Chemotherapy, immune deficiency and choices
Ok, scenario, you had a breast cancer tumor. It was 3cm. They removed it. The sentinel lymph node showed no cancer but was ‘benign with reactive changes’. But when breast cancer tumors are 3cm+ a clear lymph node result (ie no cancer there) has a 14% chance of being a false negative. Plus cancer can travel through the lymph node without embedding there and cancer cells can float away from the tumor, off into the lymph only to later embed in other body parts; lung, liver, bowel, bone.
So if this was you then you COULD have cancer cells that escaped into other parts of your body where they may develop and kill you. But it’s maybe only a 15% chance that happened. There’s maybe an 85% it DIDN’T.
And in your case, imagine that you are lucky because your breast cancer was hormone receptive (in my case ER+… they feel off estrogen produced by my ovaries), so they can switch off the hormones that can feed those cancer cells. Sure, that means menopause in your case, but that never killed anyone and you’re 47 anyway, so what if you have to accept that early, suddenly, in the next two weeks.
But because ALL the cells in your cancer may not all be hormone receptive, they’d still recommend chemotherapy…. just in case, as an adjuvant therapy. Now imagine you are from the cancer recurrence family with 31 people who’ve had cancer, most dying from aggressive and/or recurrent cancers… and one of those people was your father.
But you know chemo will knock your immune system to the floor, hit your gut hard, and lose you weight, and you are small and already have no spare weight, and you are immune deficient, have been all your life, you have low IgA, low IgG2, low white cells and you haven’t even started chemo!
Now imagine you have already cross referenced every supplement and food and lifestyle strategy that has ever been found to reduce cancer growth and cancer risk with pubmed studies so see what held water. And you were already on the case before and after your cancer so you know those routes aren’t going to solve this.
What would you do?
I’m at least going to ask for the Oncotype DX test to get a recurrence likelihood score to know I’d not be bombing my body with chemo for nothing. But what would you do if this were you?
Donna Williams, BA Hons, Dip Ed.
Author, artist, singer-songwriter, screenwriter.
Autism consultant and public speaker.
http://www.donnawilliams.net
I acknowledge Aboriginal and Torres Strait Islander people as the Traditional Owners of this country throughout Australia, and their connection to land and community.
Hi Donna,
I have a friend of mine who’s father died – he had cancer & had chemo.
My friend said he was going fairly well after his tumour was removed (can’t remember what type of cancer), but she felt the chemo was ultimately what did him in. It just laid him so low & he couldn’t recover.
My thoughts are, you’ve had the masectomy & thus removed the tumour. That’s a big enough shock to the body, let alone the stress that goes with it. If you’ve got a crap immune system – I’d say no to chemo. But please, be guided most of all by your intuition. Which voice in your head is the loudest – yes for chemo, or no for chemo? (Make sure you go with your gut instinct – whenever I haven’t followed mine, that’s when I get into trouble.)What does Chris think? I know he loves you dearly so take on board his views. Ultimately, any of us could be hit by a car tomorrow. My view is you’ve had the masectomy, got rid of the tumour, I’d focus now on recovering from that. Get well & enjoy some lovely cuddles with Chris. Warm wishes for a healthy Donna & Chris. We’re thinking of you.
you know, Kathryn, if only it were that easy… you see invasive tumors aren’t self contained. They have solid parts at the centre but the rest is perhaps best compared to a dust ball…. imagine picking up an old sweet left under a sofa for 20 years. It would be solid at the centre but all around it would be thick, fragile, dust particles. Try and remove the sweet without those dust particles becoming airborne, any of them. Now each tumor develops from a single cancer cell… just like one of those dust particles. The docs can’t see these stray cells when they remove the tumor. And so studies have found that some of these stray cells can have travelled away, outside of the margins, even into and through the lymph without nesting there to make cancer. They can travel off to the liver, pancreas, lungs, anywhere, then they settle and they do what they are designed to do… multiply and make new tumors.
When a tumor has nice contained edges or is 2cm and under this is less likely. My tumor was 3cm with highly irregular and spiculated (fine thread like) edges so on the scans it looked like a stoned graffiti artist had sprayed a sideways ‘H’. And what those irregular edges mean is higher chance of losing cells. My type of cells included comedocarcinomas which are 100% malignant… so if they strayed they will make other cancers…. and these are fast developing… my 3cm tumor came up in probably 2-3 months, max… most breast cancers grow 1cm per YEAR. My relatives tend to have highly recurrent, aggressive cancers.
So in my case its not so easy to say tumor gone = cancer gone. All we can say is tumor gone, cancer cells may have strayed, those may have very high recurrence potential if not killed before they multiply.
Even the tumor they took out they thought had one focus, but it had two. The one at the centre of it was an intermediate grade comedocarcinoma that had then invaded and diversified. But under the 3cm tumor was another comedocarcinoma, this time a high grade one. So more than one was already at work.
its a real tough call.
Hi Donna, you asked what would I do if I was in your shoes. I would have the Chemotherapy. Why? Because I am someone who tends to be quite black and white, and either feel in control or out of control. Without the Chemo I would be walking around worried my inaction might allow stay cells to get a foothold on my organs without my knowledge. And that would do my head in. Also in my life some of my choices have not panned out and I’ve had to deal with the consequences. But I coped better in these situations, than in those when I failed to act. Basically I always regret inaction more than action.
But having said that, given your immune deficiencies, I would get ready for a long stay away from any public places and people in general, apart from Chris. And even around him I would wear one of those surgical masks to try and eliminate any potential droplet inhalation. Because your immune deficiency issue is just THAT IMPORTANT!Â
Whatever decision you make, I know it will be well considered, researched and mulled over again and again. Good luck, and know all of us out here support you from afar and wish you the best whatever path you choose.