Oncology, does that mean definite chemotherapy?

Hi all

I have stage 2 grade 2 breast cancer with a positive node. I have had a lumpectomy and cavity shave and was told yesterday they have achieved clear margins, thank goodness! I was led to believe that my next steps would be radiotherapy and tamoxifen (I'm 47) but I was told yesterday that the outcome of the MDT was that I should have an appointment with an oncologist to discuss.

I was previously a bit surprised that I wouldn't have chemo given the node involvement but despite that I was still a bit shocked when it suddenly became a possibility. However, the nurse said she couldn't tell me anything further about the MDT discussion as I need to speak to the oncologist.

So now I am waiting for an appointment (always waiting!) and still feeling completely uncertain about what the next steps are. I know if I am given a choice I will take chemo - psychologically I think the 'chuck everything at it' approach will give me greater peace of mind, but I can't help feeling like I'd rather just be told whether I NEED it or not. Such a complete mishmash of contradictory emotions :( 

My mother died of BC at 38 having been diagnosed at 29 (I was 8 when she died) so I suspect it may be my family history that is raising question marks about my treatment plan. 

I was just wondering what choices other people have made and if they are happy with their decision?

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  • Hi SharLou,

    A very warm welcome to our forum.

    I am so sorry to hear that you lost your mum at such a young age. I also lost my mum to secondary breast cancer. Unfortunately, a cancer diagnosis brings many stages of uncertainty and these all tend to play with our minds. Most decisions about the optimum treatment for you, will be made at the MDT meeting. This is where all of the people involved in your care, decide between them, how to proceed with your care. This can only be decided when they have the results of your initial scans. biopsies, etc, so nothing can be decided upon, until they have these back. This makes your treatment a team decision, rather than an individual one. This is reassuring, as there is less likelihood of any mistakes being made.

    I had 2 bouts of breast cancer 14 years ago and saw an oncologist, who recommended that I had radiotherapy. For reasons, which I won't go into, there had been a delay of 11 months before I saw her and I didn't feel sure that this would work, so long after surgery. I was sent to see two eminent researchers in radiotherapy. One thought that I might as well try it, but the other was insistent that it would not be effective if administered so long after my operation. He seemed by far the more knowledgeable and could back up his opinion well, so I took his advice. Instead I took Tamoxifen for the first year and changed to Letrozole, when I discovered a second cancer in the same breast the following year. I took this for 6 and a half years (Both of my cancers were Pure Mucinous, stage 1, with no lymph node involvement)..

    Given your family history, the fact that your cancer is stage 2 and that you have a positive node, you may possibly  be advised to have chemo, as "a belt and braces approach". If I were in your position, I would feel like you and want to "throw everything at it", but you'll be able to discuss the benefits with your oncologist before making a final decision. There is a test that can be done to determine how beneficial chemo might be for you and it would be worth discussing this with your oncologist, before making the final decision.

    I hope that you get your appointment through soon and that, between the two of you, you reach the best decision.

    Please keep in touch and let us know how you get on. We are always here for you.

    Kind regards,

    Jolamine xx

  • Thank you so much everyone for your replies. I saw the oncologist on Tuesday and it was recommended that I have a course of chemotherapy, so I will start treatment on 5 September. Bit shocked but if it is needed so be it. 

    Thanks again for your responses, it is such a help being able to talk to people who 'get' it xx

  • Hi SharLou, just checking in to see how you're doing? 

    I've felt bit tired, but ok...went for a short walk yesterday, but ended up lying on my sister's sofa feeling sicky&dizzy(only lasted 15 mins& I was fine afterwards)-but definatly a lesson learnt to not overdo it!!! 

    Hope u are feeling ok...sending love, take care xx

  • Helloo! I was wondering how you're getting on. I'm with you on the tiredness front, it's a steep learning curve isn't it. I actually ended up in A&E yesterday...the rib and chest pain got worse and I was quite breathless so the oncology helpline sent me straight to hospital. Turns out the meds have triggered a flare up of costochondritis so I got given morphine and sent home with codeine. They checked my bloods, lungs and heart though and all was fine, which helped put my mind at rest as the slightest twinge causes a worry doesn't it! 

    Did you manage to do your injection OK? I facetimed my sisters for moral support whilst I did it but it really wasn't as bad as I expected. 

    Glad you're managing relatively ok - long may it last! Xx

  • Oh nooo, sounds like a scary time yesterday, but I'm glad they fully checked you out, and all is ok! Hope the meds relieve your pain. 

    Yes I was bit nervous but managed injection ok...will be glad when that bits over, but suppose it will become easier each day.

    It's absolutely pouring down with rain here today, so a very good excuse to cuddle down on sofa, watch TV, and read book!!

    Hope your pain relief continues to work, look after yourself xx

  • We had glorious weather this morning but now the heavens have opened! Went out for some food but now I'm slobbing on the settee.  I seem to be permanently hungry today :/ 

    Have you washed your hair yet? I washed mine today as I have a wig appointment tomorrow and she asked me to wash my hair so I won't be trying wigs on with grotty hair haha! Understandable obviously. Anyway I washed it and dried it off on a cool, gentle setting...I got a bit of a shock to be honest. My hair is like straw!! So brittle and dry...haven't lost any yet (probably still too early for that) but I was aghast at the condition of it.  It's made me think about going for the pixie cut to be honest. I'm going to try another cold cap with next treatment but if my hair carries on being damaged to this extent its going to have to go! (To be fair I'm prone to dry hair anyway which may be why it's affecting it so much). 

    Hope you enjoy your sofa day, I'll be doing the same for the rest of the day :) xx

  • Yes, I've got a roast dinner to have in abit, kindly brought around by my sister!! 

    No, I haven't actually washed hair yet, but it does feel quite dry. I have had small patches of alopecia in the past, so strands of hair falling out are fairly normal for me, tho I've felt today that maybe a few more are coming out!! Once I feel its coming out&becoming more noticeable, I'm thinking of getting it cut quite short(it's just below my shoulders at moment)-just so it doesn't seem so scary!

    We had torrential rain until 3pm...still very grey out there!! Enjoyed my day on sofa! Hope the wig appointment goes ok tomorrow xx

  • I'm with you on shorter hair being less scary! Mine is also shoulder length but if this level of damage keeps up it's going to be bye bye sooner than I thought. 

    Will update you on wig - hopefully I won't end up looking like Captain Hook!

    Hope you have a lovely restful evening :) xx

  • Hi SharLou, how r u doing? How did the wig fitting go?

    I've been a little tired throughout the week, but really pleased I've had no sickness! My partner was away golfing for a few day last week & I used the time to rest, read&relax...I felt so refreshed by the time he got home!!!

    Haven't really liked doing the injections, so glad they are over for a couple of weeks!! My next cycle is on the 27th.

    Hope things are going well for you too...take care xxx

  • Helloo! I haven't been too bad really, I tire easily and have had the WORST dry mouth but nothing major thankfully! 

    I didn't know whether to post about the wig as I didn't want to make other people downhearted, but it really wasn't good. It looked quite obviously wiglike, very shiny and synthetic looking. The colour was a good match to mine but I really don't think I would feel remotely comfortable being out and about in it, so I came home and ordered a real hair one online. I do have thick, bushy hair which will be difficult to replicate in a wig which may be why it didn't really work for me, and hopefully other people will have better reviews! I feel so guilty as we are so lucky to get them free on the NHS but it just wasn't for me unfortunately. 

    Talking of hair, I had to wash it yesterday as I felt so grotty, and I had some slight matting that took a little while to detangle. There didn't seem to be more shedding than usual (I always lose hair when I wash it) but my scalp felt tight and itchy last night so I think some shedding might be on the way. 

    Is it filgrastim injections you are doing? I only had to do one the day after chemo. I wonder why some people have one and others have several? Could you ask for just the single version?

    My next treatment is 19th. People keep telling me that side effects are cumulative and will probably get worse with each cycle but if I can just tick along like this that would be great. Might put a request in with my oncologist

    Glad you're doing ok! xx

  • Oh yes, I've got the 'matting' of the hair too, sort of at the nape of my neck, had to carefully detangle as didn't want it to just come out! Wisps of hair are coming out, but nothing too dramatic yet!!!

    My injection was called Nivestim, &had to be taken days 3-9...it's an 'immune stimulating injection'! I've had an appointment thro with the oncologist for the 23rd(it says it's just to talk through how my first cycle was), so may ask if there's another way to take it! 

    Yes, people have said that the cycles will progressively become worse, but I just keep holding onto the fact that I'm one down, so, hopefully, only 5 to go!!

    Good luck for your next cycle xxx

  • That's exactly where mine is matting too. Expected to wake up with my whole head of hair on my pillow but thankfully this wasn't the case...

    Is nivestim the same as filgrastim? I've still no idea what's what, I literally just do as I'm told and take whatever I'm told to take. I'm sure they said it was to boost my immune system though.  I'm glad I just had the one! 

    You must be on a different regime to me, I'm having 4 EC and then 4 paclitaxel bi-weekly. The time between treatments seems to fly by, can't believe I'm back in on Thursday! 

    Best of luck for yours too, although I'm sure I'll be quizzing you about things on here before then haha! Xx

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  • That's exactly where mine is matting too. Expected to wake up with my whole head of hair on my pillow but thankfully this wasn't the case...

    Is nivestim the same as filgrastim? I've still no idea what's what, I literally just do as I'm told and take whatever I'm told to take. I'm sure they said it was to boost my immune system though.  I'm glad I just had the one! 

    You must be on a different regime to me, I'm having 4 EC and then 4 paclitaxel bi-weekly. The time between treatments seems to fly by, can't believe I'm back in on Thursday! 

    Best of luck for yours too, although I'm sure I'll be quizzing you about things on here before then haha! Xx

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