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Older Women Treated With Hormone Therapy May Not Need Radiation



  • glenning
    glenning Member Posts: 3
    edited March 2019

    Hi mamabexar - there must be certain criteria in bc that shows having radiation or hormone therapy offer a low percentage of non-recurrence against just getting on with your life. I think it was on this website I read 7 in 10 people do NOT have a recurrence without any treatment/radiation at all - this is rarely if ever explained to clearly to patients. Meaning 70% or 7 in 10 people are being over treated. I've just opted to have no radiation or hormone therapy, I'm 63, I've had a lumpectomy, clean margins, clean lymph. I'm with you and whilst paying super attention to my lifestyle I'm hoping I'll be left with just two little scars but a whole lot wiser.

  • cassiecanada
    cassiecanada Member Posts: 101
    edited March 2019

    hi..brilliant question and i was just

    recently told this by radiologist.

    my plan, at sge 63, with favourable tumour,

    is to do partial rad and skip

    the drug

  • cassiecanada
    cassiecanada Member Posts: 101
    edited March 2019

    we are very similar...

    mine has a low risk of recurrence

    ( new to site, so need to figure out

    how to get my stats added to bottom

    like everyone else).... my plan

    after my feb lupectomy is to

    go with partial rad and skip the

    femarin as it only cuts my risk

    by 1

  • cassiecanada
    cassiecanada Member Posts: 101
    edited March 2019

    Hi glenning-

    wow... i am also 63 and skipping femara

    and starting partial rad soon.

    My gut is telling me to forgo

    full rad if i am a candidate for


  • cassiecanada
    cassiecanada Member Posts: 101
    edited March 2019
    Hi Chi Sandy- just joined site
    and finding all these similar scenarios.
    I am 63 and plan on skipping femara
    as it will only lower my risk of recurrence
    by 1% and i was shocked to
    read about femara side effects.
    how do you feel on femara?
  • keywestfan
    keywestfan Member Posts: 358
    edited May 2019

    What I hate so much in the hypofractionated partial 16 rads is that they take 7-10 chest xrays before the rad begins. They do this each time to precisely line up the tumor bed and margins around it. I don't know, but doubt they do this with WBI. I asked if it would cause new cancers in 30 years- of course I'll be 115 then.

  • Sal462
    Sal462 Member Posts: 11
    edited September 2019

    Does that mean if you already had the radiation your can skip the hormonal? Yay.

  • Member Posts: 1,434
    edited September 2019

    Sal, no unfortunately it does not mean that.

    Hormonal therapy is systemic, i.e. it works throughout your body. t lowers the risk of a localized (in the breast area) recurrence, by about 45%-50%. It lowers the risk of a distant/metastatic recurrence by about 35%. And it lowers the risk of a new primary breast cancer in either breast (a separate breast cancer related to the first diagnosis) by about 50% (some studies suggest a higher or lower benefit).

    Radiation therapy is a local treatment, specific to the breast area. Radiation lowers the risk of a localized recurrence by approx. 50%.

    So hormone therapy provides benefit in the same area as radiation, but radiation does not provide benefit in all the same areas as hormone therapy.

  • meow13
    meow13 Member Posts: 1,363
    edited September 2019

    Beesie, that was exactly my understsnding too.

  • Chris39
    Chris39 Member Posts: 2
    edited December 2019

    this so sad

  • Romy103
    Romy103 Member Posts: 3
    edited October 2020

    What is PARTIAL rads? I have same situation and was told I could do hormones, but not need rads. Am trying to decide whether that is good or not for longevity. Appreciate your perspective. Thx.

  • Romy103
    Romy103 Member Posts: 3
    edited October 2020

    I agree with those who have said that age + health should be taken into consideration when deciding on treatment. At my age of 74, according to actuarial tables, I am likely to live to 90. Because I have only 1 child, a daughter age 32 with medical problems, whom I had late in life, I would like to live as long as possible (as everyone, just for different reasons!). My BS recommended lumpectomy, no rads, with hormones. He said without rads, chance of recurrence 1% a year, with rads .2% a year. So at 84 I'd have a 10% chance of recurrence. I'm thinking good odds, but I'm already unlucky, I got BC, (when only 1 out of 8 women do) so do I want to try my luck and if I lose, I die earlier? I don't think so. (Do I want rads unnecessarily? No don't want that, either) But now I have to stand up to him, go against his advice, or find another BS perhaps. I need to decide soon. I will read the study, but if anyone has suggestions, they are welcome. Have been reading all the responses, but they are on both sides, it seems.

    Dx Biopsy 10/7/2020 IDC, Right, <1cm, Stage I, Grade 1, ER+/PR+HER- ; Luminal A Breast Cancer

  • SuseMarie
    SuseMarie Member Posts: 12
    edited December 2020

    Hello everyone older than 60 :-), I am new on the site. I wondered about this very thing today when I just today learned my markers (receptors) are in the 80 percents for both Estrogen and Progesterone. Seems high to me, but maybe this is common.

    I am 63 years old, had my biopsy 10 days ago (Dec 17) and learned I have Ductal Invasive C Grade 2. The Ultrasound showed 0,8 mm size, then on the 24th (Christmas Eve) I had an MRI, which showed the tumor size to be 3 cm! Just today the pathology report showed up on My Chart. I have my initial appointment with surgery the day after tomorrow.

    For 10 years I have been taking Progesterone 100 mg every night. And I have an Estrogen skin cream from compound pharmacy I have had for 7 years and only take a tiny smidgen of that. I'm feeling concerned about going off the Progesterone since I've adapted to it and it helps me sleep, not too concerned about stopping the Estrogen. I do realize I need to get off both! And will call my MD tomorrow to ask for advice on weaning off the Progesterone.

    I do know I'll very likely be starting on what I've learned is called "hormonal therapy". I read up some of it today and am concerned about the side effects listed. Must be quite a shock to the system to eradicate absolutely all female hormones from the body. Can anyone tell me about their experiences with it?

    Since I'm new to this yet, and will know more about my likely course of treatment after Tuesday's surgery visit, I don't have a lot of knowledge on this.... but at this point it seems to me the hormonal therapy doing its job could be adequate for strictly Est and Progest tumors. Lots more to learn tho...

    Appreciate any input, thanks,


  • Stellawt57
    Stellawt57 Member Posts: 65
    edited December 2020

    suzieMarie, best wishes with your appt. have you decided to have a lumpectomy or mastectomy? Either way you will most likely be given a Rx of hormone inhibitor or tamoxifen which also reduces/eliminates the estrogen produced. The first thing to do is take one day at a time. Ask many questions as to why you should or shouldn’t have radiation during or after surgery.

    My tumor was <1 cm, stage 1A & grade 3, which allowed me to be a part of a study for women who were 60+ yrs to have IORT, single strong dose of radiation during my lumpectomy. Then a week later I started taking Anastrozole and had several side effects. At first the SE were extreme, but subsided over time along with seeing an Integrative Dr. who helped by having me take supplements & acupuncture, so taking anastrozole now is doable. There are others who have had whole breast radiation and others who have not, but do take an AI or tamoxifen.

    Keeping you in my thoughts and prayers!

  • dtad
    dtad Member Posts: 771
    edited December 2020

    Hi everyone. I'm now 67 and was diagnosed almost 6 years ago. I had a BMX but nothing else. I refused hormone therapy from the start. I lost 30 pounds and try to exercise daily. So far so good! Weight loss and exercise has been shown to lower recurrence rates by 40 percent. Not much different than aromatase inhibitors. I'm not advocating this for anyone but myself. We all have to make our own informed decisions about treatment. Good luck to all. Happy New Year!

  • luv2walk2
    luv2walk2 Member Posts: 8
    edited January 2021

    this is interesting. I am 68 and having a lumpectomy on 1/6/21. I am afraid of radiation therapy and chemo based upon things that happened in my family. I have a rare breast cancer...papillary it is 1 x .7 x 1 cm with an invasive spot 1.5 mm . It is HR+ PR+, HER2- cell grade 2 Ki 67 10%. At my age I wonder if I do no treatment will I pass before a recurrence.

    They tell me I am in control of everything. I want to do the right thing. My sister wants me to have a double mastectomy. My spot is so small I hate to agree to such a radical surgery. I wish an oncologist consultation was allowed to help me make the right decision. I hope I am doing the right thing. I had to tell my kids on Christmas day that I have cancer. Those 3 words took my breath away. I feel so stupid for being such a wimp about this. I have to buck up and just go with the flow. I have been through worse. It is just saying I have cancer has brought me to my knees.

    When I got upset after hearing this news my husband asked "what's your problem?" I know I do not have his support and that is ok, nothing new. I have to make my own decisions. I hope if I am friend to anyone else who is first diagnosed I can be a rock for them during their storm.

  • 75nowarranty
    75nowarranty Member Posts: 6
    edited June 2021

    Due to my age (76) and low risk status of the IDC, the RO did not recommend RT with the understanding that i would take HR. I was happy with this because it was in my left breast and I would rather take a whole body HT. Also because I had uterine cancer diagnosis, also stage 1A , 9 months previously followed by a hysterotomy, the whole body HR seemed to be the best for me. My genetic test was negative. My MO listened to my reservations about the HR, mostly the side effects that are also what old age brings and my concerns about a double dose of fatigue, joint pains, weight gain, bone loss, risk of stroke, etc. Also discussed my quality of life for the next 5+ years since my husband is 81 with afib and reduced lung capacity.

    Since AIs are contraindicated due to pending dental surgery and some osteopenia, I have been taking a reduced dose of Tamoxifen every other day for 6 weeks. The first 4 wks were the hardest with some side effects: a few hot flashes, irritability, weight gain and felt like I was operating at a 50% energy level so less activity. Now I still am operating at a lower activity level, have less will power when it comes to eating carbs and am slightly less irritable. After my appt with the MO, I have agreed to take this same dose for another 3 months. Will go back to a WW plan to lose the weight I gained in the last 15 months after maintaining my 35 lbs loss 3 years ago for 2 years. Hope to curb the irritability as well. I do not know if I will ever agree to a stronger dose of this HR or if I will continue this low dose HR for 5 years. My MO thinks getting me to take the equivalent of 5 mg of Tamo/day is better than taking none.

  • KateHanni
    KateHanni Member Posts: 70
    edited June 2021

    I'm 60, had early HR plus HER2 minus, lumpectomy and brachytherapy radiation and now I'm with an Oncologist who has done my Oncotype DX score which was 17 and he's insisting I take Estrogen Blocker called Anastrazole which after one week made me depressed, weight gain, joint pain, severe headache and several other bad side effects which in my scouring the internet appears to be very common and about 36% stop taking ER due to side effects, even though most of the information out there says only 5% stop taking it as many people don't report to their MD that they've stopped

    I'm really just trying to do the right thing for both longevity and quality of life. Any thoughts or comments or knowledge is greatly appreciated.

  • KateHanni
    KateHanni Member Posts: 70
    edited June 2021

    We have the exact same type of cancer HR + HER2- and I also had lumpectomy and radiation. Now they want me on Hormone Blockers even though my IDC was 12 mm (the sizes changed every time I had a scan) and one week of twice per day brachytherapy radiation. The hormone blockers have so many negative side effects for me, I only took for 1.5 weeks and on that last day of taking it last week I awoke to an extremely dry mouth, weakness, splitting headache like I thought I was having a stroke, swollen ankles and fingers and rapid weight gain.

    I work for a healthcare based non profit writing research grants so I'm trying to find out if there is anything that would help i.e. ovary removal or hysterectomy (endometrial cancer also runs in my family), or any natural hormone blockers that won't put me down physically and mentally for the next 5 years.

    My oncologist said it's not unusual to have these symptoms but that I should stop for 3-4 days then re-start the same medication and it should be better. Obviously I'm terrified of taking this medication again.

  • KateHanni
    KateHanni Member Posts: 70
    edited June 2021

    My experience, so far, has not been good and I've done a huge amount of research about the hormone blockers and the true percentage of people who stop taking them and who don't report they've stopped taking them due to the side effects is more like 36%. Could be even more people. Very few of the hormone blocker cancer survivors make it to the 5 year mark of taking them due to side effects.

    On one hand my mom who had the same type of breast cancer took anastrozole for 5 years without any side effects (that she can recall). My experience was the opposite, within 1.5 weeks I had nearly all of the negative side effects. Throwing up, nausea, weight gain, headache so bad I thought I was having a stroke, weakness and fatigue but sleep disturbance was high. I'm at the point of deciding if I'm going back on them or staying off and trying other things.

    I had lumpectomy, tumor was 12 mm x 4 mm x 7 mm IDC, then one week of twice per day radiation therapy and now my oncologist wants me on hormone blockers. But if these are the side effects I'm not sure I want to or even can handle them for 5 years.

    Just my honest truth. I'm not giving advice, just reporting my experience.

  • flashlight
    flashlight Member Posts: 311
    edited June 2021

    Hi KateHanni, I'm on Tamoxifen and not Anastrazole. I have read where some take it every other day to decrease the dose. With tamoxifen you would probably need a total hysterectomy (I had last Year). The 20mg tab can be cut in half, or there is a 10mg tab that can be cut in half for 5mg. I started out slow and gradually increased my dose. It did take 2-years for me to be doing well on this medication. It is really important to stay hydrated. Check out the supplement posts. Fish oil for dry eyes and b-complex for energy are really helping me. You have been through a lot this year both mentally and physically. Adding the hormone therapy is a double whammy.

  • Tasha35
    Tasha35 Member Posts: 2
    edited December 2021

    I agree.. I was told I could skip radiation because my tumor was only 1.8 cm and no lymph nodes had cancer. They said as long as I took Arimidex it really wasn't needed. I decided to get the radiation. I still have 4 more treatments. If for some reason I can't take the Arimidex or the side effects are too bad. I feel I at least took care of the few cancer cells that may have been left in there from the lumpectomy. I was told by the surgeon that there was cancer in part of my margin, so they ended up taking a bigger margin in that area. DX score was 20.. but still it all worries me.. so I will do what they recommend but don't like what I read about these Arimidex pills.

  • gracestella1948
    gracestella1948 Member Posts: 12
    edited March 2022

    Thats very interesting. I see the post is from 2015 is there any updates on that?

  • gracestella1948
    gracestella1948 Member Posts: 12
    edited March 2022

    That was very interesting to hear that hormonal treatment not only lowers the risk of getting cancer in the other breast but also a distant recurrence which I did not know. I was debating if I should take hormones also

  • susanfwilliams
    susanfwilliams Member Posts: 1
    edited April 2022


    I am 65 and read that article about older women and no radiation. I am going to forgo the radiation and chemo (actually wasn't even offered chemo) because of my low grade and very small sites (two in left breast less than 1 cm)...However, I want to forgo the hormonal treatment as well...even though I have been on Bio identical hormones for years and LOVE THEM...not because of menopausal side effects, but for the fountain of youth...I can still do cartwheels and fox hunt on a horse every weekend. Both, sites were estrogen and progesterone positive, but my research shows that a balanced level of hormones (especially) progesterone is actually protective and prevents cancer cells from growing. I am going to have my hormones checked for balance and tweak any imbalance that may exist. I am going to have a lumpectomy and, I will take Cimetidine (400mg's in the morning and 400mg's at night) for protection against recurrence. Also, after the lumpectomy I am going to go to the Riordan Clinic in Kansas have all hormone levels checked, balanced, IV treatment with vitamin C and prescription for Iscador (mistletoe extract) that will be a subcutaneous injection 2-3 times a week.

  • cowgirl13
    cowgirl13 Member Posts: 763
    edited April 2022

    Hi Susan, another horse girl addition to your research I'd like to suggest that you have a consultation with an oncologist. The oncologist can give you actual figures/information on what your risks are in deciding not to take the hormonals. You may still decide on not doing them but you will be able to make a decision based on complete information.

  • Kay7751
    Kay7751 Member Posts: 5
    edited June 2022

    watch the hormone doctors. They never give up pushing the pharma drugs. I useI3C Indole3carbinol Excellent estrogen metabolizer.