CHEMO THERAPY AND RADIATION POST LUMPECTOMY

[SNAIR]

Dear Doctor
My best friend's wife  is diaganosed breast carcinoma with left and has undergone lumpectomy this month( Size 2.6X 1.5 cm in the left breast at 12'o clock position). Her IHC ER, PR & Cerb- B2(Her-2/Neu) Report is as under.
Estrogen receptors : Positive in 95% nuclei
Progestrone receptors : Positive in 95% nuclei
Cerb B2 staining : Negative for the membranous pattern
Impression  ER Positive
                  PR Positive
                  Cerb B2 Negative
In the histopathological report 13 nodes in the left axillary are negative for tumor,
Left apical nodes- Two nodes negative for tumor
The doctor has advised chemotherapy(six sittings) with in 23 days of the operation which is due on 11 July 2008.
Would your kind panel enlighten me as to how important is the chemotherapy in this case. Is it necessary to be taken with in 23 days or can we wait for another oncologists suggestion/opinion?
Kindly help this lady for which she and her family would ever be grateful to you and your organisation

[SNAIR]

Thanks doctor,
patient has already undergone first cycle and recuperating. They heve decided to undergo both chemo and radiation. I would surely get in touch once the treatment is complete.
warm regards

[DrNoopurMD]

Hi,

I can understand your anxiety so please do not hesitate to ask questions.
The radiation therapy combined with chemotherapy will eliminate all the microscopic cancer cells and thereby reduce the relapse rates for breast cancer patients.
Chemotherapy is designed to kill the cancer cells but it also affects the normal body cells as well. The most common side effects of chemotherapy is nausea, vomiting, fatigue, hair loss, increased chances of bruising and bleeding, anemia and infection. It also causes weight loss and appetite changes sore moth and gums/
Every person does not get side effects and some people get only few. The doctor usually prescribes medications to prevent the side effects.
Surgery combined with chemotherapy and radiotherapy reduces to chances of recurrence significantly.

[SNAIR]

Thanks Doctor,
The patient has already taken appointment with an Oncologist at Jupiter hospital Thane west. She will be taking Chemo from 14 Jul 08. the doctor has asked her to go for six siittings and followed by radiation for 35 sittings.
Dr I have a doubt, After chemo is it necessary to go for radiation? The cancerous cell do not die with Chemo or is it to make very sure that does not recur? do all patients loose hair post chemo? What precautions are to be taken post chemo? In this case what are the shances of recurrence? Does the patient have any chance to develop cancer in any other part of the bidy.Pleasr  do not get airritated with these silly questions. Kindly answer.. out of curiosity let me ask you another question, which hospital are you attached to. If you wish you may keep it a secret. But request you to keep helping people on this site
Regards
Shivaji nair

[DrNoopurMD]

Hi,

If you are staying in and around Mumbai the best place to refer is TATA memorial hospital. It has a team of excellent oncologists though getting an appointment may take some time. Take care!

[SNAIR]

Thanks a million doctor. In fact my friend has an appoiontment with another oncologist on 12 Jul 2008. But he is not spacialised in breast cancer. What ever tha case be ,I will surely let you know the recommendation of this doctor..
Doctors like you are blessed lot who give valuable information to the needy which really gives great relief and confidence to the patient.
I would be grateful if you can suggest a good breast cancer spacialist  who is practicing near Thane in Maharashtra
May god bless you.
With warm regards
Shivaji Nair

[DrNoopurMD]

Hi,

How are you?
Since your friend’s wife has negative axillary and apical lymph nodes for cancer cells, it indicates that this was an early stage locally advanced cancer.
Generally in a locally advanced cancer chemotherapy is administered after surgery to kill the microscopic cells that may still be left after surgery and have the capability to grow back into a full fledged cancer. Since such patients are generally in good health chemotherapy is usually started within a few days or weeks after surgery. The exact time gap is decided by the oncologist and general health of the patient. If you are very worried about all this you can seek a second recommendation from an oncologist who specializes in breast cancer. Let me know if you need more information. Take care!