Helped Over 500,000 patients with 98%+ satisfaction.

Connect & Get Personalized 1-to-1 Answers from Expert Doctors

DoctorSpring > Question Home

Do AI interfere with radiation in LOBULAR CANCER?

Resolved Question:

Thank you for all your answers.

My doctor reminded me today, that my most likely way to metastatic cancer, is that I have isolated tumor cells in my bone marrow (2-3 percent). They are just single cells. No "bone marrow cancer" or bone cancer yet.

The idea has been that the chemo will kill or make most of them dormant, and then the AI's will make the rest go to sleep (ALLRED=8).

But, here's what I'm worried about--I'm going to have to wait 4 months to start the AI's while I have a mastectomy and radiation. My doctor will NOT let me take the AI's until I am done with both of those, because he thinks the AI's interfere with radiation.

Do you think the lobular itc's will just sit there and do nothing for 4 months, or am I risking getting bone marrow or bone cancer by waiting those 4 months, without taking AI's?

The one consultation I had at Stanford University--that doctor thought the itc's would move pretty slowly. What do you know about this?

Category: Oncologist

Ask Your Own Question

Category: Hematologist
 19 Doctors Online

Hello.
Thank you for your query at DoctorSpring.com.

This is the same that I intended to convey to you. Absence of systemic therapy during surgery is OKAY. AIs can be started after radiation. The old concept has changed now.

I hope Stanford doctors have also reassured you about your good prognosis because of your good ALLRED score.

Feel free to discuss further.
Kind regards.


Patient replied :

How worried do YOU think I should be about the itc's metastasizing to the bone marrow.? Is this truly likely? I am so afraid I will get metastasis from the itc's BEFORE I even start the AI's. I guess the real question is, how aggressive are these itc's likely to be?
I think my big worry is that with my immunity lowered from chemo and radiation, the itc's will be able to move right in. What do you think of that?


You are right now on chemotherapy which can have an impact (kill or suppress) on the ITCs. They are cancer cells which can grow. I agree with it but with good ER positivity, I can say that they need not be aggressive. ER positive tumors are generally indolent ones. 4 months is a normal gap for all patients undergoing chemo surgery and radiation.


THe recent concept is that AI can be started with radiation. No harm. However, physicians differ in their own opinions. Many Oncologists worldwide follow the well recognized NCCN guidelines for patiens which states that concurrent or sequential administration of endocrine therapy is acceptable. SEE PAGE BINV 6, LEGEND - W in the following link:
https://drive.google.com/file/d/0B-8ZMSsBayxJNUpGSjZZNWtJeXhvdnhiQUI5b2RIRmpnbWYw/edit?usp=sharing

Please revert back if any queries.

Kind regards.


Patient replied :

How long do you think indolent lobular estrogen postivie itc's could go without becoming bone or bone marrow cancer? Do you think six months? A year? Because, depending on how the mastectomy heals, I may need to wait longer for the radiation, and then the whole thing would take longer than 4 months.
I've heard it might even be years before these itc's start dividing--but I don't know if this can be possible.


ER positive tumors may take even decades to come back.

Did you see the reference I sent you with previous mail? AI can be started with along with radiation. You may start it after the surgical wound heals.

Regards.


Patient replied :

I showed the reference to my doctor. He says he believes AI's stop the radiation from working. But, thank you so much for sending the link.
How long do you think a a very ER positive ITC or lymph node can avoid spreading IF THE AI'S HAVE NOT BEEN STARTED YET??? As I said, I'm worried I might have to wait even 6 months, if the mastectomy heals badly.
Just to remind you, even though I have Classic Lobular Cancer, which is supposed to divide slowly--it IS Grade 2--so that might speed it up.


If I were your doc, I would definitely start on AI as early as possible. However, opinions vary. If at all disease recurs, it would take a long time. So please be assured. I hope your Oncologists also would have suggested the same.

Regards.


Dr. Prasad Eswaran
Category: Hematologist
Experience: 
Doctorate in Medicine (Fellowship in Oncology), DM,  Madras Medical College & Govt. General Hospital, Chennai, India.

Doctor of Medicine (Residency in Radiation Oncology) , MD, Christian Medical College, Vellore, Tamilnadu, India, 2004-06.

Diploma in Medical Radiology & Therapy (Residency in Radiation Oncology), D.M.R.T, Madras Medical College & Govt. General Hospital, Chennai, India, 2004-06.

Bachelor of Medicine & Bachelor of Surgery - M.B.B.S, Govt. Stanley Medical College & Hospital, Chennai, India, 1998-2004.
Dr. Prasad Eswaran and 4 other Medical Specialists are ready to help you

Users who read this, also read:

Make informed and better medical decisions.

Join the 500,000 people who found a smarter, quicker way to get Answers, Recommendations & Expert Opinions.

Expert Doctors at fingertips

Recommendation on next step. Second-opinion.Multi-specialty.

Save Time

Average time for answers: 6 hours.

Save Money

$35 for typical specialist consult vs. $120 for a local appointment.

Free Follow-ups

Clarify, ask further questions for free in private conversation.

100% Satisfaction

Money back guarantee for the 1st reply. MEDNET Quality Board.

Start My Consultation

CHAT NOW

About DoctorSpring.com

Doctor Spring is a novel online Doctor consultation platform where you can get your medical questions answered by leading Doctors. Just Submit your question and rest assured that you will consult a Doctor easily. Once you submit the question, the Doctor from the concerned specialty will reply within hours. You can always ask more questions or add details with follow-up question options and make it an online doctor chat. You may use this service to consult a specialty or for getting medical second opinion. All paid services come with a MEDNET quality assurance and 100% money back guarantee.

DoctorSpring in news