Fear of radiation after lumpectomy

Posted by diane12 @diane12, Apr 19, 2018

I was seriously thinking of refusing radiation after lumpectomy because I had complete removal of tumor with wide negative margins. I was convinced that there would be no lung, rib, or heart radiation by using the prone(lying on stomach) with breast hanging down. They have been very careful with treatments & very accommodating so after 4 treatments I am feeling more secure by my decision to do this to ensure all cancer was caught.

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@rene1636

I’m thinking against radiation for my situation & am wondering if anyone else has/had a similar situation. I was diagnosed with DCIS grade 2, ER/PR+. The area of DCIS was small, .2cm dimension. I has a Stereotactic biopsy that apparently removed all of the DCIS. I had a lumpectomy to be sure nothing remained. The pathology report came back with zero cancer present, confirming it was all already removed. I’m still being recommended for radiation since this is “standard” care. After extensive research on radiating the breast & seeing the problems that can continue to present years later I’m thinking about passing on radiation. My thought is that since you can only radiate each breast 1x & if I did have a reoccurrence in the same breast of DCIS or an IBC then my only choice left would be a mastectomy if I follow through now. I will try the hormone suppression since my type was positive for both. I’m currently waiting on results for the Oconotype DX DCIS genomic test to see what my chance of reoccurrence is & I’ll finalize my decision depending on the results.. I will be monitored every 6 months by a mammogram followed by a breast MRI 6 months later so anything that shows up would be caught early, within 6 months. If so, then another lumpectomy might be possible instead of a mastectomy. I’d like to keep future options open since I now have a higher statistical chance for another breast cancer since having DCIS.

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If you live near a proton radiation center, talk the radiation oncologist. I had 16 treatments post left mastectomy and did fine. Google proton radiation and read about its amazing release of all of the energy right at the target. Good luck.

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@dick61

If you live near a proton radiation center, talk the radiation oncologist. I had 16 treatments post left mastectomy and did fine. Google proton radiation and read about its amazing release of all of the energy right at the target. Good luck.

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I have researched Proton radiation & asked my radiologist but where I’m currently being treated it isn’t offered. If I do decide to get radiation I’ll most probably switch to another bigger local cancer center that does offer proton radiation. I think you’re correct, that it’s a safer type of radiation especially in the breast. Thank you for sharing the information!

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It is extremely safe. I had proton radiation to successfully treat prostate cancer in 2018 as well as post-mastectomy proton radiation in 2021. The radiologists who don't have access to it often minimize its advantages, etc. It is an amazing form of radiation because all of the proton's energy is released only at the target. Please locate the nearest proton center and choose it. Good luck.

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@olg1

I had triple negative invasive carcinoma I suffered from several orthopedic injury injuries and I’m in a wheelchair I also had gastrointestinal issues and I couldn’t get an aid during Covid which I would’ve needed in order to get through the chemotherapy because I live alone. My oncologist pushed the chemo and I tried very hard to get any when I couldn’t I realize that maybe God was telling me I really shouldn’t have it probably would’ve killed me I went to radiation over radiated and have horrible side effects from the radiation but this is everybody’s personal decisions you have to weigh all the factors. Quality of life was important to me if I was gonna not be here on the planet for a long time that I didn’t wanna spend it suffering I also am very religious very spiritual and I’m a counselor by trade social worker so I decided to use visualization and work on myself and with the help of God I’m in remission which is really a miracle it’s triple negative it’s hard to cure without all these strong treatments oncologist recommend but I went by my own instincts and intuition and I think that’s what you have to follow you have to weigh the doctors advice how you feel personally about your quality of life and where you are spiritually. You can buy an old saying all those things and you’ll come to the right decision sometimes the standard therapy is a one size fits all which doesn’t fit everybody so everybody has to make their own personal decision. It’s tough but at the end you have control and the best part of fighting cancer is that you don’t let it control you with fear. So all those Warriors out there I salute you for your courage those who went through chemo those who went to radiation and those who decided not to because that also takes courage. God bless you all

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Forgot to tell you,I am in remission.since I couldn’t get the chemo I went to a world renown acupuncturist in Boston. He did wonders for me. Look up Tom. Tam he has classes on line.It is a great addition to your regular cancer therapy. I was a skeptic even when my voters friend was cured of stage 4 stomach cancer, who could tolerate chemo went to him and has been cancer free for 20 years.

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@rene1636

I have researched Proton radiation & asked my radiologist but where I’m currently being treated it isn’t offered. If I do decide to get radiation I’ll most probably switch to another bigger local cancer center that does offer proton radiation. I think you’re correct, that it’s a safer type of radiation especially in the breast. Thank you for sharing the information!

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@rene1636 I’m not familiar w/ proton radiation. If you do that type of radiation, is it possible to radiate that breast again? My understanding is that If you have a breast radiated (usual radiation), you cannot radiate it again. Ask this question due to having a lumpectomy now.

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@sequoia

@rene1636 I’m not familiar w/ proton radiation. If you do that type of radiation, is it possible to radiate that breast again? My understanding is that If you have a breast radiated (usual radiation), you cannot radiate it again. Ask this question due to having a lumpectomy now.

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You can use photons to radiate a small area or: 20 years later, radiate one area with protons. They recommend a mastectomy for me if my cancer comes back.

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@sequoia

@rene1636 I’m not familiar w/ proton radiation. If you do that type of radiation, is it possible to radiate that breast again? My understanding is that If you have a breast radiated (usual radiation), you cannot radiate it again. Ask this question due to having a lumpectomy now.

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I only know that it’s supposed to be safer since it uses a different type of radiation & it’s more targeted to the specific area that it’s needed for. Please research any suggested treatments for your type of breast cancer. I’ve found it makes me feel like I’m less helpless, more in control, less stressed & more capable of deciding on what I think is best for “me”. Sometimes the “standard” treatments don’t feel like the best decisions for my specific situation but everybody’s case is different . I’ve found that every related treatment has pro’s & con’s. I’m picking & choosing what I’m willing to risk or not risk.
There’s lots of information on the web for Proton radiation & I’ve found not every facility has one. Here’s 2 links……Good luck & best wishes on your journey!
Here’s a link from the NCI.
https://www.cancer.gov/news-events/cancer-currents-blog/2020/proton-therapy-safety-versus-traditional-radiation
Another link this is for Susan G Komen
https://www.komen.org/breast-cancer/treatment/type/radiation-therapy/emerging-areas-radiation-therapy/

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@sequoia

@rene1636 I’m not familiar w/ proton radiation. If you do that type of radiation, is it possible to radiate that breast again? My understanding is that If you have a breast radiated (usual radiation), you cannot radiate it again. Ask this question due to having a lumpectomy now.

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Once the proton radiation is calculated and administered, that's it. No more is needed.

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@elliej

Hi, I too am awaiting OncoType test to determine treatment options. I am concerned with the standard prescribed radiation/inhibitor for 5year plan protocols.
I took HRT for over 30years, so am currently experiencing the dreaded menopause symptoms. At 73years of age, will I benefit from years of AI or will it reduce considerably my quality of life. I have a family history of Osterporosis and Leukemia.
Let me know how your journey proceeds, I’ll be watching and hoping all goes well for you!

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Update: I also forgot to mention that I have Osteoporosis also. My mom took Tamoxafin for 5 years after her breast cancer surgery, and now she has full blown severe osteoporosis with inability to stand up straight. It has crippled and incapacitated her. I don't want to end up like that. I got my Oncotype results after waiting 4 weeks. It showed a very low risk of recurrence (4%) with taking an AI and oncologist says it will be about 10% risk over a 9-year period if I don't take an AI. I was disappointed to find out the Oncotype test only tells whether there is a need for chemo, which I already knew there wouldn't be. My surgeon had advised that chemo would not be necessary based on my biopsy and post-surgery pathology results.
So when she had "good news" (i.e., no chemo), it was really deflating since I already knew that and was hoping she would say I didn't need radiation. Nothing was shown about risks or need for radiation! She couldn't even give me any information to evaluate whether radiation was a good option for me or not - despite it being recommended as a standard, "one size fits all" treatment.
When I asked what recurrance odds would be with radiation, she just said a "slight" benefit. I told her "slight" benefit isn't good enough. I feel like I have been given very little information with which to make a major life/health decision. If in doubt, I'm not buying into radiation. Since the risk difference is so small between taking AI vs. not taking AI, I'm not going that route either since my quality of life already sucks and I have so many other health issues with the EXACT same side effects. Why would I want to take something that makes them worse? No thanks.
I already had a compression fracture of my vertebrae when I was 47 due to the osteoporosis and it has greatly impacted my quality of life. That was in 2008 and I'm still suffering severe back pain. If a doctor can't provide any more compelling evidence and substantive data beyond "slight" benefit, I'm not risking getting leukemia and worsening my already bad osteoporosis, in addition to all my other autoimmune diseases. My mother doesn't want me to do it either since she is now suffering with the effects from a 5 year tamoxafin regimen. She doesn't recall the doctors telling her in advance that it would worsen her osteoporosis.
So far, I am very disappointed in this entire process and the lack of direction I have received from the "team" of doctors. There seems to be a disconnect between doctors. Yesterday I got a call from a radiologist to set up an appointment, after I told my oncologist I would not do the AI or radiation. Turns out my PRIMARY doctor has sent in an order/referral! Does this seem inappropriate to anyone since I already have an oncologist?
The whole process so far just feels like a major cluster. I truly question whether this broad-based, "one size fits all" approach is really recommended for the benefit of the patient, or the benefit of hospitals making more money. These "treatments" only seem to be recommended as an "insurance policy" and nothing more. Even then, the doctors do not provide any compelling reason to justify a risky course of action that has potential to cause more damage than benefit. I am still continuing to research on my own, since virtually all the statistical data I have found (albeit limited) has come from my own initiative. I wonder if others have had this experience with their medical "teams"? No doctors, nurses, etc. have been able to answer my questions, including why I am still feeling so cold all the time (my temp has consistently been below 97 degrees since surgery). Has anyone else out there had difficulty in getting straight answers from the medical community?

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@mpirruccel

My story is I just had lumpectomy last week, 3 mm size. Estrogen positive, progesterone negative and HER negative. Tumor was actually removed when I had biopsy but surgeon still removed a golf ball size bit plus lymph tissue. Sentinel node was negative, hallelujah! Because of small size, may not get oncotype test. But will do genetic testing on about 30 genes. If any are bad, will do double mastectomy. Otherwise radiation and estrogen blocker for 5-10 years, the latter more concerning to me regarding bone health. So one day at a time.

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Update on above: 3 months out, lumpectomy has healed well, on Arimidex now for 5-10 years plus Fosamax for 2 to help bones. No chemo needed 😊 and chose not have radiation. As big a problem is my 18 month old total knee replacement Sue which has not gone well. In constant pain and keep trying different therapies but nothing has worked so far. Still have hope

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