How to choose whether to do chemo or not
My oncologist has essentially told me that the decision about chemotherapy is mine. The research suggests that my type of cancer may not benefit much from chemo and that ovarian suppression may provide a similar benefit. I enrolled in the OFSET trial and was randomized to the arm that does not require chemotherapy, but my doctor said I can either continue with the trial or withdraw and do chemo (Taxotere and Cytoxan).
Here are the details of my cancer: premenopausal, ER+, PR-, HER2-, Stage IIB IDC, Grade 3 (2.2 cm), Grade 2 DCIS, perineural invasion, and 1 positive lymph node with extranodal extension (metastasis at least 2 cm). My MammaPrint was low risk, and my Oncotype score was 21. My estimated distant recurrence risk at 5 years with endocrine therapy alone is 9%, and the average absolute benefit from chemotherapy is 2.7%.
I've already had a bilateral mastectomy and lymph node dissection, and I will be doing radiation plus ovarian suppression and an aromatase inhibitor.
I’m really struggling with whether the potential benefit of chemotherapy is worth going through it.
Comments
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Hi @sed5035, It's hard when you are told to make your own decision about chemotherapy because you are on the borderline of whether it will be useful. I was in a similar situation but postmenopausal. After doing the research I concluded that the small benefit was probably not worth the chance of ending up with permanent chemo induced neuropathy. Of course, I was also older than you are.
The clinical trial you are enrolled in is hoping to answer your very question. If you are having second thoughts about the trial because you landed in the no chemo arm it might be an indication that you would feel more comfortable doing chemo. Unfortunately there is no way to guarantee that you will never have a recurrence so you just have to decide what your risk tolerance level is. I asked myself if I could live with my treatment decisions if things didn't work out as I hoped they would. I ended out having a very rare late reaction to radiation but I still feel that at the time I made the best decisions I could. Since we can't foresee the future we just have to go with what feels right at the time. All the best; I hope whatever you do works out well.
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