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Medical Forum / Diseases and Disorders / Breast Cancer / October 2006

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Radiation Therapy - Question for Tim

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John Wilson - 30 Oct 2006 11:53 GMT
Tim - about my mother's post surgery treatment - we had 3 opinions - 2 said
to do the radiation therapy and 3rd said it would be  debateable on whether
it was necessary. Our main concern is whether the amount of radiation, even
though it is focused, would cause her some damage with toxicity etc in the
future. On the other hand we worry that possibly there may still be some
cancer cells (her cancer was diagnosed as 'high grade') and so the radiation
therapy may kill whatever existing cancer cells remain.
Just wanted your opinion please.
Tim Jackson - 30 Oct 2006 19:56 GMT
> Tim - about my mother's post surgery treatment - we had 3 opinions - 2 said
> to do the radiation therapy and 3rd said it would be  debateable on whether
[quoted text clipped - 4 lines]
> therapy may kill whatever existing cancer cells remain.
> Just wanted your opinion please.

Understand I am not a doctor or in any way medically qualified to offer
a recommendation.  Anything I say must be treated as the sort of advice
one might get, for example, talking to a guy in a bar.

This is not a life-or death decision, as we have said, there is no
evidence that adjuvant radiation reduces mortality, it just reduces the
risk of needing further surgery for a local recurrence.

So the real balance we are looking at is whether she would rather risk
going back under the knife, perhaps at a time when she is less able to
cope with it, or alternatively risk having less ability to cope with
whatever old age may eventually throw at her, and possibly having a
slightly shorter life overall.

Even this last is not as simple as it looks, if one is in a situation
where the long term effects of radiation may shorten your life, there is
a good chance that your quality of life is already pretty degraded, so
the loss of quality life is not as much as it might seem at first sight:
in some cases curtailing suffering might even be an actual benefit.

I would be inclined to agree with your 3rd opinion, that it is too close
to call clinically, and ends up as a personal decision on the basis of
personal factors and how you feel you are going to live in old age.
Look at survival of older relatives.  Look at your economic and
healthcare situation (good health insurance?).  Look at her health
history (smoking, obesity, blood pressure?).  Maybe some of these can
throw some weight on one or other side of the balance.

Tim
John Wilson - 31 Oct 2006 09:43 GMT
>> Tim - about my mother's post surgery treatment - we had 3 opinions - 2
>> said to do the radiation therapy and 3rd said it would be  debateable on
[quoted text clipped - 33 lines]
> obesity, blood pressure?).  Maybe some of these can throw some weight on
> one or other side of the balance.

Thanks very much Tim - (that was one pretty clever guy I was talking to in
the pub!)
I take all your points and we are looking at this from a somewhat different
perspective.
I guess you are right and there is little to choose  and the factors you
have mentioned will take more importance. Very kind for your time.

John
 
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