Treatment plan
Hello! I'm 56 yrs old and found my lump a year ago. It appeared almost overnight and I assumed it was a cyst or a byproduct of the life long fibrocystic disease I had growing up. Finally broke down and had it checked. Invasive Ductal Carcinoma, Stage 2, Grade 3, Estrogen positive, Her2 positive. I am scheduled for a lumpectomy on Wednesday, as well as removal of corresponding lymph nodes. I declined chemo, and will probably decline radiation as well. I know its not advised, but I just dont want to put my body through more than I absolutely have to. Has anyone had success with just the surgery, without any type of therapy? My oncologist said that for some (although few) people, the surgery was sufficient and the cancer didnt return. Has anyone had this same success?
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I will caution you that your breast cancer is the type that once had the worst prognosis. There was just nothing to really target those cells and that breast cancer was notorious for coming back because it is so aggressive. It had the worst survival rates out of all of them. It now has a very good survival rate and that's because the chemotherapy we have along with the immunotherapy can target those cells effectively. If you go through the recommended treatment you have an excellent shot of never having to hear the word breast cancer again in reference to yourself. If you don't your statistics quite frankly are not very good. I have never read of anyone here with a HER2+ tumor refuse the recommended treatment because of that. Obviously it's up to you and anyone should be able to refuse treatment for any reason at any time. But it is important to know exactly what the risks are in refusing it.
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Thank you for your insight. I might be willing to do the immunotherapy and Armidex, but the chemo is out of the question for me at this point. I have suffered from depression since the age of 15, and its not a vanity thing, but an insecurity thing when it comes to losing my hair. I know it would plummet me into despair, and I feel that depression can be just as deadly as cancer. I also cant justify doing a "whole body" treatment when its a "localized" area. Not to mention what it puts your body through. My oncologist told me that sometimes people can have the lumpectomy and lymph node removal and never get it again. I was just curious if anyone on here had a similar situation and managed just fine. I wont make my final decision until the labs come back on my lymph nodes of course. Im just trying to prepare at this point. Thank you so much for responding!
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I too, was estrogen and Her2 positive and stage 2. You can see from my signature that I did all the recommended treatments; some I am still doing. As kaynotrealname said, before the discovery of Herceptin, Her 2 positive breast cancer was one of the deadliest types to have.
Treatment is tough, but very doable. The time goes by quickly. Personally I don't think it is worth risking your life. I was 57 at diagnosis.
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I don't know at this time if they do immunotherapy separate from chemo. I think they have to put it together for them to want to use it at all. And as far as localized cancer there is no guarantee that it is unfortunately even if your lymph nodes are clear. Breast cancer has a nasty habit of sending out cells before it is detectable by touch or by scan. So by the time we even know we have it there is a good chance that it has already spread through the blood vessels to distant sites. Luckily this is an inefficient way to metastasize so most of the time nothing comes from it. But occasionally it does which is why not a small percentage of early case breast cancer patients go on to get a stage 4 diagnosis which is not curable. And the more aggressive the breast cancer the more likely it is to be successful at microscopic spread. It is something to think about. But I do know that depression is debilitating so I get wanting to avoid it at all costs. I wish you the best of luck in making the right decision for you.
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It just seems like a lot to put your body through, not to mention the other issues it can cause with your heart and other organs that might not have been affected otherwise etc. Im sorry you have been through so much.
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zrzekmane,
Let me start by saying that I concur with comments others have made. It is unlikely that you will find too many folks with HER2+ bc who turned down chemo/Herceptin because it has been a such a lifesaver…literally. Even if you did find someone who did, there is no predictive value in that . It says absolutely nothing about how you would do under similar circumstances.
kaynotrealname mentioned bc cells traveling through the bloodstream and the fact that it’s not common. She is correct but I am someone who has bone metastasis likely due to just that. But again, there is no predictive value in that. So although your bc appears to be local, there truly is no way to know what those cells are doing and as others have noted, HER2+ breast cancers had dreadful outcomes prior to Herceptin . Yes, side effects do happen but note the frequency as some are rare, while others are commonplace with meds to help if needed. Is it a lot to put your body through? I think most people would say yes but it’s for a limited time and most people , though not all, recover with no or little lasting side effects. The reality is no one can predict nor guarantee side effects nor the outcome of tx. However, looking at historical data on HER2+ , Herceptin was an incredible game changer.As to what your oncologist said, yes, there are outliers. The problem with that is that it isn’t clear as to why they fall into that category as there are too few and few common threads among them. Personally, I don’t think I’d count on the rare possibility of being an outlier as a treatment strategy.
All decisions about treatment are yours and as long as you make those decisions being fully informed and based on facts, then you’ve made the right decision for yourself. Take care
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I truly appreciate the input everyone has given. I am just still in the shock and denial phase, but Im sure once I have my surgery Wednesday, I will be given more insight. I thought I could just take the easiest route, but you have all enlightened me on how important treating that Her2 is to give me my best chance. My husband said he will always be here for me through this, and I always want to be here for him too. Thank you everyone.
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@zrzekmane - Welcome to the BCO community! We're so sorry for the reason that brings you here, but we're glad you found us. Whatever you decide, please know that we're here for you to support you.
Sending gentle hugs and good thoughts for your upcoming surgery on Wednesday. Let us know how it goes!
Warmly,
The Mods
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