Does Surgery Or Surgery With Chemotherapy Help To Fight Cancer?

Posted on Tue, 17 Mar 2015

Question: need to follow-up with dr indranil XXXXXXX for further report.
hi dr indranil
please check my mom pet scan report
please let me know
1. does it say mom has cancer if yes
1 Dio we need to go only surgery or surgery with chemo.
and what are the chances of recurrence

please see the attachment

Answered by Dr. Indranil Ghosh (2 days later)

Brief Answer:
I feel chemo followed by surgery

Detailed Answer:
Hi
Thanks for follow up.

Few things to note..

1. PET scan can't differentiate between cancer and non-cancer. It is for the stage determination. However, the report is very much suggestive of cancer. For cancer confirmation you already have the fnac.

2. This is a large tumor, 9 cm, with armpit nodes. So it is stage 3 but not 4. The USG report was a misprint (9 mm)

3. In this stage it should be chemo followed by surgery.

4. Before initiating chemo we need a needle trucut biopsy to determine estrogen receptor, progesterone receptor and her2, because these may vanish after chemo.

The bottom line is even though it is a locally advanced tumor, it can be taken care if treated appropriately. Chances of recurring after treatment is around 30%, for which regular follow up required.

Hope this helps.
Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Indranil Ghosh (57 minutes later)

Thanks a lot for you reply, I really appreciate your quick response
need some clarity regarding these
1. how many rounds of chemo needed befor and after surgery
2. what can be done to mitigate the side effect of chemo
3 will my mom will lead a normal life during chemo.
3. what can be done to minimise the chance of reoccurance
4. what are the chances that she will be fully treated.
5. do they need to wait for tratement to begin before the biopsy result or can they start chemo just after taking the sample
6. what are the chance of re-occurrence if we have breast removed along with the lymph nodes without chemo

Thanks a lot

Answered by Dr. Indranil Ghosh (3 hours later)

Brief Answer:
Please refer below

Detailed Answer:
My answers

1. how many rounds of chemo needed befor and after surgery
A. usually we practice 6-8 cycles followed by surgery. Some people give 3-4 then surgery then another 3-4. Both ok

2. what can be done to mitigate the side effect of chemo
A. We can give various medicines to prevent vomiting, infections and other side effects

3 will my mom will lead a normal life during chemo.
A. this varies. Many are able to but some are quite sick and able to do little activity.

3. what can be done to minimise the chance of reoccurance
A. Chemotherapy, radiotherapy after the surgery and hormonal therapy if estrogen receptor positive (tablets) or herceptin injections (if her2 positive) are given to prevent recurrence

4. what are the chances that she will be fully treated.
A. As I said, 30-40% chances of recurrence after full treatment

5. do they need to wait for tratement to begin before the biopsy result or can they start chemo just after taking the sample
A. At least they should confirm that there is enough material to run all the tests

6. what are the chance of re-occurrence if we have breast removed along with the lymph nodes without chemo
A. At least double, ie 60-70%

Regards

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Above answer was peer-reviewed by : Dr. Yogesh D