Is taking Tamoxifin but declining radiation a sensible choice

[Jittery_Jan]

I'm 63 and I've recently had breast tissue conserving surgery and thought I'd be happy to have radiation therapy when I agreed to that rather than opt for the mastectomy. Several weeks down the road, I'm wondering if I made such a wise choice? The side effects of radiation, especially the tiredness and soreness during, and the chance of breaking ribs and radiation-induced cancers later, scare me. (as does getting a recurrence if I don't have it, of course!) The Margin and Lymph nodes were clear and my tumour was 1.6 cm, Grade (1-)2 and 95% estrogen positive. I've started taking Tamoxifin, and now I'm wondering why I need the radiation and the anti-hormone treatment. IE. if tamoxifin stops cancers growing why wouldn't it work on the site of the original tumour? I asked the radiation oncologist and she said that it would, but they haven't got enough data on recurrence risk in my age group, so keep recommending both treatments. She also indicated that I would 'probably be alright without it, but best treatment would be to have it). Is there anyone who has decided against radiology in these circumstances who could share their experience with me please? Jan

[Betsy]

Hi Jan, While my circumstances were slightly different to yours, I understand your questioning the type of treatment recommended. I had a mastectomy, chemo, and radiation and am also on tamoxifen. I too have questioned whether I really did need radiation, as a result of the pain, tiredness, which still continues, but I think back to my consultation with the Radiation Oncologist and her reasons for recommending the course of treatment and I know that I had to have faith in her experience and expertise. We have to remember that with breast cancer the treatments are extremely targeted. They know with each type, size, spread of the cancer what is the best course of action for the best outcome. For better or worse, I hold onto that fact even though I wish I had never even heard the word radiation let alone had to endure it and it's after effects. The Tamoxifen is important to stop any hormonal cancer cells growing. I don't know if I would choose to do it the same way if it came back, but if I had to re-live my journey so far, I would do it all again. I don't think about what might happen in the future - re fractured ribs etc, after all we don't know what tomorrow has in store for us at all. I wish you well on your journey and hope you find the answers you are looking for. Betsy

[Jittery_Jan]

Hi Betsy, thank you for replying and sharing your experience. I keep changing my mind so often, I think it'll be a case of what ever I feel like on next weds which is the 'measuring-up'day, and then go with that. Thinking I need the courage of my convictions -but I not convinced one way or the other. Although, right now, my desire to not have it seems more like trying running away and not having to face the fact of my status as cancer victim. I'm trying to find whatever I can to justify that decision... Thanks again, and all the very best Jan

[Betsy]

Jan - just remember it takes time to comes to terms with diagnosis and then with treatment, and a lot of times it has all happened before you have time to connect that it is really happening to you, let alone come to terms with it all. Don't be hard on yourself and know that it is ok to question what is happening and if you have chosen the right thing - ultimately you have chosen what will have been best for you at the time. Best Wishes Betsy

[Ron50]

Hi Jan, I am not a breast cancer sufferer although I have a male mate who has had it twice. I had colon cancer. My surgeon ruled out radiation because the colon moves around and is hard to target .It is the first choice in rectal cancer which can be targetted. My surgeon believed rad was far superior to chemo which he described as that filthy stuff. Having said that crc not a hormone triggered cancer and the crc chemotherapy was not designed to work in the same way as tamoxifin. I think that what you are having and have had will give you the best chance at survival. Cancer is very much a real time disease .All you can do is to go with the best available treatment at the time your cancer is dxed and have faith in it. All the best Ron.

[SILLY]

I don't have any personal experience of your cancer but I would probably be guided by my doctor . Sometimes we never really know what the best choice is, but we learn to live with whatever .

[Jittery_Jan]

Thank you all who responded to my query, sorry for the delay in acknowledging some later comments, I forgot my password and it all seemed too difficult!! Anyway, I've managed to get over that hurdle and I am in my third week of radiation therapy now - with minimal side-effects so far. Very best wishes to all Jittery Jan

[suzie_s]

Hi Jan, I had breast cancer and a mastectomy in April 2012, so my circumstances vary a little to yours but my dilemma regarding treatment still plays on my mind. I had a 2.5cm tumor with micro-met in one lymph node. Told by the surgeon I would need chemo so I geared myself up for that, but then the oncologist said I was 'borderline' and was best treated with tamoxifen and now zoladex injections. Seems I could have had chemo if I had really "wanted" to. This gave me huge amounts of anguish, and still does if the truth be told. I didn't have the chemo as mainly my family was against it as the risks didn't outweigh the benefits. I'm glad to hear that you seem to getting on alright with the radiation, sometimes just making the decision is the hardest part - and being happy with it. (Not no sure I am!) Anyway, guess we just have to put our faith in others sometimes. Not so easy to do when this cancer was glossed over for 18 months as "harmless". Trying to get over it! My very best wishes to you and thanks for letting me ramble! suzie