[AlaskaAngel]

This thread brings up a rather important and rarely discussed (if not generally deliberately unstated) aspect about how to choose from proposed treatments for breast cancer.

All patients have the choice not to do any treatment at all after surgery and medical providers ethically should be truthful with the patient by actually stating that as one option when they meet with the patient, whether or not that is what the provider would advise them to do.

By not clearly stating it as one of the choices at the outset, the discussion between the health care provider and the patient is unfairly biased against very logical delay for further consideration.

The reason I bring this up in this thread is because the recently diagnosed person is never told in the process of discussing choices of treatment that by actually beginning any particular treatment regimen, the doors to so many other choices are firmly closed.

One single treatment closes the door to a variety of clinical trials that are only open to the untreated newly diagnosed.

In the stampede to get started on treatment "before a rogue cell" can supposedly start mets (which is still unproven theory), other choices are rarely explored fully to allow patients to "see" the entire range of possibilities.

The group that is most likely to benefit from taking the time to consider many of the other choices would be those diagnosed with early stage bc and who are endocrine-responsive. These people stand a very real chance to be adequately treated with ovarian ablation and continued endocrine treatment. These are people whose risk without any treatment occurs primarily after they are 5 years out; if one adds endocrine treatment PLUS Herceptin and radiation treatment, the possibility genuinely exists for them to deal with their cancer without having had to ever take on all the problems that come with doing chemotherapy.

It also makes a LOT of sense in that it doesn't slam the door right off the bat to newer treatments and trials as they come along.

AlaskaAngel