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You can find the current article at its original source at https://www.theguardian.com/commentisfree/2018/jun/04/chemo-breast-cancer-oncotype-dx-test
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| Version 1 | Version 2 |
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| No chemo: the test that made me a lucky breast cancer patient | No chemo: the test that made me a lucky breast cancer patient |
| (about 1 month later) | |
| Having cancer involves getting a lot of news from a lot of doctors, and for a while the news is bad. First you have cancer; then they’re not sure whether it’s spread. You’re given worst-case scenarios because the medics have to do that – even if they suspect that you’re going to be one of the lucky ones. | Having cancer involves getting a lot of news from a lot of doctors, and for a while the news is bad. First you have cancer; then they’re not sure whether it’s spread. You’re given worst-case scenarios because the medics have to do that – even if they suspect that you’re going to be one of the lucky ones. |
| Thousands of breast cancer patients could avoid chemo, study finds | Thousands of breast cancer patients could avoid chemo, study finds |
| But then, if you are one of the lucky ones, the tide turns. The news starts to be good – and good news has never seemed so sweet, so welcome, so joyous, as this good news. | But then, if you are one of the lucky ones, the tide turns. The news starts to be good – and good news has never seemed so sweet, so welcome, so joyous, as this good news. |
| Four years ago this week I was in that situation, and about to receive some wonderful information: I didn’t, after all, need chemotherapy after surgery for breast cancer. I was one of the early beneficiaries of a test that, it was reported yesterday, is revolutionising treatment for thousands of women. | Four years ago this week I was in that situation, and about to receive some wonderful information: I didn’t, after all, need chemotherapy after surgery for breast cancer. I was one of the early beneficiaries of a test that, it was reported yesterday, is revolutionising treatment for thousands of women. |
| The test, called oncotype DX, pinpoints those women who will benefit from chemotherapy because they have a higher risk of recurrent breast cancer, while identifying those whose lower risk means that they will do just as well without chemotherapy. The new procedure involves a complex biopsy of a woman’s tumour, during which 21 tumour genes are mapped. The result is a score of between zero and 100: the higher the number, the more likely cancer is to return within 10 years, and the greater the potential benefit of chemotherapy. | The test, called oncotype DX, pinpoints those women who will benefit from chemotherapy because they have a higher risk of recurrent breast cancer, while identifying those whose lower risk means that they will do just as well without chemotherapy. The new procedure involves a complex biopsy of a woman’s tumour, during which 21 tumour genes are mapped. The result is a score of between zero and 100: the higher the number, the more likely cancer is to return within 10 years, and the greater the potential benefit of chemotherapy. |
| Not all women with breast cancer are eligible for the test: to qualify, your disease must be hormone-receptor-positive, HER2-negative, and axillary-node-negative. But about half of all breast cancers, mine included, do fit into this category; and for us, the test can be a game-changer, especially if – again, like me – you’re one of the approximately 60% of women with the disease whose surgery is a lumpectomy, as opposed to the more radical mastectomy. | Not all women with breast cancer are eligible for the test: to qualify, your disease must be hormone-receptor-positive, HER2-negative, and axillary-node-negative. But about half of all breast cancers, mine included, do fit into this category; and for us, the test can be a game-changer, especially if – again, like me – you’re one of the approximately 60% of women with the disease whose surgery is a lumpectomy, as opposed to the more radical mastectomy. |
| In these cases, the existence of the oncotype DX test can transform the experience of breast cancer. In my own case, it meant that treatment hardly seemed a physical event at all: I had to cope with only three minor operations, which were all done as day-case surgery – and I didn’t need to take even an aspirin after any of them. Chemotherapy would have made things very different: there would have been months of feeling dreadful, and long periods off work – the very things, in other words, that give illness the power to upend our lives– not to mention hair loss, which many women who have had chemotherapy for breast cancer say is the single worst thing about the whole experience. | In these cases, the existence of the oncotype DX test can transform the experience of breast cancer. In my own case, it meant that treatment hardly seemed a physical event at all: I had to cope with only three minor operations, which were all done as day-case surgery – and I didn’t need to take even an aspirin after any of them. Chemotherapy would have made things very different: there would have been months of feeling dreadful, and long periods off work – the very things, in other words, that give illness the power to upend our lives– not to mention hair loss, which many women who have had chemotherapy for breast cancer say is the single worst thing about the whole experience. |
| ‘Cancer I could deal with. Losing my breast I could not’ | ‘Cancer I could deal with. Losing my breast I could not’ |
| So not only women who have already benefited from it, but also women who will benefit from it in the future, have good reason to be grateful to this test, and to all the research that is being done to make cancer treatment more targeted. The days of chemotherapy being used as a sledgehammer are coming to an end. The difference, in real lives such as my own, is immeasurable. | So not only women who have already benefited from it, but also women who will benefit from it in the future, have good reason to be grateful to this test, and to all the research that is being done to make cancer treatment more targeted. The days of chemotherapy being used as a sledgehammer are coming to an end. The difference, in real lives such as my own, is immeasurable. |
| I’ll never forget the day I got my oncotype DX results. I’d arrived at my appointment feeling very scared. The moment I saw the smile on my doctor’s face I knew I had a low score. (It turned out to be 15; anything below 25 means no need for chemotherapy in a woman aged 50-plus). | I’ll never forget the day I got my oncotype DX results. I’d arrived at my appointment feeling very scared. The moment I saw the smile on my doctor’s face I knew I had a low score. (It turned out to be 15; anything below 25 means no need for chemotherapy in a woman aged 50-plus). |
| “I feel lucky,” I said. “Well, you were unlucky to get cancer in the first place,” she pointed out. “But you’re definitely lucky not to need chemotherapy.” It felt like the turning of the tide; like luck was on my side again. I have gone on feeling lucky ever since. | “I feel lucky,” I said. “Well, you were unlucky to get cancer in the first place,” she pointed out. “But you’re definitely lucky not to need chemotherapy.” It felt like the turning of the tide; like luck was on my side again. I have gone on feeling lucky ever since. |
| • Joanna Moorhead is a regular Guardian contributor | • Joanna Moorhead is a regular Guardian contributor |
| Breast cancer | Breast cancer |
| Opinion | Opinion |
| Medical research | Medical research |
| Women | Women |
| Health | Health |
| Cancer | Cancer |
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