To do Radiation or Not?

I am 48 years old, Stage 2 got diagnosed with ER/PR + HR2-. I grew up in a Alternative medicine household and barely ever went to the doctor so now that I am faced with breast cancer, I am trying to do a mix of conventional and natural stuff since I don’t totally trust conventional medicine. I was born and raised a vegetarian, exercised, yoga etc. So im so perplexed how I got cancer.
Had a Lumpectomy in my right breast and Sentinel node biopsy which showed 1 node positive with micrometastasis. I am agreeing to do Tamoxifen for 10yrs and now they want me to do 20 sessions of Whole Breast Radiation ( including my armpit because of the lymph node) I am so torn by making a decision to do Radiation. They said I have a 30% chance of recurrence. If I do Radiation it would go down to 8-10%. Also, since I had one node positive they said there is a 13% chance that there could be other nodes in there that are positive as well.
First, I am very, very concerned about the MANY awful side effects, especially the cosmetic outcome of what may happen to my right breast. Everyone has things in their life that are extremely important to them. My breasts are those things and they are my best asset. I am very body confident, still single, have a very active and fun social life, vacations, in bikinis and always dress sexy. I would be devastated and my mental health would decline more than it already is, if my breast became deformed or looked/felt not normal, got lymphedema, nerve damage, etc after radiation treatments, even if it they were late side effects years down the line. Even though it may save me.. My quality of life would be horrible and I would rather die than live a bad quality of life. I also I don’t feel right about damaging my tissues or insides. Just the thought of that seems wrong to me, this treatment seems very invasive. Obviously I have cancer and I want to do all I can to save myself, but at the same time, quality of life is very important and you only live once. I have had a rough life as it is and I cant take any more bad things happening to me, it would diminish my mental health more than it already is if I was left with permanent issues from Radiation. The cancer can still come back even if I go thru with it.
I am risky person by nature, so skipping Radiation doesn’t really scare me, because you never know, the cancer might never come back. If it does, I can deal with it at that time. But I am having a hard time making a decision about if I should not go thru with the Radiation and risk it and see what happens. Or do I go thru with Radiation to get a little bit more peace of mind that the stray cells (if any) COULD be gone, but risk getting a deformed breast and other crazy issues put in my life. Please let me know if anyone has had these thoughts and had to make this decision or just your overall thoughts on what I should do. Just need some advice, no one I know has cancer.
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star888,
I am sorry you find yourself in this difficult position. Let me start by saying that despite the clean lifestyle you’ve led, there was never any promise that you would remain cancer/disease free. Though you have done much to be healthy, all incidences of cancer are not attributable to diet and lifestyle. My sister lived the cleanest lifestyle imaginable, even before that was a thing, and was diagnosed with a uterine sarcoma and dead six months later. She was very bitter and almost felt betrayed by the fact that her lifestyle hadn’t shielded her. So please understand that this can happen to anyone.
Side effects from radiation vary. Most people do very well and don’t experience any ongoing problems. Some do experience problems though it is unusual (not impossible) for any rads side effects to have life altering consequences. Having a horrible quality of life after rads is very unlikely. The thing is that there is simply no way to predict if one will have side effects or not.
For anyone contemplating skipping recommended treatment, the question I ask is if you will feel regret if you then have a recurrence later, particularly a metastatic recurrence. I don’t believe you mentioned your stage but I will assume it’s early stage. Statistics exist on the efficacy of early stage treatments and they are quite good, though bc has no cure so there is no 100% guarantee.
What you are weighing are potential side effects, which may never happen, against historical data from those in similar situations. This doesn’t predict how well you will do, but does show how others in similar circumstances did. In the end it is simply a matter of how much risk you can deal with vs side effects which may or may not happen (and again, highly unlikely to change your quality of life much even if unpleasant to deal with at the time). TBH, I have never heard of rads damaging someone’s QOL so badly that they would rather die but this is your choice. Take care3 -
Thank you so much for your words, much appreciated
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Get the rads. I hate to sound unsupportive, but it doesn’t make sense to say you’d rather take a chance on long term consequences of progression, more difficult treatments making QOL more difficult because of a fear of a cosmetic outcome. Plastic surgeons at specialty centers like PRMA can do amazing work to correct things should you have side effects you want to address. It’s easy to say, “I’d rather not live if XYZ” until you’re actually stage 4, and you find out you’re probably not going to live long enough to rue gray hair, having a breast that doesn’t have a port projecting out above it in every scoop neck top you try, or seeing any grandchild start their first day of school and being there for your parents in their last days. There are no guarantees in cancer as I’ve lived a pretty clean and healthy life and had three different cancers ambush me by age 50! Many of my good friends are young, super healthy, run a marathon, then find out they are stage 4. Hit cancer hard, with everything you’ve got, at the beginning then live your best life knowing you fought for every minute of it.
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@star888 I hear you, there is both shock and confusion in your post. The why me feeling is natural, we live as best as we can and then wonder. Why did I get cancer and not the junk food eating person? And the fact is no one knows why our cancer cells mutate develop into disease or disappear . Sometimes we have expectations that “if this then that” and all will be good or all will be bad, and life in my experience it is so much nuanced then that. There are no certainties one way or the other, there are probabilities and statistics and then best guesses.
From my 2 year cancer journey so far, I have found a few things super helpful. One trust the recommendations of my medical team. You have hired them via your insurance, to do their best based on their expertise and if they recommend radiation, then it’s a good bet that it is needful and helpful. If you don’t trust them fully, gather others for second opinions . Doing your own due diligence to ask questions and weighing the costs to your mental well being and managing life with cancer well is a good thing, but acting on emotions alone is usually not. Noticing your feelings for sure, noting your thoughts too, but in the end going with sound medical advice. I am very happy I did the radiation, I actually recently finished it and it totally squashed my remaining cancer cells, I’m sorry I did not do it my first time around. It was easy and the se minimal if any.
Given how strongly you feel about your body image, I might just offer the idea that it all bodies change over time. You will change a lot over the next ten years, if you are lucky. Change is natural. It might be a good time to work with your emotional well-being with a professional as well, a healer or therapist. There are oncology therapists, both rational and alternative you might look into. Just knowing you have the support you need, in addition to this forum might be a good thing as you travel this road. ❤️1 -
Hi @star888, first off, I really empathize with you - radiation is scary. That said, I'm going with others and recommending that you do the radiation. I did mine after 12 taxols + herceptin in Dec 2021 and Jan 2022. I was actually more terrified of rads than of chemo, nearly chickened out the day of the mock run, and hated every single day of it, but I'm really glad I went through with it. For me personally, looking at this 3 years in the rear view mirror, I can barely tell the difference between the cancer and the non cancer side, other than never having to shave that pit (don't miss it), a bit of tenderness, and some slight stiffness when I raise that arm. If it comes back, it comes back, but for me, if it does, I want to know I did everything in my power to prevent that from happening. I don't want to be kicking myself for not having done anything recommended that could lessen the chance of recurrence. Hang in there, and my best to you.
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Thank you all so much for your advice! This is extremely helpful!
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Hey there
If you decide not to do rads...read read read & listen to every podcast by Dr Thomas Sigfreid & Prof Dom D'agodtino and "metabolic therapy" and pulse press theory. It's keto/ supplements and Hypobaric oxygen chamber sessions.
I did rads when stage2 & similar surgery to you in 2018, the rads were a easy for me, zero side effects. I swam after every session and felt fine & my breasts actually perked up and looked better after treatment and still do. Sadly in 2024 metastasized everywhere.…
I fear Chemo now but take the targeted & endocrine drugs easily. I'm fully keto ( was always vego prior) & practice 16h intermittent fasting. I plan to do "metabolic Therapy" next & will probably have to live in Turkey or Hungry for months as no Dr's can get me into hyperbaric machine here.
I personally would do Rads if in your shoes & monitor you health markers like a demon if you don't do Rads!!
Bloods/Pet etc..know all your tumours sizes & blood markers readings & watch like a hawk!!! Tamoxifen stopped working at year 4 for me but they don't offer PET's in Aust until stage 4,so it wasn't picked up. You are in USA...use every avail therapy!!
I begged in 2018 for a double mastectomy, but in Australia this not the standard practice & after 4 different surgeons rejected my request I sucked it up...give me a time machine!!
Trust me when I say...throw everything at it early.
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Star888, joining the chorus advising you to do the rads. Stage 2, a positive lymph node with micromets, and especially your age (only 48) all indicate that is the wisest course of action for you. Lately, radiation has been deemed unnecessary for postmenopausal patients >60 with no positive nodes (and even SNLB is now contraindicated if there are no clinical signs of lymph node involvement).
You are wise to agree to endocrine therapy (in your case, again due to your relative youth, tamoxifen). 20 sessions of whole-breast radiation is a much more manageable protocol than what was indicated back in 2015, when I was diagnosed: though I qualified (almost 65, Stage IA, Grade 2, aromatase inhibitor endocrine therapy) for and underwent the then-experimental protocol of only 16 sessions of higher-dose fractionated rads aimed at just the tumor bed, the prevailing protocol back then was 36 sessions (6 weeks M-F plus 6 high dose "boosts") of whole-breast. I sailed through mine with nothing but a little redness that turned tan; 20 weeks is far less likely than 36 to cause major skin effects, especially if (unlike me) it's regular-strength dose. In fact, it did enlarge my tumor-bed seroma to the point that my operated breast—normally 2 cup sizes smaller than its counterpart—temporarily became the same size as the healthy breast. (It has since deflated).
Why did you get breast cancer despite a stellar healthy lifestyle and no genetic mutations? Same reason my ocular oncologist gave me when I asked him how I—dark eyes, always wore sunscreen & sunglasses in daylight, no genetic mutations—managed to develop a potentially deadly eye cancer: "s#*+ happens." One of my friends is a vegan triathlete who never smoked nor drank yet still got DCIS.
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@chisandy lol “s#*+ happens.” Girl isn't that the truth lol! ❤️
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