Older Women Treated With Hormone Therapy May Not Need Radiation

Only one study? May be able to skip radiation? I have recently had bc surgery to remove 2 tumours and am 65 with no previous history. While the idea of skipping radiation is very appealing, I would need MUCH more evidence before I chose not to have it

kinda late for me. I am 63 and 4 months from radiation To me, one study is not enough. i would have t see a lot more studies. I have read too many post here where someone with early stage decides not to do radiation then gets a reacurrance. I was DCIS when dx., and now i am doing arimadex yet i still feel i have not done enough. Guess i am still healing emotionally as well.

I agree with Bounce and Gian.

I think there is also a limited time after surgery to get radiation. With Hormonal tx you can change to another if one does not work for you.

Would this be or all early stagers or would it depend on the receptors.

I would love to have the link to that study.

How wonderful that your cancer was found at such an early stage esp with neg nodes. Each treatment has it's drawbacks.
Was this found at your regular mammogram. That's why we have them. Bless you.

MamaBexar- my sister had similar diagnosis - told, "If you have to have cancer, this is the type to have." Sort of a back-door compliment, I guess. She had radiation, then aromatase med. Myself, radiologist watching calcifications. Had previous steriotatic (spel?) biopsy a couple of years yearlier showing clear cells. I had to under go Rotator Cuff surgery in June of 2012 and with ongoing Physical Therapy, cancelled my September mammogram. Scheduled in late December and cancer was detected - Surgery 1-4-13, IDC with another suspicious, similar area that was removed along with the cancer area. First lymph node had cancer cells. Later that year I had to cope with lung infiltration from radiation, but I still feel fortunate that they found my cancer. I met so many ladies at Cancer Center that had more serious conditions but nothing took away their smiles. What an experience. Keep well.

64 going on 65 here (I go on Medicare come January). My RO told me that with my type and stage of tumor (Oncotype DX 16), were I over 70 they might not have recommended radiation. But at nearly 65, better safe than sorry. So I will be doing partial-breast accelerated radiation, which at my age is as effective as the 33-treatment whole-breast protocol. After that, hormonal therapy. (There are some outliers who advocate slender women over 70 with early non-aggressive hormone-positive cancers can even skip the hormone therapy on the theory that their adrenals make so little androstenedione and whatever fat cells they have make so little estrogen that the extra year of theoretical longevity may be outweighed by the side effects---but again, those are outliers). I feel safer having the highest-risk part of my breast irradiated, and the possibility of estrogen production by my endocrine system and fat cells foreclosed. (Wonder if liposuction, since it removes some fat cells, also lowers estrogen production).

I'm interested in this because I'm recovering from lumpectomy and I'm really scared about radiation. Dr. has ordered oncotype, but we don't have results yet. I'm 60 and she did tell me about being over 70 and not needing it.

She told me that if no radiation, there's a 10% chance of reoccurrence and with radiation 2-3%. Waiting for report and she said to talk to radiation oncologist after we get report. But she said I'd need hormone therapy. Not sure about that either. Would love to read more about it or hear about experiences.

Linda

I'm 58, and because of life circumstances and the type of cancer I have, am electing to not do radiation. I had a bad hip prior to my BC Dx, and treatment was put on hold for the cancer. I had the last of a number of steroid injections to buy time 2 weeks before my BMX. The shot wore off, and my hip is bone on bone with a badly torn labrum. It needs replacement and I'm doing that 2/10.

I also chose not to do Standard chemo, as research shows it doesn't work well on my type of ILC. Endocrine therapy is best.

So it's wait and see. I'll keep the group posted as to how I do

I am 69 and have DCIS and have had lumpectomy and re-excision with still unclean margins, so will have to have mastectomy anyway...no radiation. But it is my understanding that the question of radiation depends upon the grade of the DCIS if it is high grade, it means it is fast growing and that the research results indicate that radiation is the best way to go. If it is low grade or very slow growing, then it is possible to not have radiation. I would suggest talking about this with your doctor and radiologist oncologist.

I am 75 years old and I developed cancer in my left breast. I didnt want a lumpectomy because if part of my body is sick and I can live without it, then its gone...My nodes are clear. So I had a mastectomy 3 months ago, and Doc said no Radiation because of my age and he didnt feel that I needed it. and on my onctest I fell in the lowest number in middle of chart. 18. So the recommendation was Hormone Therapy with or without chemo. I chose without because I am sole caretaker for my mother who is 92 years old.and really I dont have anyone to help me. But I am wondering how Tamoxifen can help me because of my age, Im sure my body makes very little estrogen and/or hormones. Lots of bad side effects

Its really a very hard decision, and I have to make up my mind before I go back to Doc.

Hi, Odd-Ms. Age-wise, I'm in between you and ChiSandy. I looked at my oncotype score and noted that tamoxifen would cut my chance of recurrence (that's distant recurrence, the kind we don't want) in half. "Noted" is an understatment, by the way. That fact was, and, three and a half years later, still is, chiseled into my brain. You could look at it this way--None of us has the estrogen level our bodies once had, but exactly how much estrogen does a tiny leftover cancer cell need to keep it vital?

My mom was 80 at diagnosis (she is now 83). Stage 1, 1.4 cm tumor, ER+ PR+ Her2- Local hospital recommended chemo and rads.

I had her up to Univ of Michigan, an NCI Designated cancer center within 2 days - I'm a patient there, my sister is a BC patient there, and mom is a patient there.) Anyway, she had a Lumpectomy - she flew through that (was at the casino the next day much to my chagrin!) No Chemo per Tumor Board - they let her make the call on Radiation - only a 3% help in her case. She said no. She was on Arimidex for 2 years, but then started to have balance issues. She quit.

I'm 70, have IDC also, ER/PR+, HER2-, Stage IIa , with one sentinel node positive out of 14 nodes removed. I had a mastectomy late August with an expander. My MammaPrint came back LowRisk. 99% chance of no recurrence with chemo and hormone blockers or 93% no recurrence with hormone treatment only. I have decided not to have the chemo. I'm up in the air regarding radiation as I'm not sure what's left to radiate. I'd like to learn your doctor's opinion if you are also Low Risk. Best Wishes on a favorable outcome.

My dear chat room sisters: There is not one study but several that indicate that, depending on the type of cancer, stage, receptors, etc, persons with MX may or may not benefit from radio, chemo, and cancer-controlling experiences. As you have noted, not everyone responds well to AI. I am on Arimidex and is causing me a lot of hand cramps and joint pains and decided to stay in it. I have read many, many articles on chemo and radio and rejected chemo; I was evaluated for radio and the lady sent me for a conventional protocol of 35 sessions which I will negotiate because the amount of rad, the equipment they use, and the logistics of the whole thing is too much. I had radical MX of right breast, sentinel biopsy of lymph nodes (in which the OS removed the only contaminated lymph node under the axilla), and in the PET/CT scan they found two more nodes on the supra-clavicullar fossa. That is the only region in which there is cancer activity. I will be more benefited by a partial breast rad tx or hypofragmentation, especially when they know that excessive rad can cause cancer to any of us. I sincerely have even told everyone, at the first burn, I drop out of tx. I still have a friction burn from two and half months ago and it has not cleared nor the skin has regenerated. I don't want that for my body. Not everyone reacts equally to rad or chemo, so we must be very cautious. I have had acquaintances that have died of chemo effects.

If the physicians have explained quite well the interpretations of Mammaprint and Oncotype results, chemo only adds up to the percentage of survival of women using tamoxifen. The percentage added depends really on the score one gets, according to the study's graphs. In my case I was 26 (Onco) and -.526 in Mammaprint (intermediate and high risk, respectively). However, the percentage of added "survival rate" it was 8 % on the first and 12% on the second. If you really ask me how I feel about being intoxicated or burned inside out for a 8% (12%) in chemo and 4% in radio, I will tell you the risks outweigh the benefits of chemo or radiation. They have to give me more valuable info to make a wise decision. I don't want the RO chasing cancer ghosts in my body just for the sake of a protocol because she thinks I have millions of cancer cells when I might have a few thousands. I need to be sure she won't create millions of them in trying to kill the thousands I have within me. I do believe in personalized medicine and it means that the whole tx is personalized.

The reality is that Mammoprint or Oncotype do not consider rad tx in their graphs. When I checked on the videos of physicians directing oncology sites in medical centers, they expose that in women with radical mx and less than four nodes, the added survival rate is only 4 per cent.compared to those who had mx and no rad tx at all, another time for me to think about risks and benefits. The RO who evaluated me sincerely told me that after rad tx, physicians keep checking on patients because the aftermath of rad tx.: cancer, pneumonitis, damage to heart and lungs, usually of the permanent type, exacerbation of osteoporosis, bone cancer, and many, many other undesirable long term side effects of rad. Chemo is also full of those too. So if your Dr. tells you that under your circumstances, you do not need the RT or chemo, don't push. Even going thru the chemo or rad, does not assure us of not having recurrence. And, if you go thru, there is an added percent that you may develop another type of cancer depending on the chemo agents MOs use.

So please, dear ladies, be careful. Ask, ask, and continue asking. It is hard to think that we may have some kind of responsibility on the kind of tx we receive, but is true. Drs. are not the the sole responsible for tx, we are whether we ask, inform ourselves or do the right things to achieve the best results. Hiding ourselves is not the best policy. Giving an informed consent is. And my best diatribe goes to: the ostrich. They don't hide the head in a hole to hide from danger. When they put their head in the hole, they measure distance from danger, type of danger, and a lot of info they obtain before running in the right direction.

hi Sandy,

You are define,y my go to expert. I asked you before about insurance and now I can't find your answer.

I need to know if I should purchase prescription drug coverage.

I have Medicare part a&b and blue shields supplemental.

It is open enrollment now and I am wondering to select Medicare d or purchase prescription coverage with blue shield.

I haven't started radiation yet but I am anticipating the anti hormonal pills cost.I have no idea of the cost.

Thanks again,

Hope you are well.Linda

Hello
I had lumpectomy last month. I am now more confused and frustrated trying to decide what follow up treatment I should choose. . My final pathological diagnosis was IDC with tubular features, , grade 1, 4mm, stage 1, grade 1, pos estrogen-prog-her- neg. margins were close, so surgeon went in again to widen margins, biopsy sentinel lymph gland- was neg also. I was told chemo was out of question, very low rate of reoccurrence, and never given that oncotype test. I was told by surgeon standard of care was for radiation, and to visit MO also. Most of the diagnoses I am finding on these posts are larger tumors, higher grades and stages and involve chemotherapy and many mastectomies. The MO made me aware of " standard care". He also mentioned the foregoing of rad and taking hormones for about 5--10 years since I am 70, in excellent health and small chance of reoccurance. However, RO recommends radiation. I don't want to over treat or undertreat. If a reoccurrence occurs, I will be faced with a mastectomy of one breast. If I choose hormones and cannot deal with side effects, I will be left without any protection. Each dr seems to encourage treatment they give. This is not helping me make a decision.
Has anyone just had a lumpectomy without radiation and /or without hormones?
I can't help feeling that this inability to make a decision is telling me that neither is right, although I do have a tendency not to be able to make decisions. My time is running out to schedule radiation. I have been reading the posts on all the terrible side effects and regrets from women who had radiation and same for hormone therapy. I don't know how to choose the best treatment for me in my situation. . Is there anyone who has a similar diagnosis who maybe have been in my situation and have had more honest and/ or straight forward medical advice than I have received?thank you
Roche