​When the breast surgeon gets breast cancer

Traveltext

An interesting article:

https://www.theatlantic.com/health/archive/2018/02...

Denise-G

Traveltext - THANK YOU SO MUCH for posting this. It is very meaningful.

Falconer

a good read

Micmel

definitely worth reading. Brings an entire new view that doctors may face. This is some scary shit! Fu cancer! Thanks for sharing ~M~

farmerlucy

Excellent. Thank you.

I’m always a bit taken back when I hear a Dr has breast cancer. It's like I think in the back of my mind that since they have access to all the best screening they'll be good. Nope. Same sad sack as the rest of us.

Arrrg if I here another person say, “I had a clear mammo. I'm good". Ugh. Big. Fat. Lie. T'aint necessarily so. Arrrg

Traveltext

Yes, they're just like us. I've followed Liz on Twitter since she was diagnosed and I related in that I had an ultrasound that was finally granted after three months of complaining of a lump. In my case it was the sonographers 'so eyes that popped out of her head during the scan. That and her quickly exiting the room to call the doctor!

Paco

Great article, Traveltext, thanks for posting.

There is an ad that runs on TV for the local, nationally-ranked cancer center that features one of the doctors relating his personal experience with cancer. It makes him seem much more believable knowing that he is a survivor too, but after reading this article, I can understand why doctors might be hesitant to let people know they've had cancer.

TWills

Sorry this is off topic.

“She got the all clear” “The cancer is gone”.

I wish I had gotten that! I wish everyone could get that, and that is the hope but... I feel like that is what confuses everyone about BC including me. I hate that it bugs me but it does and I’m not a doom and gloom person and for me I do feel like they probably got it all and my treatments most likely got the rest if any, but I do not feel like I can use those words but I really wish I could.

beauz

The vast amount of posts on BCO would make a good ethics training material for medical professionals.

Traveltext

TWills, your stats are a bit like mine, and like me you've had the fullest of treatments. Sure, we have our chances of recurrence, but we should realise we've got the odds on our side for a long life.

Beauz, I agree with you, there's a wealth of info here for the medical profession to study.

ksusan

Agreed! I've posed questions a few times to inform training seminars I'm conducting for therapists.

Interestingly, the responses to Therapist choice: One who has, or hasn't had breast cancer? have come out somewhat strongly against (though of course we don't know one way or the other if the therapist doesn't make a disclosure). Where the Atlantic article mirrors the doctor's insights about empathy and attention to language, many responses in the therapist thread question whether the therapist would be able to focus on clients' needs and support their decision-making. I find this interesting since therapists are extensively trained in this and most medical professionals don't get a lot of education on it, but perhaps the responses reflect something about having a longer or more emotional relationship with a therapist.

Outfield

TWills, keep in mind "she got the all clear" are the author's words, not necessarily the surgeon's. I can't imagine a breast surgeon having an understanding of "the cancer is gone" after the treatment described. It sounds like, by her 10 year prognosis, she was probably diagnosed at stage III, and I can't imagine any doctor who required chemo for a solid tumor (as opposed to something like lymphoma) believing that it could be said with certainty "the cancer is gone."

That's the whole struggle of moving on. Even 7 years after finishing treatment, I struggle with making plans for the future any further away than a couple years. I don't want to let myself dream of things like grandkids or retirement too much, because I've got that risk of not making it that's higher than the average woman my age. I would love for my oncologist to look me in the eye and say, "Cured!" but both he and I know it wouldn't be honest and I wouldn't believe it.

ksusan, the time and training a therapist would have for talking with someone about breast cancer is really different from the time available to a surgeon, who also would not have the same kind of training to do it. I think a lot of people feel cut-off or dismissed when their physicians won't get deep into discussions of emotions or experience, but in this medical culture it's just not their role. I'm not a surgeon - I have much more time with people - but there's still the same pressure to deal with the issues of the body before the next person is due in the room. I think we know patients want us to be therapists sometimes, but it's just not possible. The closest I can think of to helping someone explore their emotions and values is a "goals of care" discussion, which can be complicated approaching end of life, but is usually pretty simple for cancer because the choices aren't limitless. If the person can't make up their mind easily, not because they don't understand the options but because one choice isn't clearly better when considering what they value in life, my hope for surgeons is that they at least recognize the situation, but most of the time, if they do, they'll just say "Think about it" rather than try to get to an end. Maybe delegate if the resources are there, but they usually aren't. It's the horrid, paternalistic ones who say "You would be happier with X" - like the surgeons who purposefully leave extra skin "just in case" when a woman says she will not be getting reconstruction. But yeah, I would definitely not want to see a therapist who had also dealt with breast cancer. I think people have a strong need to have their choices validated, and one way to experience that is to see other people make the same choice. I am very, very conscious of watching my words when I am speaking with another breast cancer patient, but I'm sure I'm not perfectly non-judgemental. The last thing I'd want as a patient would be a therapist who had been through the very same thing, faced the same choices, and had a niggling, but very human, need to be validated.

ksusan

I imagine that some clients would want a disclosure and some would not, and like all identity issues, there's probably a need for a range of therapist disclosure levels. Where I get perplexed in thinking this through is that with the frequency of people who get breast cancer, I'm not sure I can actually think of any therapist I know over 55 or so who hasn't at least had a close relative or friend with breast cancer, so it's in their lives and relationships with clients whether they disclose it or not. I'm interested in the meaning of the disclosure for potential clients.

Wildplaces

traveltext,

we are like everybody else and still ....we are different,

ksusan and outfield

Hmm...I have doubts about posting but here it goes. This is only my story and my view.

First - I had a Birads2 Mammogram that didn't gel - sent it for a second opinion - I got it - " forget the fibroadenoma at 3 what about the cancer at 12". The second opinion was my brother. This came 6 weeks after the only other female in my consultant group ( of 24 😊) had been diagnosed with breast cancer and was facing chemo. I was afraid I would be seen as panicking and managed to get an MRI requested quietly by a surgeon I work with. Just before I went in the scanner the duty radiologist told me - he is good, but think he is overcalling this mammo - you will be alright. I lit like a Christmas tree !! and since they were busy measuring my sizeable lump while I was in the room changing, there truly was no hiding from it.

There are advantages to being medical - in the next two days all three breast surgeons I worked with offered to help/operate - I had even been offered a closed theatre on a Saturday morning. I got out of town and found myself a place with the "crowds" - when it comes to surgery you want your surgeon NOT to think you are special. I did manage to fit in a mastectomy and AxCl, no recon hysterectomy bilateral oophorectomy and a port plus recovery within 20 days of that MRI and start dose dense chemo.

I was petrified - I still am but I have a practical nature - not use crying over spilled milk - I am grateful for where I am now and ? for what lies ahead ?.

I, like ALL PRAY I stay healthy.

As a medical professional - I had a fair bit of knowledge about treatment options - I understood the options and was able to tap into colleagues with experience and a bedside style I found comforting. I was able to collect my income insurance which meant for the period of my recovery I was sane and SAFE when it came to balancing my budget.

That puts me in a privileged group - not many other patients have those resources so on hand or at ALL - and 😊 - the simple truth - they SHOULD.

Not just a regimen of surgery, chemo and rads fitted when and how you can in a system often bursting at the pipes - but a well supported way back to a LIFE - and it takes more then one oncologist/surgeon to get that - it takes a whole group of different professionals.

Isn't that what we fight for ?? Life, family.

Now to the second part of this.

Did it make me a better doctor? No, absolutely not.

In fact if anything I am much conservative in how I spend my time. I love my work and I put in some crazy crazy hours - I don't do that anymore, I pull away nicely but firmly from situations that take me to a stress level I know is not good for me. It's not so much that I don't give it my all, it is that I put a clock on that and have scheduled a fair bit of me time.

So what is my rambling point?

Well TWO THINGS:

1. I am not convinced that as a doctor you have to get sick to have empathy for your patients or a will to fight for them.

In fact I hope that is NOT the case - I think you have to be a decent human being and keep reminding yourself no matter how wild the day gets ( and ...there are some days...) that it is best to only treat one person at a time, the one there in front of you at this time!! You keep that in mind the rest should flow to you...

2. Breast cancer is a disease with a huge toll, often on for a long period of time, sometimes for your whole life - we don't talk about it - those who have resources - money, friends, family and knowledge - usually get more cohesive and effective treatments.

We should talk about it - because everybody should get their best treatment, in their best time with minimum effort on their behalf

Well, that for me 😊 would be taking it beyond pink.

(PS I work in the area and I don't talk about my diagnosis - some of my choices involved throwing the kitchen sink at it - I had no issues with potential side effects. I was very much aware that no treatment is set in stone - you can actually say stop if something you are doing is wrong for you as you are doing it.

I try and stay focused on what each individual needs and wants, in that order. It's illuminating what responses you get when you get women to split needs from wants in the choices of their treatment. I try and make sure the options are lay out as clearly as possible.)

😊🌷🐣

edwards750

My sister’s BS died from it.

Diane