Deciding on radiation or not

Posted by frogjumper @frogjumper, May 17, 2023

So, I have been going back and forth about radiation now for awhile. I am trying to pursue Proton Beam which seems safe enough considering my tumor bed is directly over my heart. So for me I know I wont' do regular radiation. But this is what perplexes me and makes my decision difficult. Basically 3 out of 100 women like me will have a recurrence without radiation, with radiation 2 out of 100 will have a recurrence. I read that and think...is radiation worth it? bearing in my mind my tumor was low grade, tiny and no lymph nodes, clear margins and very well behaving, it actually decreased in size over 6 months prior to surgery.
Is it time to just walk away from treatment and enjoy my good fortune?
I'd appreciate any input.

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Profile picture for may2024 @may2024

I am at the same point of decision ... rejected chemo and meds so now need to make a decision re radiation. The suffering women are reporting who have done radiation is moving my decision needle towards no, this is a real dilemma for me at this time

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Seriously---radiation was a day at the beach compared to the adjuvant therapy drugs they want you to take for 5, 10 or 15 years. I had no serious issues with radiation and drove myself there, alone, 33 times. I had extremely serious issues with both Tamoxifen and Anastrozole and quit both on Aug. 30, 2023.

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Profile picture for einnoc @einnoc

Seriously---radiation was a day at the beach compared to the adjuvant therapy drugs they want you to take for 5, 10 or 15 years. I had no serious issues with radiation and drove myself there, alone, 33 times. I had extremely serious issues with both Tamoxifen and Anastrozole and quit both on Aug. 30, 2023.

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I should also add that I was 76 years old (or young) when I had my 33 radiation treatments. I started in late May and completed them in July, 2022. At the mid-point mark I had a few minor side effects. Up to that point, it went extremely well and at #15 it was just some minor burning that they sent me home to rest up from before continuing. I feel that radiation is the ONLY thing that may, in the long run, "save" me from a recurrence, as life was not worth living on Anastrozole and Tamoxifen was only slightly better for me. I gave a year of my life to attempting to learn to tolerate those drugs, and neither one allowed me to return to "normal" or live life without major hurdles like mood swings, teariness at inopportune moments, brain fog, excruciating pain in all my joints, but especially in my injured left knee and my back, insomnia brought on by non-stop pain and, ultimately, crippling me and putting me in a wheelchair for 6 months with an injury that most resembled a meniscus tear. Was X-rayed on 9/19; 9/21; 9/28 and 11/15. No break. Just a lot of inflammation brought on by Anastrozole. With Tamoxifen I experienced non-stop UTI infections (the antibiotics to quell them then gave me a fungal infection) and could only be awake for 3 hours a day. Compared to those side effects the minor "sunburn" I experienced after session #15 was nothing, and it is all I have to "protect" me from a potential recurrence of a tumor that was 95% estrogen positive and has a 36% probability of recurring without pills, according to my 29 onco score. Think long and hard about what you'll do if you're one of the 10 to 12% of us who cannot tolerate or adjust to the goadawful pills they want you to take for lengthy periods of time,

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Profile picture for boathouse @boathouse

Hello
Everyone’s treatment plan is different for their type of breast cancer.
I had a double mastectomy, 25 rounds of radiation, and preventive chemo.
I just completed my reconstruction - fat graph for small b cup.

I am cancer free - a long journey.

My advice is to do what is medically right and not convenient.

I had stage 3 HER 2 positive and wanted to limit my percent chance for reoccurrence - I am recovering as I write this from reconstruction and I am excited to have courageously made it positively through all treatments over the past year!

I will be monitored for the next 5 years.
I am ready to only look forward and continue living without regrets on my decision with my care team.

Focus on your long term health and you are worth driving 2 hours each way!!

Follow what treatment is right for you-we are more courageous than we think

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@boathouse What was your overall Gy dose?

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Profile picture for einnoc @einnoc

Seriously---radiation was a day at the beach compared to the adjuvant therapy drugs they want you to take for 5, 10 or 15 years. I had no serious issues with radiation and drove myself there, alone, 33 times. I had extremely serious issues with both Tamoxifen and Anastrozole and quit both on Aug. 30, 2023.

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@einnoc What year was your rad. tx and do you have any pulmonary fibrosis or other fibrosis? Did you do any deep breath holding to spare tissue from radiation?

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Profile picture for katho3 @katho3

@frogjumper—I, too, am going back and forth about radiation. My diagnosis was low grade, stage 0 DCIS. I had a lumpectomy on 4/4; the lesion was 7mm, with 6mm clear margins all around and hormone positive.

On the advice of my medical oncologist, I am not doing the hormone blocker. The Sloan Kettering nomogram for my circumstances says 6% recurrence in 5 years and 9% in 10 years without radiation; reduced to 2% and 4% with radiation. I have a CAT scan on Friday to determine if I am a candidate for localized radiation vs whole breast. Radiation oncologist says my situation is “special” due to small size and large margins and I may be able to have a much abbreviated course. However, the lesion was over my heart. Proton therapy is not available here, nor is brachytherapy, but I was also told about the breath holding to help avoid the heart.

This is a difficult decision and it seems like I’m changing my mind daily. What makes it more difficult is that there is no clear or right answer. My PCP says the right path for me will become apparent and to go with my gut! Best wishes to you, @frogjumper.

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@katho3 @frogjumper and everyone here....It is May 20, 2026 and I had left breast lumpectomy on April 1. My Grade 2, 2cm tumor, Invasive Ductal Carcinoma was caught in a mamogram on Feb. 18.
My doctor recommended 5 days of targeted radiation therapy followed by 5 years of the hormone blocking pills. The margins were clear and no lymph node involvement. They found a 4.8 aneurysmal dilatation on my ascending aorta in the pre-surgery MRI. I have also had pneumonia several times in the past, but that was over a decade ago.
I went to my radiation consultation, and my BP was higher than I've ever known. The nurse stated that it was dangerously high and I should go to the ER (the cancer center is at the hospital) It went even higher after that. I said I would contact my PCP the next day and request BP medication, which I did. I took it for 1 week (half dose) and ended up starting to get Stevens Johnson, which I got with ADHD medication years ago. My lips were swollen and blistered, and my tongue was sore with geographic tongue patterns. I stopped the Losartan, and that has diminished. I'm thinking, if that happened with such a common medication on half-dose in one week, perhaps I need to reassess the radiation. The do not use Proton, nor do they let you lie facing downward. The heart/aorta issue scares me as the tumor was at 10 o'clock on left side, right over my heart. ....I am not sleeping now. My husband somehow came down with Salmonella and was very sick when I was to go for the mapping appointment, so I canceled it. I felt at peace at first, but now worry I am doing the wrong thing. I am also following a plant-based diet, making the juice, salads, smoothies and recipes suggested in the Square 1 Course (Chris Beat Cancer) and on other sites, such as Food Revolution. I am truly fearful of the side effects of the radiation (one again is Stevens Johnson, and the heart and lung issues) that may not even be apparent until months or years later. I know I'm going on and on, but I just am really struggling now. It looks like the post in this thread are several years old in most cases. HOW are you doing now? Do you have regrets....were there side-effects besides the "sunburn" (which I'm not even worried about) that came up later? Thanks.

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