her Oncologist if he could introduce her to a few of his earlier patients who have finished chemo. She will get motivated once she meets them. Just give her a positive vibe. She will come out on her own.
Thank you once again for your reassuring words Dr. She is so disturbed and scared, that I am having a lot of difficulty in convincing her to just follow the doctors advise and get completely cured as quickly as possible. My final query with you was whether she can defer her chemo treatment by a few weeks? There is a wedding in the family, and it is being held during Jan-Feb of next year, and this is one of the reasons why she is totally depressed. She does not mind undergoing radiation therapy first and then the chemotherapy after the wedding.
Sorry, that can’t be done. For a person who has so many nodes positive in the armpit, it is not at all advisable to wait. Ideal time for chemo to start is around 3rd to 4th week from day of surgery. Ask her to undergo a PORT insertion. You Oncologist will give you more details.
She can still attend the wedding. Except, that there will be some hair loss. But she still can.
Thanks for your prompt advise once again Dr. I will have to somehow convince her to start off with her treatment ASAP. She is already very tensed, and this news will make her even more depressed. Don't know how we will cope with her till she completes her full treatment.
Some friends were suggesting that US Hospitals like Mayo Clinic and John Hopkins have very advance treatment techniques, with very little side effects, is that true Dr.?
Even I am hoping that there is no spread also Dr. Thank you for your advice. We will be starting the treatment as soon as all the reports come in and after her surgical wounds fully heal, as advised by the oncologist here.
Reading your messages, I come to know that she is worried about her hair falling after chemotherapy. That's just a temporary problem sir. Prioritise things. God will take care of the rest.
Hello Ms. Madhumathi, Thank you very much for your reassuring words. We are meeting the Oncologist as soon as the ER/PR and HER2 reports come. I only hope and pray that he minimises the number of Chemo sessions she may have to undergo.
Hi, I agree with your suggestion, but wig will easily be noticed, and what about the eyebrows and eye lashes? These were the questions she asked when we suggested to her about this temporary alternative she may have to mange with.
Hello! My mother is also a cancer survivor. She had same case. I think chemotherapy is necessary but radiotherapy is only can be opted if margin is free from carcinoma cells.
But, you should follow the instructions of a expert oncologist. Please, go to TATA memorial Hospital If it is possible.
Hello Ms. Reetika, Thank you for your suggestion. I was planning to take an opinion from TATA Institute of Fundamental Research, after meeting the Oncologist at Bangalore anyway. Really appreciate your sharing your thoughts and advising me to take the right decisions. In fact each and everyone of you who have taken the trouble to guide me during this very traumatic time........ A Big Heartfelt Thank You.
Hi krishbengluru please stay strong and positive find a good oncologist start the chemo asap I.e asa the drain inserted broke clear of fluid followed by RT subsequent treatment will depend on the markers I wish you the best have faith in your oncologist
The biopsy reports have come in and they do not look very good. I had asked for an opinion from Dr. Anita Borges who is supposed to be a world renowned Pathologist in SRL Laboratories Mumbai. The results are:
Invasive Ductal Carcinoma Grade 3 with Axillary Lymph Node Metastasis (26/31) ( Earlier report from SRL B'lore was Grade 2 of 3 with Axillary Lymph Node Metastasis 32/39).
ER - Strongly Positive 90% of Tumour
PR - Strongly Positive 3% of Tumour
c erB2** - Score 2
The results have really disturbed us all, and we're all extremely anxious about how to ensure that she gets through the treatment without any setbacks. I have a few questions to ask the doctors here to guide me on the right course, as you have so patiently done for so many of us with so many scary fears affecting us to think properly.
1) The Oncologist here has advised chemo (6-7 sessions), radiation therapy (5-6 weeks) and hormone therapy. Dr. Sumeet Shah had also advised the same sequence of treatment.
2) Since she is really petrified and traumatised to undergo Chemotherapy, the Dr. said that maybe she can take the radiation therapy first and then undergo the chemo later. Can she do this? Are there any adverse repercussions to this method of treatment?
3) One of the primary reasons she is so scared of chemotherapy, is the side effects of complete hair loss, nausea, mouth sores, etc. I have read somewhere in these posts, someone mentioning that since their mother was worried about hair loss, the doctor changed the medication, and she did not have any hair loss while undergoing chemotherapy. Are they any advanced chemo medicines without such side effects, anywhere in the world?
3) What is the success rate of complete cure after her treatment?
4) Which hospital is the best for taking this treatment in?
5) How about immunotherapy? I have been reading that this is a more effective way to treat cancers, with a lot of advancements made in the past few years. How effective is it? Can chemo be avoided if she takes up immunotherapy? Since the ER and PR are positive, she will be anyway put on hormone therapy.
I would be really thankful if I get some clear and frank answers. I have found a lot of comfort and support from everyone who have taken the trouble to clear so many of my doubts. I will always be grateful for this. The whole family is completely devastated and we are unable to think clearly on how to go about getting her out of her misery as quickly as possible.
Http://breastcancer.org is a good site for information, as well as what's new and promising. Some of the newer drugs are only available to drug trial participants. CURE magazine, which can be read on line, also has some good information.
For appearance issues have her go to lookgoodfeelbetter.org The site has a lot of good information about makeup, dealing with hair loss and wigs, etc. A good wig, whether synthetic or made with real hair will not be obvious. Now is the time to look, before she needs one.
The worst part of chemotherapy is thinking about it and the longest 5 minutes of her life will be the five minutes before her first infusion. Things will fall into a pattern after that. There are many options for treating side effects. If one doesn't work, ask about changing to something else. Putting it off until later would be harder for me than just getting it over with.
Hello @pkenn, thank you so much for sharing your thoughts and giving this very good advice on how to deal with the problem of convincing. I really appreciate your concern.
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