Best Of
Re: Older Women Treated With Hormone Therapy May Not Need Radiation
Hi Elem:
With hormone receptor-positive disease (ER+ and/or PR+), when you meet with the medical oncologist, you will probably discuss "endocrine therapy" (e.g., tamoxifen or an aromatase inhibitor ("AI")). These drugs are in "pill" form.
Be sure to ask the medical oncologist about the HER2 status. HER2-positive disease is treated quite differently from HER2-negative disease, so this result is critical information with respect to chemotherapy and HER2-targeted therapy.
If you have not already done so, be sure to obtain copies of the pathology reports from all biopsies and surgeries, along with any addenda or supplements with ER, PR and HER2 test results for your review and records. It is best practice to confirm the information you receive with the underlying documents (with your name and actual results).
As far as radiation and the original post in this thread, I think that this is the related news feature (dated May 18, 2015). The Moderators should have included a link to it in their post.
Feature: http://www.breastcancer.org/research-news/some-treated-w-hormonal-tx-may-not-need-rads
Liu (2015) Study Publication: http://ascopubs.org/doi/full/10.1200/JCO.2014.57.7999
Bellon (2015) comment: http://ascopubs.org/doi/full/10.1200/JCO.2015.61.2069
The title of the feature is rather misleading, and the study had significant limitations. As a result, this study was not seen as a practice changing study. Further research to substantiate or validate the findings is needed before it is implemented in the clinic, as noted by the authors:
"However, omitting RT and using intrinsic subtyping and clinical factors is a substantial change in care. The breast cancer community would likely require additional prospective evidence before this becomes standard of practice. To validate this observation, a prospective, single-arm clinical trial open to women age 55 years or older with pT1N0 grade 1 to 2 luminal A breast cancer has begun in Canada. . .
. . .Further studies may validate the exploratory finding of a low-risk group of postmenopausal women with early-stage luminal A breast cancer group who may be spared the inconvenience and adverse effects of breast RT."
Other clinical trials regarding the omission of radiation therapy in older patients have used higher age cut-offs (e.g., PRIME II, age 65 or older; CALGB 9343, ≥ 70 years).
As of this date, the National Comprehensive Cancer Network (NCCN) guidelines (Version 2.2016) provide that breast radiation therapy may be omitted in select patients ≥70 y of age with estrogen-receptor positive, clinically node-negative, T1 tumors who receive adjuvant endocrine therapy (category 1). Patients should seek case-specific, expert professional advice from a Radiation Oncologist to understand whether this is a reasonable option for them.
In any event, when you meet with the Radiation Oncologist, do not hesitate to request a personalized risk benefit analysis. Inquire what clinical and pathologic factors weigh in favor of radiation therapy in your specific case. Ask about your estimated risk of local recurrence, and the estimated absolute risk reduction benefit you would receive from any particular course, which must be weighed against the risks. With some lower risk disease, shorter courses may be an option.
BarredOwl
Re: My Husband, My Life, My Love, My Family, My Cancer
Ah @mara51506 I wish I could give you a big hug. It darn well hurts with the lack of family support, even with a phone call initiated by them. I think we all should have nurse navigator to handle those questions. We should not have to guess, suppose, or fret over proper instructions. If portals are suppose to be the answer, well I beg to differ. It took a week to get a response last time I used it and that was only after I posted the second time.
Our weather is going to plummet from 79 to 29 withing 24hrs! DH says he might have to wear a t-shirt. lol.
Best wishes to all for good scans, stable "Mabels" (borrowed that from a prior breastcancer member) and warmer weather.
Re: Can we have a forum for "older" people with bc?
Teka, it is a tie!! We also had snow last night.
I haven't gotten much done today. However, it is Sunday.
I left a book-club several years ago because of relationship problems with another member. I had a talk with that person a week ago. I understand my part in the difficulty, and I am interested in returning. I don't know, but something is happening. A wait and see kind of thing.
I am getting a bit more lax with my rehab exercises, but I will still get my five sessions for today. A nap and Mass got things out of kilter for the 10, 12, 2, 4, and 6 schedule. I want to get at least half an hour resting between sessions. Oh, what problems!
mcbaker
Re: Who's starting Radiation in November 2025? Let's gather here to share!
Hi everyone, I am going to be started full breast radiation everyday for 4 weeks and I have some questions. I am hearing difference stories about being able to be around kids during my radiation or having to take time out of work and I didn't know if anyone has gone through the same and knew if any of that is true and maybe help guide me on what to expect.
I do plan on asking my doctor when I see her for my Stem visit on 11/20 but I didn't know if anyone here could help me on what to expect.
Thank you!
Re: My Husband, My Life, My Love, My Family, My Cancer
@irishlove Glad you go assistance with your meds and of course they need to get your charts corrected as a necessary medicine could be withheld with that diabetes notice thinking there would be interaction to a non existant med,. Hope that clears up for you soon.
I slept well but felt sad to the point of tears on not seeing family. I realize there is a lot they are dealing with and that I took them off the hook for groceries given Paratransit or delivery would take care of it. Decided will phone SIL one week and DB another, just a quick check in and chat instead of bemoaning their absence. Need to solve the problem a bit. Let DB know I miss seeing them, even if it is a coffee type visit but will let that thought go until I see SIL and she can tell me what she is dealing with, still does not want to say over the phone. Far as I know, if the referral goes through with the neurosurgeon, she will come. For now calls will come from me.
I did get some groceries yesterday. Got a mix of penne noodles and the queso bowl, warmed yesterday, let cool and they are in a container. Got a pound of chicken in the fridge as well, it can be added to everything. It is halal chicken but tastes the same to me. I have until wednesday to finish them up.
For meals, they will all feature the chicken I cooked yesterday so thinking about microwaving an egg and some beans, and some chicken let that cool off and throw in the chopper with cheese, bit of BBQ chips that are too spicy as well. Then take the chopped stuff and a spoonful of the pasta and throw in a pan with garlic and butter, crank up the heat and turn off with the lid letting the flavours come together. Later have an english muffin with cheese and garlic spread with a mini pizza OR meat pie. Once I am done with the chicken, will heat up frozen burger, grind it and use it as an extra topping for stuff. Chia seeds are in meals as well, always soaked and no more than a tbsp at a time. I will post if anything is really good tasting.
House needs a good sweep, been terrible on getting floors done, plenty of time for that, still got laundry and want to wash clothes and hang up in my clothes dryer, it is fun to use and quick to dry up stuff. As far as the floors, broom and basic mop work best and will use the dry function of the wet dry vac to clean up the litterbox area, a lot of litter back there that cats have kicked out, just have to move stuff out of there.
Anyway, hope all have a good day, we are supposed to get snow for a couple of days, unsure how heavy but do not care since we go back to double digits above freezing. If I had to go out this week, could simply melt snow where I think I need too. No trips out, phone call with social worker Thursday. I still have no idea what services I should claim since I am still mobile, not upset about my brain at this point. I will see. Going to phone RO office and find out if she has info because I would have thought there would be some urgency of investigation of the cyst with blood flow. I do not see RO again til Nov 27 but unsure if there is much point in seeing her without seeing neurosurgeon. Oh well, I cant answer my questions, will phone and see what the office tells me. Got to get my own questions answered.
Well, I hope everyone has a good day ahead and in pockets for those who need it, in my own pocket to get done what I want to get done as well.
Re: My Husband, My Life, My Love, My Family, My Cancer
@irishlove That is good news about your grant. So happy. I had an incorrect dx of diabetis in my chart too, but a new PCP noticed, said I didn't have it anymore due to current labs, and removed it. She figured it was because I was on steroids for a period of time which causes temporary diabetis. Could that have happened to you? Just a thought.
@shanagirl Also happy to read your spinal ablation worked and you are pain free from that.
I have a scan on Tuesday, otherwise just trying to get over this cold. Praying for others as I read through.
Re: My Husband, My Life, My Love, My Family, My Cancer
GoodMorning Dearies on this gloomy Sunday Morning. We’re expecting stormy rainy weather, I feel it in my bones. So Any way Happy Sunday to you all Dear ones.
@mara51506 , stay warm with your expected snow . And I have no doubt you will be cooking so enjoy the day, eat and watch some movies🥰
@irishlove I’m so happy for you that you about your grant. As Mets patients we really need our records to be correct.. I always find myself combing through my records on MYChart and trying to analyze everything.🧐
@Chicagoan I’m thinking of you today.🌷🩵. @mkestrel You too are always on my mind. I hop all is straightened out with your medical records. I went through this one time with my records with a horrible gyno woman I called her out on her records and she never said anything she just dropped me as a patient due to some insurance issue she claimed I am not covered for… it was a blessing in disguise. I am sending love to @threetree @goldensrbest @candy-678 @cookie54 @micmel @eleanora @intolight @illimae @everyone else I chat with on the bone Mets forum and fasoldex girls forum and all of you dear girls. as well as any men who post on thos forums.
tomorrow morning I am meeting with RO to get my tattoo so I can start Palliative radiation for my hip groin low back pain all related to a Vestabulum lesion that is the cause of my walking pain and limping. I pray it works.. and then Next Thursday I have a follow-up with the Neurological Surgeon from the spine Brain Institute, wh did the RadioFrequency Ablation on the 8 facets in my cervical spine. I’ve been pretty much pain free as far as that is concerned, PT is also helping with my neck healing too.🩵
Re: My Husband, My Life, My Love, My Family, My Cancer
@irishlove thank you for the kind thoughts. Congrats on getting assistance with your medicine. About the error in your chart, you have every right to ask for it to be corrected. That can carry over into all of your other charts because they just copy and paste. I was a medical transcriptionist, and I was constantly audited on my work for every tiny typo. Now I see errors all over my charts and it drives me nuts. They are just using speech recognition and leaving all the errors, putting a disclaimer at the bottom that this is AI.
mkestrel
Long term benefits vs awful short term sacrifices
Hello all
Lumpectomy Oct 21, post op meeting with surgeon, she said"pathology looks good, got the tumor, nothing in the lymph nodes, treatment remains radiation
A week later, met with the MO who blindsided me with my high oncotype score(31), and recommended chemo.
The idea of going through LBC/risk of infection, hair loss, nausea, neuropathy, and later brain fog from chemo only to drop the chances from 31% to 15% is just not very reassuring!
Anyone want to share their decision making or what they did to convince themselves that the short term awfulness is outweighed by the long term peace of mind?
yogagoat
Re: My Husband, My Life, My Love, My Family, My Cancer
Good early morning everyone. @mkestrel I had to go back and read some posts that I had missed and I was so shocked to read of your progression. In your pocket and prayers that they can get the liver mets under control now! I may have missed another lovely lady that scanned and they found progression, I apologize if I did. Do you ever get one of those eye headaches? It feels like a stabbing effect in the eye. I usually blame MS but this one is a whopper. I've been off Ibrance since Oct. 6th. MO appt. Monday. Hope to get back on it then. The neurologist depends on the Ibrance to help keep MS under control. No Ibrance, MS is running amok.
Been smiling and trying to figure who my angel might be regarding the grant money. I applied for a grant from Pfizer every year and that was hell on earth to obtain. But no one else. Perhaps the financial lady, as we spoke about the ridiculous copay for Xgeva and we schedule the shot around Soc. Sec. time. Or maybe sweet Dr. C., my MO. He listens and I must say something a bit out there, but when you find a Doctor that you are in sync with, regardless of his specialty, you want to hang on to him or her. So forgive me if this offends anyone, but I'm hoping to keep him till death I do part. It's kinda like marriage vows, instead it's medical vows and there's a certain peace in knowing he'll be with me thru this journey. Can you tell I don't like change? Must be why I'm married to DH for 46 plus years.
Sure could use a suggestion on how to remove incorrect diagnosis on my medical chart. It states I have Type 2 diabetes and that the doctor went over my meds and the importance of yada yada yada. Ok, so I don't have Diabetes Period. I called Primary and also sent a message thru the portal. That got me nowhere. Office Manager said I'd have to track down who put that info in my chart. I said well my current PA must have due to the date and oh yeah, his name is alongside of it. I was in his office that day. She informed me that means nothing. Now what do I do?? This could lead to very serious consequences if I am unable to provide medical input whilst in the hospital. Besides, my blood boils that such errors occur and hit a stone wall. I won't give up, even if it means obtaining a lawyer (hope for pro bono).
In pockets for all my sweet, dear friends as we keep supporting each other thru this journey no one wants to take.
Laurel