Parade Magazine's Breast Cancer Article

[Colleens_Husband]

Dear Friends:

I don't know if you get the Parade Magazine inserted into your Sunday newspaper, but there was an article about a lady who was diagnosed with breast cancer and she shopped around till she found an oncologist who eventually agreed to use the least aggressive program to fight her cancer.

After being around the HER2 community where the most aggressive course seems the only prudent path, and being around the brave warriors on this site, I am wondering how you felt about the author of this article.

She did manage to have several factual errors when describing her cancer and she seems to be taking foolish risks. I finished the article thinking this woman was probably the last person that a national publication should choose as a spokesperson for breast cancer.

Or maybe I'm all wrong.

Lee

[dlaxague]

Hi Lee,

I hadn't seen this but after reading your post I found it online, here:

http://www.parade.com/health/2008/10...fter-diagnosis

or tinyurl: http://tinyurl.com/5lsb2z

It's a bit vague about details, and not very good writing, but didn't really seem inaccurate as far as it went. I've known women with DCIS who had similar experiences - some having as many as 3 lumpectomies and still not achieving clean margins and in the end, having a mastectomy. But they didn't regret the attempts with lumpectomy because by the time they got to mastectomy they knew it was necessary. DCIS, because it often follows along the ductal "trees" of the breast, can sometimes be quite widespread while still not being invasive.

As far as taking risks - DCIS treatment is different from invasive cancer. Removing it with clean margins, and then sometimes radiation afterwards, is the extent of therapy. Most DCIS would probably never threaten life but some will progress to invasive cancer - they are learning more but not there yet as far as knowing which is which. Some women are also offered hormonal treatment, to reduce the risk of new primaries, I think.

(In an aside, I have a local friend who had a recurrence or new primary of DCIS after lumpectomy. At that point, standard treatment is mastectomy and she received that recommendation from 3 surgeons before going to UCSF where she is participating in a trial. She took an AI for 3 months, had another lumpectomy, and is continuing on the AI with frequent surveilance. My friend is an enthusiastic, high-energy personality and she really clicked with Laura Esserman's style at UCSF.)

I hope that the take-home message received by people reading this article was that it's always good to get second opinions. That's not a bad message.

Debbie Laxague

[Colleens_Husband]

Hey Debbie:

Thanks for your opinions. I must admit that DCIS is an area that I am not very familiar with. I guess I assumed that after three lumpectomies that it probably wasn't DCIS after all, and from what you are saying, it very well could be. That makes a lot more sense.

I agree that in some cases a second opinion isn't a bad idea but I am worried that people will shop for a doctor that will be less aggressive and, in the end, may endanger their lives.

Lee

[Hopeful]

Lee,

I followed the link and read the article, and did not find it alarming in any way. I think the author made a lot of good points, particularly with regard to the need to seek additonal opinions and what to expect from the process. Patients should not make decisions from panic; most professionals agree that there is a safe margin of a few weeks to gather information in order to make a decision on surgery.

I also respectfully disagree with your statement, "the most aggressive course seems the only prudent path." The prudent path, IMO, is to do the research, get opinions (more than one) on tx options, and make your decision based on the research, the medical opinions, and your own gut. Overtreatment is as much of a problem as undertreatment; the most important thing is to get the RIGHT tx.

Hopeful

[Chelee]

Hi Lee,

Actually I had to agree with this article. When I was dx I was scared to death as most are. I had very little information to go off, & all they did was drum into my head that this was very aggressive bc with a poor prognosis.

When I asked for a 2nd opinion I was told that would "delay" things by weeks & possible longer. I was told that wasn't a good idea...but if I really felt I had too...go ahead. (They actually scared me out of getting a 2nd opinion.) They took advantage of my fear. (I was in total panic mode & they all knew it.)

I ended up with the youngest & newest onc in this cancer center which told me my chemo would be TCH. He told me I had no say so in my trt. (Much later I found out by law they have to give you all your options.)

After I finished my TCH I got a 2nd opinion after the fact. I had two different places say since I was stage IIIA, with 5 positive nodes they would of both treated me with AC, followed by TH.

The one thing I really liked about this article is stressing the fact that she got three opinions. That is so important. When someone is first dx someone on your team needs to get you out of your panic mode long enough to look out for your best interest & actually recommend you seek 2nd & even 3rd opinion. I was actually discourgaged from seeking one. That's just not right. So I liked this article for that reason alone.

Chelee

[CLTann]

I read carefully the thread posted for the Parade article. I failed to detect that the patient was seeking the least or mildest treatment plan. She didn't shop for such a doctor.

Many patients associate the most aggressive treatment as the best treatment. I respectively reject such overt and dangerous conclusion. We must weigh the liklihood of secondarly side-effects from the proposed primary treatments that could cause unnecessary health deterioration. Many in this forum developed leukemia from chemo and heart/lung problem from radiation. While in many patients, chemo and radiation are medically called for, there are borderline cases even the treating doctors may question the need for such heavy and aggressive treatments.

Keep in mind that there are micro cancers in all our bodies, including those never diagnosed with cancer. Our bodies have the build-in immune defense system to keep us healthy. We rely mostly on this mechanism to keep us NED. Healthy life style contributes to this very important mechanism.

Also, bear in mind that most treating doctors will not try to talk you out of the most aggressive treatment method you have selected. They just do not want to have a potential law suit in the future.

Each case is different and must be considered on its own merits. I have nothing against chemo and radiation but I have a feeling that many people are guided by fear and frustration, and without scientific and medical data jumped into a regretable conclusion.