Breast Cancer India
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Delay in Radiation Therapy

My mom (70 yrs old) had carcinoma left breast and underwent bcs in April this yr, T2N0M0,stage IIA, ER/PR - negative and Her2 positive. She underwent 6 cycles of TCH and will continue with the targeted therapy Herceptin for 17 cycles. She tolerated the chemo pretty well but the surgical wound had not healed well and we started seeing puss discharge from the 5th chemo cycle. Looks like the wound had not healed completely before we started the chemo and once the chemo began it did not heal. Also when we transitioned from the surgical to the medical oncologist for the chemo after surgery we ended changing the hospitals - as our criteria for chemo was a place closer to home. She underwent a flap reconstruction and suturing of the surgical wound after completing the chemo. We were supposed to start the radiation therapy for a month, but obviously cannot until the wound heals. I want to know what kind of gap is acceptable between completion of chemo and start of radiation therapy. The expectation now is to wait for a couple of weeks more and check on the wound resulting in more than a month gap between end of chemo and possible start of radiation.

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When was the last chemo?

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Last chemo was on 28th Aug.

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Let the wound heal and then go for radiation. Such delays are beyond our control. Luckily your mother is very much in an early stage. So don’t worry. Just follow your team and start radiation when they tell you to.

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Thank you Dr. Sumeet for your advise. Its concurs with what the medical oncologist as told us.

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Hi Kiran,

Can I please ask you where is your mother taking chemo and further treatment and was changing the hospital and doctors convenient or not? My mother was also diagnosed with exactly the same condition as your mother’s but we have only had her surgeries done as of now and we are still awaiting Doctor’s advise on chemo and further treatment. But we are thinking if we should take multiple opinions from other doctors and different hospitals.

Thanks in advance. I wish your mother a speedy recovery.

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Hi Neha - We are based out of Blore and moved to Manipal hospitals for the chemotherapy. Looking back, we are happy we made the decision to change the hospital to a place closer home for chemo as it requires multiple visits for blood tests etc and any emergency reactions. The last thing we wanted was to be stuck in road traffic for more than hour during this process. Though we liked the Dr - the surgical oncologist, who advised us initially and addressed a lot of our initial queries, the hospital was in the other end of the city. Once we realised that a transition needed to made to a medical oncologist we did go for multiple opinions . Also we initially thought that chemo might not be required (as nodes were negative). But once the post-surgical biopsy report confirmed her ER/PR status as negative, we were advised chemotherapy and reconfirmed this course of treatment with a couple of other medical oncologists, before narrowing down an option. The learning for us from my mother's experience with her surgical wound not healing has been that we should have taken an opinion from a surgical oncologist in the new hospital as well before beginning the chemotherapy.

Thank you for the wishes and wish the same for your mom.

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Thanks again Kiran for taking the time to reply.

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