Let's do the chemo mañana...
November 26, 2009 10:23 AM Subscribe
In cancer treatment, how much does delaying chemo by a couple of weeks exacerbate recurrance risk?
posted by Estragon to Health & Fitness (9 answers total)
My mother has breast cancer. Based on the biopsy report, it's fairly aggressive, hormone-receptor negative, and had spread to the lymph nodes in her armpit on the same side as the breast with the tumor. She had the tumors removed last week, and is recovering well from the surgery.
She lives in a relatively small city, and the first opportunity to see a local oncologist is on Dec 15, which seems like a long time away. However, there are some larger cities nearby where she could probably see someone sooner. I'm thinking that she could get a recommendation for a chemo regime from further away, then receive the treatment in her home town. However, for reasons I don't understand, her surgeon is resistant to this idea. Money is not the issue: she is loaded. I'm wondering how hard I should push on this. Is delaying the chemo by a couple of weeks likely to substantially increase the risk that the cancer will recur? I would have thought by doing the chemo while the metastases were still small, you could reduce the risk of a chemo-resistance mutation, because there would be fewer cancer cells to explore the space of possible mutations. (I will be asking the surgeon this, too, of course, but I'm looking for an unbiased view. Any pointers to research papers bearing on this question would be particularly welcome.)
Ideally this would be her responsibility, but she can't seem to think about it clearly because there is a big elephant lumbering through the room with "CANCER=DEATH" inscribed in large gothic script on both its flanks, and she won't go near it. She affects a child-like faith in the good intentions and skills of her surgeon, and any time I try to talk about the risks or the personal responsibility to verify that the treatment makes sense, she freaks out or retreats into assertions about the surgeon's skill and positive outlook. (Despite the fact that he has told me that statistically, she's in pretty bad shape.) So I feel like the responsibility's on me, to a certain extent, and I can't communicate effectively with her on the issue. Doesn't help that I'm on a different continent...
The surgeon says that based on the pathology results so far from the analysis of the main tumor, he believes that the tumor is HER2 positive, but we don't have the results for the HER2 lab test back, yet. There were no obvious metastases in a full-body scan, and he said he found no evidence that the cancer had colonized the exteriors of the lymph nodes, which he says is a good sign.