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Posted 2/27/2006 7:04 PM (GMT 0)
Hi - this is about a friend of mine - she had a mammogram in October and it came back clear...in November she found a lump in her breast but she had a wedding come up and Christmas and she decided to put off going to the doc until January...so she had another mammogram in January and they set her up for an ultrasound and then a biopsy of the lump and took some lymph nodes - the biopsy came back malignant and the lymph nodes came back impacted. She was scheduled for a lumpectomy but the oncologist called and said he is cancelling the surgery and jumping right into chemo for her, she starts this week.
I feel like I am missing something here and her doctor is only giving the need to know in the moment kind of answer. Anyone have this kind of experience or have an idea of why the surgery would be skipped (she now has a lymph node the size of a golf ball under her arm and they are leaving it there - WHY?)
Honestly, but gut says something is not right here, my personal thoughts would be get it out of me and lets work on it from there, or if they wanted to decrease the size of the lump (or tumor as they are calling it) wouldn't they use radiation?
How can I help her? She loves life, I feel ashamed for how I take mine for granted. No, this isn't about me, I just want to know from people who have been there to let me know the good the bad and the ugly...some of this might not need to be shared with her, I realize that, but I need to understand why the surgery is being skipped and the jump is right to chemo.
Any insight would be greatly appreciated.
Posted 2/27/2006 8:54 PM (GMT 0)

Hi Mary-Anne! Your friend is lucky to have someone like you in her corner. Something doesn't sound right to me either. Has she sought a 2nd opinion? If not, I would suggest doing so asap. I have heard of chemo being done before the surgery but I'm sorry to say that I don't understand why. I also can't imagine any surgeon doing a lumpectomy if there is that much tumor involvment. Please, please suggest to your friend that she get another opinion. Also a 3rd if necessary. If she has waited this long, the a couple of more days aren't going to hurt.

Keep the faith. BC today is a "manageable" disease, not a death sentence. The most important thing is to be proactive in your own health care and make sure that the treatment you are getting is right and the best.

Please keep us informed. Invite your friend to come and get some support from us.

Hugs...Deb

In order to see the rainbow, you must first endure the rain!!!!

Posted 2/27/2006 9:14 PM (GMT 0)
You are a good friend.  My understanding of doing chemo before surgery is because the tumor is large and they want to reduce the size before removing it.  Chemo is the treatment of choice for that, not radiation.  It would also reduce the size of the lymphs.  But, if they had scheduled a lumpectomy, then it doesn't sound too big, so it is kind of strange. 

 

A second opinion is a great idea.  Also, tell her to ask questions about everything and take someone with her.  Maybe take a notebook to write things down.  It's a stressful time and your mind is all a blur.  You can't remember everything they tell you. 

 

Do you know the type of cancer, size of tumor, etc?

Posted 2/27/2006 10:34 PM (GMT 0)
I'm confused, I guess I thought that radiation would the first choice to shrink the tumor because I understood that chemo would knock out all the cells in her body, good and bad, to get rid of all the cancer, so her body would have a hard time getting ready to handle a surgery? Maybe it is different for each type of cancer...? I don't understand why a doctor would choose to leave a lymph node the size of a golf ball under her arm and her not fight to remove it.

I think my friend is comfortable with the only knowing as she goes along approach, and honestly, that no surgery and chemo first was better than surgery. I don't know much about this. I have read so much, and there are so many confliciting opinions out there, so many strides and so many standstills, try to stay focused on the positive and how far we've come (and we have, thank God!) but it just seems odd. I guess what concerns me is that her mammo was clear in October and in January she has a malignant tumor. In my mind, I think aggressive cancer, so I automatically think aggressive treatment...cut it out and treat your body so that it is gone gone gone. I dont' understand this opposite approach and I can't find the thought process anywhere in the research I've done - anybody know where I would find info where chemo would be chosen before surgery or radiation?

Thanks Kathy and Deb for your replies...I am with you about the second opinions and asking questions. When I was dx with lupus it was mind boggling and I had to write it all down and go over it to understand, asked millions of questions here on the lupus board and did tons of research, believing knowledge to be only revenge. It is what I've got, and I follow the doctor's advice, I take my meds, I eat better, try to exercise (I put more effort into it than I ever did before, but it's not enough) and the lupus is quiet. The fibro is another story, that's just a pain, but hopefully if I keep at these changes and learning more, I'll come across better ways to handle this too. Lupus is no longer a death sentence either, and I am blessed to not have it in any of my organs and I pray it stays that way! The only thing that gets me from time to time, and I would imagine that this is applicable to anyone with any type of disease, is the feeling that your body is betraying you...I guess no disease is a respecter of people, and it shouldn't be, none of us deserve the pain that comes with what we deal with...but yet we deal and will continue to deal.

Again, thanks for what you wrote I appreciate your input, now lets see how I can talk to my friend and see how she's getting along. Today was day #1 of chemo and I am not certain how long it is to go or what the real purpose here is yet.
Posted 2/28/2006 12:17 AM (GMT 0)
I had chemo before surgery. One of the reasons was because the tumor was large - 6 cm. My oncologist wanted to try to shrink it before surgery with the hope that I could have a lumpectomy rather than a masectomy. He had a great explanation of the reasons behind surgery first. The thing that stuck out the most was that if the first type of chemo that we used didn't work we could keep trying until we found out what would work - hence if it ever came back we would KNOW which chemo would work on my particular cancer. This made so much more sense than the hit or miss approach of chemo after surgery. Later I attented a symposium in Houston with the head of the breast cancer group at MD Anderson. He stated that eventually chemo first approach would become the first line of treatment in cases where chemo was appropriate. He also said that by using chemo first in studies new advances would be fast tracked because they could be approved years earlier than is normal now.

For me, after two different types of chemo the tumor size didn't shrink and I wound up having the masectomy, however only a small portion of the remaining tumor had active cancer cells in it so it was considered a success.

Good luck to your friend. Hugs,
Cathy
Posted 2/28/2006 1:10 AM (GMT 0)

Mary Anne,

I know it seems odd, but this is a common approach for a large growth. Shrinking everything makes it much easier to get out. Also, as said before, they can see how well the chemo is working to shrink the malignancy.

I know there are several women on the board that this approach was used with. Radiation is not used as first-line defense as once an area is radiated it cannot be radiated again, so they wouldn't use that until most of the cancer is out.

Be as supportive as you can, but your friend nees to trust her doctor. If she does then she won't have a problem following his/her advice. If she doesn't, then she needs a new doc.

Good luck,
Julie

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