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Have to make a radiation decision

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I have IDC…stage 1, HR+, PR+, HER2-, Grade 2. I’ve had a lumpectomy with tissue rearrangement and sentinel node biopsies. The sentinel nodes came back clear. The RO said that since I’m 73 yo and the tumor was small, 1.9 cm, that I can either have no radiation or a partial breast accelerated radiation course of 5 days. Even tho it’s 5 days it is equal to a 3 week course of normal radiation. I really don’t know which way to go. I’m worried about the long term effect of radiation. Has anyone had to make this decision and what did you do? Also anyone having long term effects of radiation and what are they? According to my MO I’ll also be taking anastrozole for 5 years. Thank you for your help!!!

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  • maggie15
    maggie15 Member Posts: 1,081
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    Hi @nancyefl, Your situation makes it safe to skip radiation as long as you take anastrozole or another AI for 5 years. Many people have no side effects or SEs that can be managed but some have SEs that are so bothersome that they do not complete the 5 year course. If you do radiation and don't finish the full 5 years of AIs you already have radiation's protection against recurrence.

    Whole breast and PBI are about equally effective. According to the statistics there is a slightly increased risk that the cosmetic outcome of PBI might not be quite as good. There is also a radiation protocol called FAST that is offered in some locations where you have WBI once a week for five weeks. There are some common side effects such as skin issues and fatigue that resolve for most people after several months.

    There are some rare serious side effects from radiation. Those with Sjogren's and other autoimmune diseases can develop long term problems. I unfortunately ended up with a serious lung injury. My pulmonologist said that a lung cancer RO would have seen the red flags in my medical history (esophagitis, Barret's esophagus, upper GI bleed, subclinical ILD) but my breast cancer RO was unaware of them. I still think radiation is fine for most people. However, I would ask your RO exactly how much of your other organs would be in the radiation field and have him consider all your medical conditions to estimate the probability of late term side effects.

    Good luck with your decision.

  • nancyefl
    nancyefl Member Posts: 6
    edited June 19
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    @maggie15 I am so sorry that radiation had such a terrible effect on you. To realize that it may have been avoided has to be heartbreaking.
    I have several medical issues myself. I have had both heart and lung issues with my cardiologist especially being concerned since radiation will be on the left side. I also have esophagitis. The RO said they are very careful not to involve those organs. I know that’s the plan but just trusting the plan is another story. I also already have dense tissue which has made my mammos and ultrasounds hard to read…and I read radiation can make that worse along with all of the SEs that can pop up later in years.
    As far as the AI’s I am also concerned about being able to stay on them according to what I have read. I have a lot of arthritis and osteopenia already. I don’t need anything to hinder my mobility any more but I do realize the benefits of the medicine. Maybe I’ll be one of the lucky ones who has minor SEs!
    Thank you so much for answering back. I appreciate the input from someone who is also on the journey.

  • artwish
    artwish Member Posts: 20
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    I am 72 and had 20 radiation treatments to my left breast. I can have no more. I am taking anastrozole.

    The radiation treatments were no problem for me. The anastrozole has been harder.

    We are both close to average life age. My choice was to have all treatments.

    I have bone issues, but no new bone loose.

    Water fitness has helped mentally and physically. Diet has also improved. I did contact a cancer diet specialist.

    I do think diet and fitness helped my SEs.

  • nancyefl
    nancyefl Member Posts: 6
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    @artwish I’m glad you mentioned about a cancer diet specialist. I’ve been reading how much diet can help with SE’s and also hopefully keep additional cancer away. I need to contact one. Also before the diagnosis I was walking a lot…I need to get back to that program. Just being outside helps. Thank you!!

  • artwish
    artwish Member Posts: 20
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    Glad I could help. Took most of the first 2 years to face this whole thing. I have had a blessed life and should have faced this with less fear. Learning to breath deep, relax and enjoy every day again. Take Care.