ONC nurses...please answer....

Trauma Columnist · Aug 8, 2009

I am so sorry that you are going thru this. Of course you're anxious - that's normal. We can't provide medical advice here but I wanted to offer support - you're not alone.

Here are some links:

Breast lumps in general:

http://www.medicinenet.com/breast_lumps_in_women/article.htm

Mayo Clinic site (always a good site):

http://www.mayoclinic.com/health/breast-lumps/MY00165

regnurse1995 · Aug 8, 2009

Okay, let's minus me and just discuss how many patients you have seen that have passed 6 years post chemo.

thanks much!

shortlittleRN · Aug 8, 2009

Okay, let's minus me and just discuss how many patients you have seen that have passed 6 years post chemo.
thanks much!

On the hospital floor,not many. But, in an ambulatory clinic, maybe... The really sick ones come the hospitals, thus, oncology hospital nurses probably don't see many survivors.

caroladybelle, BSN, RN · Aug 8, 2009

I received chemo back in 1984....and I am obviously still here and in remission. Overall survival rate (> 5 years) w/all cancers other than basal cell skin (common and very curable, thus not calculated in) ranges from 73-78% depending on the service reporting, the year, etc.

As far as the number of those who got chemo, or if it was for breast ca or their age, after 12 years in oncology I don't bother to keep up with numbers. They are less important in how the pt will do - each pt is very individual as to how the do, with their individual characteristics.

One problem is if you are a nurse in a hospital.....you are going to see a higher death rate. The VAST majority of uncomplicated cases with few comorbidities and that are more treatable are generally managed mostly outpatient and the hospital does not see them, except maybe for early surgical intervention.

What the hospital nurse tends to see are : the poorly insured, caught later, multiple comorbidity, complications from chemo pt. And that is not going to have the better outcomes. Or we see acute leukemics, lymphomas....which require a lot of hospitalization, more complications and poorer prognosis.

These days, I care only for leukemics, which tend to be the sickest of sick and require long hospitalization. Yet, I would not hesitate to get chemo, and have higher than average odds of needing it again, given genetic and health issues.

First, get your breast lump diagnosed. There is absolutely no use buying trouble until it knocks on your door. Trying to get estimates/statistics on breast ca when you have a breast lump but have no clue as to what it consists of, is really a exercise in futility as IF it is cancer, there so many different variables (cell type, genetics, hormone receptor status, age, cardiac status) that effect treatment and curability, it is really quite useless.

An example, Acute Leukemia (AML) in adults is graded from M0 to M7. M3 is considered very curable with rates of of 85-90%, though if not caught quickly it can take you out rapidly and cause major damage. The other forms of AML generally have much lower cure rates ....closer to 20 to 45%. The rates also vary heavily depending on age, comorbidities, cardiac status (the vast majority require treatment with drugs that have significant potential for cardiac toxicity).

GET IT DIAGNOSED!!!!! And go from there. If it is cancer, there will be a number of tests done to determine all of those variants to give your best options.

Try not to worry.....though you will as everyone does and I have multiple times. But it really does not do you much good until there is some hard facts to work with.

blondy2061h, MSN, RN · Aug 8, 2009

Okay, let's minus me and just discuss how many patients you have seen that have passed 6 years post chemo.
thanks much!

You have to realize this is a completely bizarre question. There's a million different kinds of cancer, various stages within those different types of cancer, and various kinds of chemo used to treat those different cancers. Further, everyone goes into cancer with their own comorbities. Giving an otherwise healthy young lady chemo for breast ca is totally different from loading up a 90 year old who's had 5 previous MIs, has diabetes, and COPD with chemo for leukemia.

dreavt, BSN, RN · Aug 8, 2009

I'm sorry you're facing this -- it is scary. I will answer not so much as an oncology RN (I'm a new grad, starting on an inpatient hem/onc unit next week!), but as a breast cancer survivor:

It is far from as simple as "if you get breast ca, you either do or do not do chemo." Treatment decisions for breast ca depend on size of the tumor(s), if there is any cancer in the lymph nodes, grade of the tumor, presence or absence of hormone receptors (in ER+/PR+ breast ca, hormonal tx is very important, probably moreso than chemo), and many other pathological features (in situ vs. invasive, lobular vs. ductal, etc. etc. etc.). In some cases test that look at the expression of multiple genes, such as Oncotype DX, are used to gather more information. In some cases, testing for hereditary cancer syndromes might be indicated (would not so much effect chemo decsion, but may affect surgical decisions). Comorbidities have to be considered as well, of course. Age is often a factor in whether chemo is offered (although whether that's a good thing is debatable).

So it really is impossible to answer your question, I'm afraid. A woman with a 1 cm tumor, neg nodes, ER+, who does chemo in addition to 5 yrs of hormonal tx will have a VASTLY different prognosis than a woman with a 5 cm tumor, 20/30 positive nodes, and is ER-/PR- (and hence can't reap the benefits fo hormonal tx). I do personally know MANY women who are 8, 10, 15, even 30 yrs post-dx and chemo and are doing fine, if that helps.

My advice (non-medical!) is to take a breath, slow down, and wait to see what the path on your mass shows. If it is malignant, you will be referred to a medical oncologist who should discuss your options with you. It can be overwhelming, and the waiting sucks. But you will get through it and figure it out, and do what is best for you. I am about 9 months out of chemo, and though it was no picnic, I did it (during nursing school, no less!) and did fine, and am feeling great.

http://www.breastcancer.org is a great resource, too, btw.

Hope this helps a bit!

regnurse1995 · Aug 9, 2009

Is this saying that only 2% on average survive 5 years? This is what is so confusing.

I go in on Wed. for a mammogram, then ultra sound I am sure.

I have no insurance because I am not nursing right now and don't want to go back unless I have to. The stress alone was killing me!

caroladybelle, BSN, RN · Aug 15, 2009

Update please!!

scma · Aug 15, 2009

I work in the outpatient private practice setting administering chemo daily. i have a great number of patients that have completed chemotherapy and have 5+ years cancer free. Please get a biopsy. Find out if you in fact if the lump is benign or malignant. Take it one day at a time. This year I have had 2 family members dx'd with Breast Cancer. Both of which scenerios I cried as their Oncology nurse begind closed doors. Because I know way too much. But I am thrilled to say that they both are either s/p surgery/internal beam radiation or s/p surgery/chemo/radiation and are doing great. What we all thought was the worse turned out to be totally different.

Take one day at a time. But get it checked don't wait.

Kimberly

shortlittleRN · Aug 16, 2009

Please do not wait, if it is malignant, the growth can be very rapid. You want to control it while it is small and positively before any mets has occurred. If by chance it is benign, thank the man upstairs. But do not wait. From what I can decipher of the chart posted. Of the 150000 + people of various cancers, about 2.1% with chemo therapy has a 5 years survivorship. Good luck to you.

As the earlier poster suggested... Take one day at a time . Don't let the information overwhelms you.Your body heals better with better mental coping skills. If you need to see a counselor , do you. I'll be thinking about you.

regnurse1995 · Dec 15, 2009

The lump was benign...thank you all for your comments...it really helped!