Chemotherapy, Radiation, or both?

HI,

We spoke with the radiation oncologist yesterday and he said that with radiation alone, there is a 40% chance that the cancer will metastasize elsewhere in 5-10 years and that with chemotherapy and radiation, there is only a 3% difference in the survival rates. His gut feeling is not to do chemo. What are your insights on this? My grandmother is 82 years old and has rheumatoid and osteoarthritis.

Also, what stage is she at? 4 out of 7 lymph nodes were positive with one of them completely replaced with extranodal extension. Tumor size was 2.6 cm.

Thanks.

[CCF-RN,MSN-JS]

Dear emilysjsu,  Decisions regarding further therapy relate to a variety of factors such as, staging of the disease, overall health of the patient and health history, her age, hormone receptor status.  Then the risks and benefits are weighed specific to her situation - the risks of chemotherapy, hormone therapy and/or radiation therapy vs. the possible benefits.  

The stage of her tumor may be either a IIB or III depending on the lymph nodes.  IIB consists of a tumor between 2-5cm and positive axillary lymh nodes.  Stage IIIA would be if the lymph nodes are fixed together or to other structures.  If the lymph nodes inside the chest are involved or the tumor extends into the chest wall or involves and ulcerates the skin, the lesion is Stage IIIB.