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Breast Cancer (Expert Forum)
Chemotherapy, elderly---appropriate recommendations?
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
Chemotherapy, elderly---appropriate recommendations?
by emilysjsu, Dec 26, 2002 12:00AM
Hello,
My 82 year old grandmother had a modifed radical mastectomy and she is ER/PR and Her2Neu negative. 4/7 lymph nodes were positive and one of the nodes had extra nodal extension. The mass was 2.6 cm and there were clear margins. We have seen the oncologist twice now and although he was nice, he was very quick. He has recommended chemotherapy injections one time a month for 4 months, followed by 6 weeks of radiation. My grandmother is in very good health, other than having osteoarthritis. We also have an appt with the radiation oncologist in 2 weeks. My questions are if the recommendations are appropriate? Should she need more cylces of chemotherapy? Are there other questions I should ask the oncologist like what type of drugs for the chemo? So far her chest xray, EKG, and comprehensive blood panel have come back normal. I asked the oncologist if my grandmother should have a bone scan, CT scans of the abdomen, etc. but he said that she is asymptomatic at this point and that he doesn't recommend it otherwise, he'd have to scan her whole body? Also, I've read where other people have more chemo more often. For example, some people have it once a week for 4 weeks, then break, and then do it another for weeks, then break, and finally another 4 weeks. Is what the oncologist recommended for my grandmother appropriate?
Please help and worried.
My 82 year old grandmother had a modifed radical mastectomy and she is ER/PR and Her2Neu negative. 4/7 lymph nodes were positive and one of the nodes had extra nodal extension. The mass was 2.6 cm and there were clear margins. We have seen the oncologist twice now and although he was nice, he was very quick. He has recommended chemotherapy injections one time a month for 4 months, followed by 6 weeks of radiation. My grandmother is in very good health, other than having osteoarthritis. We also have an appt with the radiation oncologist in 2 weeks. My questions are if the recommendations are appropriate? Should she need more cylces of chemotherapy? Are there other questions I should ask the oncologist like what type of drugs for the chemo? So far her chest xray, EKG, and comprehensive blood panel have come back normal. I asked the oncologist if my grandmother should have a bone scan, CT scans of the abdomen, etc. but he said that she is asymptomatic at this point and that he doesn't recommend it otherwise, he'd have to scan her whole body? Also, I've read where other people have more chemo more often. For example, some people have it once a week for 4 weeks, then break, and then do it another for weeks, then break, and finally another 4 weeks. Is what the oncologist recommended for my grandmother appropriate?
Please help and worried.
Doctor's Answer
by CCF-RN,MSN-JS, Dec 26, 2002 12:00AM
Dear emilysjsu, Recommendations for adjuvant chemotherapy are based on stage of cancer which takes into account tumor size, lymph node status and whether or not metastasis (spread) of cancer beyond the breast. This information as well as your grandmother's overall health are put together with the risks and benefits of any treatment. If your grandmother's tumor did not express hormone receptors then chemotherapy as adjuvant therapy makes sense if it looks like her overall health can take it. Adjuvant chemotherapies are usually in regimens of 4 to 6 months with a combination of drugs. There is some variation from in exact regimens between oncologists. You would want to ask the oncologist about the medications being used, possible side effects, the benefits in terms of recurrence rates and survival for the particular regimen being prescribed. Answers to these questions are then put into context of your grandmother's individual situation and a decision made from there.
The further tests are not routinely done unless there are clinical signs (symptoms, blood test abnormalities) of a problem.
The further tests are not routinely done unless there are clinical signs (symptoms, blood test abnormalities) of a problem.
