Sign up Calendar Latest Topics
 
 
 


Reply
  Author   Comment  
MsBliss

Goddess
Registered:
Posts: 103
Reply with quote  #1 
It is standard to do rads after lumpectomy, but some people just don't do it for what ever reason.  Has anyone here passed on rads for any reason?
Indigoblue

Avatar / Picture

Queen Blue Sky & Golden Light
Registered:
Posts: 1,681
Reply with quote  #2 
Hi-ho, Miss Bliss!

I was missing you, and almost posted a "Where's Miss Bliss?"

Almost four years later, I am not perfect, but I am still alive. My dear, very young, compassionate Oncologist expressed to me that he would prescribe the same meds to his own beloved mother had she been diagnosed with my stats. Well, Dr. Blue Eyes captured my heart...and I think I would have taken Arsenic if he had prescribed it.

I saw what Rads. did to both my mom and dad. That was a long time ago. It's not without side-effects, but it does eradicate the insidious, ubiquitous, omnipresent, undetectable, and smaller than what any technical instrument, microscope or telescope, can possibly find. Rads eradicates the invisible cancer ghost...



And why are you thinking of opting out of Rads?

Love,
Indi
MsBliss

Goddess
Registered:
Posts: 103
Reply with quote  #3 
Hi Indi!
Yes, rads is very different now.  It is really a good deal.  But I hesitate.  I am not sure why.  I will probably do it, but I have a nagging doubt which I can't explain.  I really have no excuse and shame on me. 

Quote:
Originally Posted by Indigoblue
Hi-ho, Miss Bliss!

I was missing you, and almost posted a "Where's Miss Bliss?"

Almost four years later, I am not perfect, but I am still alive. My dear, very young, compassionate Oncologist expressed to me that he would prescribe the same meds to his own beloved mother had she been diagnosed with my stats. Well, Dr. Blue Eyes captured my heart...and I think I would have taken Arsenic if he had prescribed it.

I saw what Rads. did to both my mom and dad. That was a long time ago. It's not without side-effects, but it does eradicate the insidious, ubiquitous, omnipresent, undetectable, and smaller than what any technical instrument, microscope or telescope, can possibly find. Rads eradicates the invisible cancer ghost...



And why are you thinking of opting out of Rads?

Love,
Indi
nosurrender

Avatar / Picture

Moderator
Registered:
Posts: 7,476
Reply with quote  #4 
Hi there Ms Bliss!
I have to find the study, but there is one that  has found that doing rads gives you a LONG TERM survival advantage... meaning you would be less likely to get a recurrence from a few years to ten years down the road than if you did not do rads.

I had regular rads the first time and I was pretty burned by them. But that was the TNBC side, and even though they burned the crap out of me, I know that machine was working!

The second time around I had IMRT which is more targeted and causes less damage.

Regular rads is like washing your car with a hose- the water goes everywhere. IMRT is like you put a nozzle on the end of the hose to make the water stream more direct and powerful to get to spot you want to wash away.

If you do rads- go for the more advanced IMRT- it is so much  better!

Hope you are doing well,

love
g


__________________


WE WILL PREVAIL





MsBliss

Goddess
Registered:
Posts: 103
Reply with quote  #5 
Dear G,
Thank you for the heads up about IMRT--I have heard of it, but didn't know it could be applicable to bc....will def check it out!
Thank you plenty!  Hope all is going well for you too!
Much Love,
MsBliss
Quote:
Originally Posted by nosurrender
Hi there Ms Bliss!
I have to find the study, but there is one that  has found that doing rads gives you a LONG TERM survival advantage... meaning you would be less likely to get a recurrence from a few years to ten years down the road than if you did not do rads.

I had regular rads the first time and I was pretty burned by them. But that was the TNBC side, and even though they burned the crap out of me, I know that machine was working!

The second time around I had IMRT which is more targeted and causes less damage.

Regular rads is like washing your car with a hose- the water goes everywhere. IMRT is like you put a nozzle on the end of the hose to make the water stream more direct and powerful to get to spot you want to wash away.

If you do rads- go for the more advanced IMRT- it is so much  better!

Hope you are doing well,

love
g

chemoabi

Avatar / Picture

Angel
Registered:
Posts: 2,320
Reply with quote  #6 
4 years ago I had a bilateral mastectomy and chemo.  My BS said I wouldn't need RADS because of the mastectomies.  When my chemo was over, my ONC mentioned RADS and I ran out of the office never to discuss it with him again. I went home and told my husband "I have had enough."

I think throughout this entire journey that is the biggest mistake that I made.  I do believe that RADS helps with long term survival.  It's too late for me to go back, but being newly diagnosed stage 4 I will encourage everyone to go along with the RADS. 

Stay strong and know there are people here who are willing to help.

Nicki

__________________
NuttyNickiNurse
MsBliss

Goddess
Registered:
Posts: 103
Reply with quote  #7 
I'm not sure, do you mean that you refused rads and now have some regret over that choice?  Did you get a recurrence after your primary treatment?

I met with a surgeon who admitted he was against rads for small tumor, neg node,  early stagers.  He felt that he had seen too many patients who did rads and had recurrence--often in the same area, and they were devastated by the lack of options for recon with radiated tissue.  He said he favored nipple sparing mx, to operate while you have no obvious disease and it leaves you in more control.  He referred me to another onc surgeon who would do this as he was the plastic surgeon.  She said it was over kill to do such a surgery and to revisit my rad onc.  My point is, no one knows what is best.  Only you know what is best and you have to listen to your gut after you gather all the info you can.

Quote:
Originally Posted by chemoabi
4 years ago I had a bilateral mastectomy and chemo.  My BS said I wouldn't need RADS because of the mastectomies.  When my chemo was over, my ONC mentioned RADS and I ran out of the office never to discuss it with him again. I went home and told my husband "I have had enough."

I think throughout this entire journey that is the biggest mistake that I made.  I do believe that RADS helps with long term survival.  It's too late for me to go back, but being newly diagnosed stage 4 I will encourage everyone to go along with the RADS. 

Stay strong and know there are people here who are willing to help.

Nicki
ChrissieD

Goddess
Registered:
Posts: 154
Reply with quote  #8 

I originally had a lumpectomy and intended to do rads.  Half way through chemo and a bit lopsided (I was barely a B cup and there is nothing lump about a lumpectomy at that size...) I opted to go back and have a bilateral mastectomy and because of that I did not get rads.  I was stage 1 with no nodes, no vascular invasion, medullary like features. 

MsBliss

Goddess
Registered:
Posts: 103
Reply with quote  #9 
How are you doing now? 

Your description sounds almost exactly like mine--stage 1, grade 3, no nodes, no lymphvascular.  Do you know the actual size of your tumor(s)? 

I have not been able to correspond with too many of my triple negative sisters who had medullary features.  There are not too many with this diagnosis.  I would love to know more about your diagnosis.  Do you know what specific medullary features you had?  I had dense lymphocytes, synctial growth, pushing borders, good circumscription--but it didn't matter.  Every onc wanted to do chemo.  They said medullary or not, hit this thing hard.   But now it matters a great deal to me because I couldn't do chemo.

I had a lumpectomy too, with sentinel node.  I couldn't do chemo because of health problems and now my rads have been delayed because of some false positive symptoms and labs, one after the other.  They thankfully turned out to be nothing.  The rad onc told me that I have lost most of the benefit of rads at this point, 7 months post op, and so I have to decide if it is worth it.

Quote:
Originally Posted by ChrissieD

I originally had a lumpectomy and intended to do rads.  Half way through chemo and a bit lopsided (I was barely a B cup and there is nothing lump about a lumpectomy at that size...) I opted to go back and have a bilateral mastectomy and because of that I did not get rads.  I was stage 1 with no nodes, no vascular invasion, medullary like features. 

bjoangtx

Avatar / Picture

Seeker
Registered:
Posts: 26
Reply with quote  #10 
I had radiation following a bi-lat mastectomy and neoadjuvant TAC x 6. I did not want radiation and I wish I had insisted on it. I found radiation much more emotionally, physically and financially draining than chemo. I was stage 2 grade 3 1 node EGFR pos, Ki67 85%. My sister is is starting treatment for TNBC stage 1 grade 3 p53 pos Ki67 55% 0 nodes. I wanted to know if anyone here has had experience with dose dense radiation. 2 x a day for 2-3 weeks instead of 6-7. Any information you all have would be much appreciated.
__________________
Joan G
edge

Chief of Research
Registered:
Posts: 1,128
Reply with quote  #11 

Joan:


What you're after is what's called hypofractionated radiation therapy (h-RT): this consists of a collection of radiotherapy techniques that deliver higher daily doses of radiation over a shorter period of time compared with whole breast irradiation (WBI), a kind of dose-intense approach. One form is hypofractionated whole breast irradiation (h-WBI), where the treatment may be reduced from 5 to 7 weeks down to 3 to 4 weeks.  An even more intense, more accelerated form is known as accelerated partial breast irradiation (APBI) and this is given in just 1 week, via using treatment to the tumor bed not to the whole breast, plus a small margin (generally 1–2 cm). Several studies demonstrate equivalent local control, minimal acute toxicity, and more convenience with these approaches for carefully selected patients.

 

The exact way to deliver APBI varies with techniques like brachytherapy, external-beam radiotherapy (EBRT), and intraoperative radiotherapy (IORT), but what's more important than the various delivery methods is patient selection.   The American Society for Therapeutic Radiology and Oncology (ASTRO) defines  the criteria and characteristics of patients that are candidates for APBI, and who are unsuitable. According to his ASTRO governing consensus, APBI is unsuitable in this cases:


Exclusionary Criteria for APBI

  • age <50
  • larger tumors > 3cm
  • DCIS
  • extensive lymphvascular invasion
  • positive surgical margins
  • node-positive disease
  • BRCA-positive disease
  • any preceding neoadjuvant CT
And although the efficacy of APBI has yet to be validated in prospective comparative trials, and limited long-term data exist for the more than 50,000 women in the US who have been treated with various forms of APBI, still we have robust if not completely dispositive data of efficacy and safety, out to 10 - 12 years, so until the  results of some prospective trials are reported, we can assumed on the accumulated evidence to date the non-inferiority of APBI compared to whole breast irradiation.

But the greatest practical impact is of these exclusionary criteria, since many patients will fail to qualify under such rigorous requirements.


Constantine Kaniklidis

Breast Cancer Watch

edge@evidencewatch.com


Previous Topic | Next Topic
Print
Reply

Quick Navigation:

Easily create a Forum Website with Website Toolbox.