Radiation for DCIS?

Dear Sally-

I am sorry to learn of your DCIS relapse. Rather than give a yes or no answer to your question,  “Should I repeat radiation therapy again?” I will list some facts below that I think are relevant to your situation, and then follow with my experience.

Grade 3 and hormone-negative DCIS cancer

“Grade 3 hormone-negative DCIS (Ductal Carcinoma In Situ) means abnormal cells are high-grade (look aggressive, grow fast) but lack hormone receptors, increasing recurrence risk, requiring treatment (surgery, maybe radiation/hormone therapy) to prevent invasive cancer, though outcomes are generally good, notes National Cancer Institute (NCI) Dictionary of Cancer Terms, Breast Cancer Research Foundation, and American Cancer Society.”

I was treated with lumpectomy and radiation

Treating Ductal Carcinoma In Situ (DCIS) with a lumpectomy and radiation is a standard approach that successfully removes cancer cells and significantly lowers the risk of the cancer returning (recurrence) or progressing to invasive breast cancer, though overall survival rates remain similar whether radiation is used or not. This treatment preserves the breast, with radiation targeting any remaining cells, but long-term management involves regular monitoring, managing potential skin changes from radiation, and discussing ongoing risks with your doctor, as some low-risk cases might omit radiation. 
Again, stage o and grade 2

Stage 0 Ductal Carcinoma In Situ (DCIS) with Grade 2 means you have non-invasive breast cancer cells in the milk ducts that are growing at a moderate pace (Grade 2), indicating they look somewhat different from normal cells and have an intermediate chance of recurrence compared to slower-growing (Grade 1) or faster-growing (Grade 3) DCIS, but treatment, often surgery, typically offers an excellent prognosis. 

My interpretation from your post is that:

You are knowledgeable about your situation and DCIS in general. You monitor your breast health regularly. You are in good physical condition. You are getting a second opinion, which is a good idea. By mentioning your heart attack, I can’t help but wonder if you think your local radiation from your first diagnosis of DCIS may have played a part?

My challenge with radiation therapy following a lumpectomy for DCIS is that, according to research, there is little, if any, survival benefit from this therapy. And there may be short-term, long-term and late-stage side effects from it.

Would an Oncotype DCIS Recurrence Test help with your decision-making? 

Good luck,

David Emerson

Hi Kim-

I sent the DCIS guide to you via your email address.

Good luck.

David Emerson

Hi Sue-

Several things. Keep in mind that DCIS is pre-cancer, not cancer. Yes, this diagnosis is difficult and scary but try to keep it in perspective. Secondly, while my role is to give you evidence-based information and research, and yes, my thinking, only you can decide what is best for you.

The therapies you list- lumpectomy, anti-hormonal therapy and radiation, all have been developed in an effort to reduce the patient’s (you) risk of relapse or in this case, a diagnosis of full blown breast cancer. The real issue, in my view, it less about “relapse” and more about dieing of breast cancer. The short, long-term and late stage side effects of radiation therapy, in my opinion, are under reported and should be studied more. But this is just my feeling…

The next issue then, is to further reduce the risk of breast cancer. I encourage you to consider taking the Oncotype DX DCIS test to learn more about your risk of relapse.

The next step is to learn about and adopt those evidence-based, non-toxic therapies shown to reduce the risk of BC. Nutrition, supplementation, exercise, etc. all have been shown to reduce the risk of BC. As a cancer survivor myself, I subscribe to the practice of non-toxic therapies shown to reduce the risk of one’s cancer relapse.

As an aside, supplements such as curcumin and omega 3 fatty acids have been shown to both reduce the risk of BC as well as reduce the syptomsof therapies like tamoxifen.

Please read this article as I think it phrases the issues-click now-

All to say that if you choose not to undergo radiation therapy, and follow the above, you can reduce your risk of relapse to a tiny fraction and may experience much higher quality of life.

My apologies for being so long-winded above. Let me know if you have questions or if you want me to provide specific therapies for you to consider.

thanks and hang in there,

David Emerson

Hi Jean-

The info linked below is only a partial list of non-toxic therapies. My cancer is very different (blood cancer called multiple myeloma) but I have taken many of the therapies below for years and I remain in complete remission.

If you have been diagnosed with DCIS and you have undergone a lumpectomy to remove the abnormal cells, you may be thinking through your next therapy steps to consider your options.

Whatever course you choose please consider the Oncotype DX DCIS test- this will tell you your risk of relapse-

Further, please consider lifestyle therapies such as acupuncture.

Further, a growing number of studies cite moderate but frequent exercise as BC therapy.

Further, supplements such as

1) iodine

2) curcumin-

3) green tea extract

4) cruciferous veggies- the research is thin here but I’ve read other studies that consider cruciferous veggies to be anti-cancer.

I am a cancer coach. I can design a complete therapy plan if you are interested.

David Emerson