That's very interesting! I have my appointment for next wed to see what my treatment plan is for bc......At least your oncologist is giving you choices, dare I think it's good news that he says you wouldn't be mad not to have chemo??? 

I have to admit the thought of chemo scares me silly....so are you having radiotherapy? Meds? Would you get closer follow ups for not going down the chemo route??

would love to follow this thread....xxxxx

I have my first oncology appointment on Monday and am surprised to read this.  I just assumed that the professionals made the decisions for us based upon what is best.  I’ve not been given any indication that there’s a choice regarding chemo but every cancer is different so there’s clearly a good reason. 

Good luck.

Julie

[@Julmess]‍ [@Marlyn]‍ What type of bc do you both have?

Mine is ductal and ER positive which I believe is the most common type of bc. It's been classed as stage 2 - I had 2 tumours and some additional tissue removed (7cm total from massive boobies!) that was shown to be cancerous, as well as 13 lymph nodes removed (1 of which showed cancer). I had been told by my surgeon that I would have to have chemo. 

My oncologist was very open with me about the risks and benefits and I wasn't told by him that I would have to have chemo at all. Apparently I'm on that group that may see some benefit from it and so they require my input. If I was to say I don't want to have any input, they would just give me the chemo as it's a purely medical decision not taking into account the impact it will have on my life and my personal preferences etc. 

He explained that some people want to just have everything they can to give themselves the peace of mind that they've done everything to get rid of it. But the reality is that the surgery has got rid of it. Chemo is about risk management. Some people benefit more from that than others. However the chemo isn't a guarantee that you won't get cancer again.

I would just have 4 weeks of rads as well as tamoxifen (I believe this would be over 5-10 years but unsure how long I'd be having it for).

It will be interesting to hear how you both get on x 

Hi Babsie007, First thing to make clear, I'm not a medical professional. But I think it's very good that the oncologist lays out the options. That does not always happen. He is treating you like an adult, which is great. Choices are often not black and white. Chemo is a very arduous procedure, with side affects that are often long lasting, if not permanent. It's good to consider the trade offs of chemo vs no chemo.

But it's important to understand the statistics here. And it may be better to ask the oncologist what the chances are of recurrence with vs without chemo, just to be absolutely sure that there is no confusion. You mention a figure of 9%. But if, for example, your chances of recurrence are 10% without chemo and 1% with chemo, you may feel differently compared to, say, 55% without chemo and 46% with chemo.

My oncologist also spells out the options. For my penile cancer a sentinal lymph node procedure was recommended. An invasive procedure with a risk of complications and permanent side effects. A very small risk, but one that cannot be ignored. My oncologist said that the chance of the cancer having spread to my lymph nodes was 10-12%. The risk with not having the procedure was that, if the cancer was present, it would be found later, and this delay reduces the chances of survival significantly. So I had the biopsy and the results were fine. And I have no side effects. I am happy that the decision was mine.

Some patients do not wish to make such choices. They prefer the oncologists to make all the decisions themselves. It's a matter of choice.

I will find out exactly what I am dealing with next Wednesday, all I know is it's ductal carcinoma and invasive.....I do hope you can come to an informed decision....xxxx

I had my first meeting with my oncologist yesterday following a mastectomy and full lymph node clearance 3 weeks ago. 

He didn't speak to me about recurrence he discussed my survival rate. (How accurate this is could be questionable as my details are put into the computer along with stats that could be 5/10 years old)

Basically with chemo it adds another 4% onto my survival rate. According to him that's "a really good number". I was somewhat surprised as I think it is such a low number. However, putting it into perspective the cancer is 'gone' following surgery so it also makes sense as the chemo is there to basically flush me out and catch any stray roaming cancer cells should there be any.

I could, as could any of us, refuse or say I don't want chemotherapy but that for me isn't even an option. I really think that every percentage counts so will endure a few months of absolute hell no doubt, to increase my chance of still being here in ten years. 

Whatever your decision, you need to do what's right for you. Good luck  x

The chances of recuurence without any treatment whatsoever is around 40% so it won't be as high as that but good advice nonetheless! 

Out of everyone in my stat bracket, 1 out of 100 will be dead at the 10 year mark. And I happen to be feeling pretty lucky ;-)

Do you know what the 10 year survival rate is [@Lorna87]‍ ? 

I had a great chat with by BCN this mornig and she actually trained with my oncologist 20 years ago when she first came into her role. Apparently he's the lead onc for my region. 

She said if I needed the chemo, he would be telling me I needed the chemo and not offering me the option. I'm feeling very comfy with the odds to and I'm prepared to take the chance but I guess that's what he was asking me.. do I want to have a look at the risks before a decision is made. 

The BCN said that they have 3-4 cases every year where a decision has been made that someone is having chemo but it gets to onc and they feel that the benefits aren't as clear and so give you the option in order to make an informed decision. 

My survival rates for 10 years :

75% without any further treatment whatsoever

+7% with tamoxifen (will start taking this after chemo)

+4% with chemotherapy 

So taking my survival rate to 86% 

Those are some good odds! I can understand why you'd opt for chemo in those circumstances.

Without the chemo, my groups 10 year survival rate is 99% so I'm really pleased with that. It's definitely the right decision for me I feel.