My wife, age 68, had a lump removed from her left breast a little over 8 years ago. It was a stage #1 ductal cancer, negative nodes, positive ERs, and clean margins. Followed by a full course of radiation, and 5 years to tomoxian (Sp?). My wife has a family history of cancer.
She now has another lump, lobular cancer, estimated to be about 3 to 5 cms, and will have the breast removed in early January.
Most of her friends who had Chemotherapy are now dead, and Chemo killed her 37 year old brother in 1975, via MD Anderson as a follow-up to his colon cancer. So my wife has strong feelings about the value of Chemotherapy. In our research we are unable to find any reports or data on survival rates when there was no Chemotherapy or radiation after surgery. We have looked on NIH, ACS, Cancerfacts, Medmet. and several other wed sights as well as general web searchs.
What can you tell us about survival rates when there is no follow-on Chemotherapy or radiation and what specific reports on the web can you point us to. Thank you, William D. Goodell
Dear Mr. Leeper: The reason why you are not finding information about survival in women who do not have chemo or radiation is that most women do not choose that path. We cannot legitimately do a study that denies people the best possible treatment, so there is no scientific way to come up with this information. When asked, a physician will only be able to relate his/her experience in terms of a handful or so of women who chose no chemo. This is hardly scientific. In real terms, there are ways to estimate the relative benefit of chemotherapy in an individual case. You might read Dr. Susan Love's breast book. She has a nice discussion on this subject that is very objective. Too much to post. Hope this helps.
Radiation is not generally done if there is a mastectomy.
So the issue is whether or not to have chemo, and you haven't provided all the data on which such a choice is generally made. You didn't state whether this is the previously treated breast or not. If it is, then presumably no lymph nodes will be available for testing. The other datum is hormone status of the tumor. Lobular cancer is likely to be estrogen sensitive, so treatment with hormone blocking agents such as tamoxifen would be possible. Given the size of the tumor, it's a definite consideration. It tends to have very minimal side effects, especially in a post-menopausal woman. Chemo, as you may know, is not only one recipe. That which is used on colon cancer is entirely different from the drugs used for breast cancer. Nor can one draw conclusions from the fact that you know women who took it and died. The situations in which it's given vary enormously. It works best in a "preventative" scenario; meaning one in which the risk of recurrance is elevated, but there is no known residual tumor in the original field or elsewhere in the body. There are clear data showing that in women with a large tumor, when nodes are ok, there will be more cured in the group taking chemo of some kind than in the group that doesn't. It urge you and your wife at least to have a discussion with an oncologist about the choices, the pros and cons, especially regarding hormone therapy.
The notion that patients treated by conventional therapies (the scientific way) live longer than untreated victims is biased by the methods of defining the groups. If a person in the untreated category dies at any time while he or she is being studied, this is recorded as a death in the control group and registered as a failure of the no treatment approach.
However, if patients in the treated category die during the course of treatment (before the course is completed), their cases are rejected from the data since these patients do not then meet the criteria established by definition of the term "treated". A patient dying on day 89 of a prescribed 90-day course of chemotherapy would be dropped from the list of treated patients.
This is hardly scientific.
Everyone has options and all must learn to take the next step to learn what their options are and not be lead without appropriate knowledge. So much conventional cancer treatments have been available for such a short period of time that it has not yet been determined all of the truely long term effects of some of these treatments.
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