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Topic: Postponing chemo in light of COVID-19 virus

Forum: All things COVID-19 or coronavirus —

A place to discuss the impact of COVID-19 (Coronavirus) on you and the ones you love.

Posted on: Mar 20, 2020 12:28PM

ysw63 wrote:

Is there anyone who is postponing their chemo during the Coronavirus pandemic? My husband is a physician who is on the front lines of screening and treating people. I am to receive a total of 4 infusions spaced every 3 weeks. Have had one so far and want to postpone the remainder of my infusions. My oncologist wants me to continue. The chemo is being done to help prevent recurrence as we think it was all removed with my lumpectomy and my sentinel nodes were negative. My Oncotype DX score was 32 and the cutoff to determine whether or not I would get chemo is 25. I don’t feel that it is crucial for me to get chemo at this time and feel like I should postpone it. Our stress level is extremely high in our house and my husband will have to find someplace else to live if I continue my chemo right now. I’m just hoping to hear from others that may be in my same situation to see what they are considering. I will of course talk some more with my doctors and will follow their recommendations

Dx 1/6/2020, ILC/IDC, Left, 1cm, Stage IB, Grade 2, 0/2 nodes, ER+/PR-, HER2- (IHC) Surgery 1/31/2020 Lumpectomy; Lymph node removal: Sentinel Chemotherapy 3/4/2020 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Mar 20, 2020 03:51PM jcerroni241 wrote:

I am also concerned about continuing my chemo. I would be on infusion # 3 out of 4 in 2 weeks. Oncology is also currently telling me to continue- I had a successful lumpectomy, micromets in 2 out of 4 lymph nodes (so technically node negative) and my Oncoscore was right on the line. We decided at the time, due to my younger age the chemo would be well tolerated and still provide benefit.

A huge Thank You to your physician husband for the work he does and to you for the support you give him! I could not imagine the stress you are experiencing right now!

I know how anxious and scared I am with a husband just working in the private sector and an 8 year old that I am most likely going to continue to keep home from school.

I will check back in with Oncology at the end of next week- as I have 3 visits I would have to make just for the one infusion. Dr visit, infusion then injection. I want to get the full benefit of chemo and not take any chances that a delay would "weaken" the results..... but the news has my nerves at DEFCON 5!




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Mar 20, 2020 04:38PM Salamandra wrote:

It sounds intensely stressful. I agree that continuing to consult with your doctors is a good way forward.

FWIW, not being in your shoes, it seems like the additional temporary stress now of living separately from your husband and dealing with chemo alone in the time of corona is still preferable to the potentially greater cost later of metastatic recurrence.

I also suspect that things will not get better, covid-19 wise, for quite a while. There is a window for chemo efficacy. Your doctor could say more what that is, and also about the additional risks of starting but not completing chemo. If you stop now, I would not count on being able to resume within the window.

Good luck with these difficult decisions. I'm sorry you're facing them at all :(

Dx at 39. 1.8cm. Oncotype 9. Dx 9/19/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (FISH) Surgery 10/18/2018 Lumpectomy; Lymph node removal: Sentinel Hormonal Therapy 11/1/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 12/3/2018 Whole-breast: Breast Hormonal Therapy 12/19/2019 Fareston (toremifene)
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Mar 20, 2020 06:30PM santabarbarian wrote:

The stats of benefit are based on completing the chemo in the prescribed protocol. If you monkey with it too, much you might reduce your benefit. Something to consider.

pCR after neoadjuvant chemo w/ integrative practices; Proton rads. Dx 7/13/2018, IDC, Left, 3cm, Stage IIB, Grade 3, ER-/PR-, HER2- (FISH) Chemotherapy 8/12/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 12/27/2018 Lumpectomy: Left Radiation Therapy 2/10/2019 Whole-breast: Breast, Lymph nodes
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Mar 20, 2020 06:33PM MinusTwo wrote:

I agree. Maybe figure out how to go ahead in sequence.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Mar 20, 2020 06:56PM MarciaM wrote:

dear friend

I salute you using common sense with corona virus and chemotherapy- it permanently damages the immune system . And it’s your choice and the fact that your husband is a dr , that makes him and you more exposed possibly . I went thru chemo ten years ago my immune system is now permanently damaged . No one made that clear to me at that time . I’m older now and even survived stage 4 brain tumor abs have been cancer free all these years , so you can survive do chemo

Later , make up your mind !
Learn to take charge of your lite .

I wish you the very best outcome !

Marcia

Marcia M Hormonal Therapy 5/19/2010 Arimidex (anastrozole) Dx 10/26/2010, IDC, 4cm, Stage IIIA, Grade 3, 7/14 nodes, ER+/PR- Dx 10/27/2010, IDC, 5cm, Stage IV, Grade 3, ER+/PR-, HER2- Surgery 11/3/2010 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left Chemotherapy 1/2/2011 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 5/14/2011 Breast, Lymph nodes
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Mar 20, 2020 10:18PM - edited Mar 20, 2020 10:21PM by sweetp6217

If it were me, I would go. Thing is, I went to a cancer center that used to allow kids to visit during chemo. That ended pretty quickly. Kids are unfortunately great at carrying viruses. If the center only permits limited assistance, etc., I would go.

P.S. Yoko, would you be able to post your diagnosis and treatment(s)? There was a big study done recently that praises the virtues of chemo for certain patients. Patients where the chemo was successful in getting rid of the tumors. I did have to postpone my final major treatment by a week due to anemia.

Dx 7/7/2017, IDC, Left, 2cm, Stage IIB, Grade 3, 1/2 nodes, HER2+ (FISH) Targeted Therapy 7/26/2017 Herceptin (trastuzumab) Chemotherapy 7/26/2017 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 1/3/2018 Lumpectomy: Left; Lymph node removal: Sentinel, Underarm/Axillary Radiation Therapy 2/20/2018 Whole-breast: Breast, Lymph nodes Hormonal Therapy 4/13/2018 Femara (letrozole)
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Mar 20, 2020 10:48PM santabarbarian wrote:

Marcia, your experience is not shared by all. I had the exact same chemo as you and my immune system is in good shape. I am sorry for your experience but it is not correct to claim what happened to you is commonplace.

pCR after neoadjuvant chemo w/ integrative practices; Proton rads. Dx 7/13/2018, IDC, Left, 3cm, Stage IIB, Grade 3, ER-/PR-, HER2- (FISH) Chemotherapy 8/12/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 12/27/2018 Lumpectomy: Left Radiation Therapy 2/10/2019 Whole-breast: Breast, Lymph nodes
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Mar 21, 2020 01:37AM MinusTwo wrote:

I too had taxotere & carboplatin - in addition to herceptin & perjeta. My immune system is also in good shape.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Mar 21, 2020 04:29PM Elderberry wrote:

yokosw: If you can do it, continue with chemo. Postponing could affect your outcome. I had chemo as the first line and it has put me in a very good place. I do understand the stress and salute your husband and all the other front line health care workers. I do H&P every three weeks and it freaks me out to think I might have to lose a few infusions. They are keeping me alive.

As for chemo and my immune system. It seems to be pretty darn good these days but I am staying at home and only venturing out for short walks to local produce/meat and bakery stores and get a little fresh air . These are scary times but we all need to take the best care of ourselves.

De Novo - this isn't a "brave battle" - it is a "furious struggle" Dx 3/6/2019, IDC, Left, 5cm, Stage IV, metastasized to liver, HER2+ Targeted Therapy Herceptin (trastuzumab) Chemotherapy Taxol (paclitaxel) Targeted Therapy Perjeta (pertuzumab)
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Mar 21, 2020 07:32PM keepthefaith wrote:

When I had TC, my immune system tanked and was low for over a year after completion of TX's..... But, it slowly got better and now my numbers are in the normal range. We are all different. You have to gather information and do what you think is best for your specific situation. If you decide on chemo, you would have your blood checked before each infusion. You may need Neulasta after each chemo to help boost your immune system. Your MO would monitor you closely and you can stop or reduce a dose if need be. Good to ask questions and be your own advocate! Best wishes.

Dx 9/17/2013, IDC, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 10/17/2013 Lumpectomy: Right; Lymph node removal: Right, Sentinel Chemotherapy 12/2/2013 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Chemotherapy 12/25/2013 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Chemotherapy 1/15/2014 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Chemotherapy 2/10/2014 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 3/31/2014 Breast Hormonal Therapy 5/22/2014
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Mar 24, 2020 11:31AM ctmbsikia wrote:

My husband has a Stage IV lung cancer and he was just cleared yesterday to begin cycle #7. He left before 10am and should be back by 3pm. I was not allowed to be in the treatment room. Their lab is also closed to the public and just being used for the oncology patients.

Very scary having him so vulnerable. Wish us luck! Worried about the weekend, when he goes down that I am able to keep him comfortable from all the side effects he deals with post treatment. I was assured that if I had an emergency, that they have some capacity to treat him locally instead of telling me to take him to a hospital. I needed to know that they and I have a plan, just in case.

Stay well everyone.

Dx 12/14/2017, DCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 1/2 nodes, ER+/PR+, HER2- Dx 1/16/2018, LCIS, Right Surgery 1/31/2018 Lumpectomy: Left; Lymph node removal: Sentinel Radiation Therapy 4/11/2018 Whole-breast: Breast Hormonal Therapy 6/25/2018 Arimidex (anastrozole)
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Mar 24, 2020 12:05PM ysw63 wrote:

Hoping you and your husband remain safe. They’ll take care of him if needed.

My oncologist is going to let me hold off on chemo for now and start radiation and Letrozole since I have estrogen receptors. Less stress in our household knowing that my husband willnot have to move out for a few months. He’s still keeping his distance and sleeping downstairs but at least he can be in his own home.

Dx 1/6/2020, ILC/IDC, Left, 1cm, Stage IB, Grade 2, 0/2 nodes, ER+/PR-, HER2- (IHC) Surgery 1/31/2020 Lumpectomy; Lymph node removal: Sentinel Chemotherapy 3/4/2020 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Mar 25, 2020 12:42PM jelloelloello wrote:

I am planning to start chemo (first time) next week for Stage 3 IDC, and no, I'm not at all considering postponing it. I couldn't be more anxious and ready to start! Yes, I'm super nervous about the potential exposure risks of going out to the hospital for treatments, but my doctors and I agree that it's worth the risk to begin the fight. The hospital has strong protective measures for COVID-19 and the infusion center, specifically, does not allow any visitors/caregivers-- patients only and restricted staff. This helps me to feel better about the situation, even though I hate that I have to do this alone. I thought I'd be going into the cancer fight with lots of friends and family around me, but because of the quarantine, it is already incredibly lonely. So many awesome friends had offered to drive me to chemo and hang out with me during the infusions, or bring me over some home-cooked meals, or just go out and pick up little things for me when I'm sick and realize I could really use a fill-in-the-blank, but now, none of that can happen. As a newly-diagnosed cancer patient, I can't even purchase the things I need to get prepared for my chemo treatments because everything is out of stock online and some places aren't able to deliver anymore-- things I didn't have before the pandemic because I didn't know I had cancer and was going to need them. This is the worst timing. But, although I could go on a lot more about how depressed, frustrated and, honestly, sad I am about the COVID-19 situation, what I came here to say was that I still feel totally confident that starting chemo is the right choice for me.

Dx 2/13/2020, IDC, Right, 6cm+, Stage IIIA, Grade 3, ER+/PR+, HER2- (FISH) Chemotherapy 4/2/2020 AC + T (Taxol) Immunotherapy 4/2/2020 Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall Surgery Lymph node removal: Underarm/Axillary; Mastectomy: Right Surgery Prophylactic ovary removal
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Mar 25, 2020 02:02PM mamaof4boys wrote:

Anyone with Triple Negative have surgery before Chemo? My surgeon and oncologist both think I should have bmx first given the Covid 19. I really am disappointed that normal sequencing will not be done. Hoping for good news from those who did have surgery first.

Dx 3/13/2020, IDC, Left, 1cm, Grade 2, ER-/PR-, HER2- (FISH)
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Mar 25, 2020 02:27PM SpecialK wrote:

mama - I was triple pos and had surgery first, if I was treated today I would have received chemo first. I am linking a triple neg thread for you, with the most recent page first. Look at the members signature lines and check the surgery and chemo dates - you will see a number of them did have surgery first. Sorry you are dealing with a new diagnosis and the Coronavirus delays - I’m sure this is stressful, wishing you the best.

https://community.breastcancer.org/forum/72/topics/752075?page=1176

BMX w/ TE 11/1/10, ALND 12/6/10. 16 additional surgeries. TCHx6 2/17-6/2/11. Herceptin until 1/19/12. Femara 8/1/11, Arimidex 6/20/12, back to Femara 2013-2018. Dx 9/27/2010, DCIS, Stage 0, Grade 3 Dx 9/27/2010, IDC, Right, 2cm, Stage IIB, Grade 3, 2/14 nodes, ER+/PR+, HER2+ (IHC)
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Mar 28, 2020 04:49AM LongHappyLife wrote:

I have a very similar case ysw63

Onco DX 30, ER+ PR borderline, Her2 Neu -ve

Very confused on how to proceed, I have had one chemo session and need to get 3 more..

https://community.breastcancer.org/forum/69/topics/875948?page=1#idx_1

I consulted 2 different MO's and both gave me different opinions, i have now just paid for a bench of experts to discuss my case and give their opinion.

They will get back to me by monday eod. I will update here on what they suggest..

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Mar 28, 2020 08:03AM ysw63 wrote:

LongHappyLife

thank you for posting your situation. My MO said it would be fine for me to postpone my chemo for now and I will be starting radiation for 3.5 weeks and take Letrozole since I am estrogen positive. She felt that in light of my situation with my husband working on the front lines of screening Covid19 patients, it would be best for mine and his mental status to delay chemo. He would have gone to live elsewhere until I finished treatments near the end of May. He's still keeping his distance when at home and sleeping in a separate bedroom just to be safe. I know there's a risk of exposure going to radiation every day for 3.5 weeks but I feel that they are doing their best to screen every person walking in the door and keeping visitors and extra people out of the building.

I wish you the best with whatever you decide.

Dx 1/6/2020, ILC/IDC, Left, 1cm, Stage IB, Grade 2, 0/2 nodes, ER+/PR-, HER2- (IHC) Surgery 1/31/2020 Lumpectomy; Lymph node removal: Sentinel Chemotherapy 3/4/2020 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Mar 28, 2020 10:14AM Togethertolearn wrote:

sit quietly and the let the answer come to you - but you probably already know what your body is telling you. Do what your gut says and don't regret. Yours will not be an answer everyone will agree with but neither is your life their. I wish you all clear headed decisions and peace after.

Diagnosed 2019, age 45. Dx 4/2019, Right, <1cm, Grade 3, 0/2 nodes, ER+/PR+, HER2-
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Mar 31, 2020 05:05PM - edited Mar 31, 2020 05:12PM by Murphity

Your stories make me feel less alone. Thank you. I am struggling with these decisions as well. My surgeon told me she felt the risk of COVID in our hospital was too high, and strongly suggested I put off my mastectomy. I agreed but am now regretting not thinking it through more. Can't get surgery anywhere else around here either. I have a new med onc consult Friday. They are re-reading my pathology to ensure I am HER-2 positive, though I get the impression it's really hard to tell with multiple foci microinvasion. It seems I am a 'borderline' case for chemo, but that it would likely lower my risk of recurrence by at least a small percentage. I am 41, BRCA neg, but with very strong family history with mortality. I am grateful my cancer is so small, but I'm agonizing terribly over the chemo decision in light of COVID. I live in NY.

I already feel so out of control of my body, and feel I am losing control over everything else, too. I feel lucky in so many ways, so hate that I'm so horribly depressed and confused.

Dx 2/28/2020, IDC, Left, Stage IA, ER+/PR+, HER2+ (FISH)

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