Suggest Treatment For Stage 1 Cancer

Posted on Wed, 14 Sep 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 14 Sep 2016 Answered on

Mon, 3 Oct 2016 Last reviewed on

Question : I recently had a lumpectomy and 5 lymph nodes removed. One of the 5 lymph nodes the one closest to the tumor came back positive. My surgeon told me the oncologist is going to recommend chemo because of this. The margins are good the got everything she said and stated the tumor was smaller than thought 1.5cm. So I was stage 1 but because of the lymph node stage 2a. Our thought is this was missed on a 2012 mammogram when first spotted. So she believed it was very slow and non aggressive. I am positive for high estrogen and progesterone but negative her2. I really don't want to do chemo as I feel and have felt for years great never knew I had this and afraid this will weaken me. Do you feel chemo is 100% nessessary is it more preventative then actual a cure for this. Not sure what to do or ask my oncologist. I am even hesitant about radiation that also it harsh what should I do?

Answered by Dr. Indranil Ghosh (5 hours later)

Brief Answer:
Mostly chemo is given in this scenario

Detailed Answer:
Hi
Thanks for your query.

To answer your query, I would need the grade of tumor also. Pending that, I can say that mostly we advise chemo in this scenario. As a preventive measure. But the benefit is not huge. Probably with this kind of tumor, the benefit is around 4-6%. Which means that chemo saves 4-6 lives out of 100 women treated, over and above surgery and hormone therapy.

There is some role of genetic tests done on the tumor, like oncotype dx or mammaprint, to decide if chemo is of any benefit in you or not. You can discuss these things with your oncologist.

Radiation is mandatory for you, as only lumpectomy has been done. Treatment will be incomplete without that. it is quite well tolerated.

Hope this helps.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (21 minutes later)

Thank you so much for yoir reply. I have accepted the radiation as i knew it was best but i worry about what i am doing to my body as it is "precautionary" and has small benefits. They for some reason dod not do an onco score? They only did the my risk blood work whixh tested me for other cancers abd markers and it all came back good all negative. I am not good at understanding pathology reports so i attached mine for you see tumor grade

Answered by Dr. Indranil Ghosh (7 hours later)

Brief Answer:
grade II

Detailed Answer:
As it is grade II tumor with high proliferative index (Ki67), I would tend to recommend chemo to my patients. But it is definitely precautionary and even without chemo many patients would do well. Blood work does not help much in deciding.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (1 hour later)

Do you think i dhould ask for a PET scan? And if i decide to skip chemo what are the risks?

Answered by Dr. Indranil Ghosh (3 hours later)

Brief Answer:
Pet scan will not help

Detailed Answer:
PET scans do not pick up microscopic disease which we want to target now.

Risk of skipping chemo as I mentioned, 10 yr survival probability reduced by 5-6% as compared to with chemo.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (28 minutes later)

I appreciate all of your help in answering my questions. The last thing i have to ask, is do you believe in alternative care as helpful? Like alkelining the body the use of tumeric and things of this nature. If so any suggestions? Once again you habd been a great help. Thank you!!!!!

Answered by Dr. Indranil Ghosh (2 hours later)

Brief Answer:
no these things are proven

Detailed Answer:
We do not recommend such therapies as there is no evidence for them.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar