Right to decide treatment in Canada

I don't think any type of treatment can be forced on a patient. Perhaps the hospital where she would get her treatment has a social worker who can help her learn about her rights as a patient.

To see an Oncologist, your mother needs a referral from her family doctor (or gynecologist). Other than making the referral, her family doctor will have absolutely no role in her treatment plan, once she is seeing the Oncologist. So what her family doctor told her about having to have chemo makes no sense. A family doctor has no say in that recommendation or decision.

There are many excellent Oncologists in the Toronto area. My recommendation would be to get a referral to the Oncology department at a major hospital, and they will assign a specific Oncologist. Princess Margaret Hospital is one of the top cancer hospitals in the world. Sunnybrook and Women's College are also excellent. The potential issue could be that they will want the pathology report showing the details of her cancer; if the report from her biopsy in Colombia is not complete, they might require a biopsy before accepting her as a patient. This might be why her family doctor wanted to send her for the biopsy.

Your mother has complete freedom to decide what treatment she wants. That said, if her cancer is advanced and chemo is clearly required and by far the best (or possibly only) treatment option, any individual Oncologist could choose to not treat her if she refuses this treatment. Additionally, there are some breast cancers, those that are hormone negative, for which chemo is the only treatment option other than surgery. There are other breast cancers, such as those that are HER2+, that are extremely aggressive and truly require chemo (along with Herceptin). An oncologist might feel that there is little that he or she can do for a patient who refuses chemo who has a hormone negative or HER2+ breast cancer. So while you mother gets to decide what treatments she will take, she should be aware that with certain diagnoses, there might be little that an Oncologist can offer if she refuses chemo.

Bessie

I was diagnosed with ER+/PR+, HER2- .   I had a mastectomy and was immediately put on an Armitose Inhibitor (Letrozole or Femara brand name).   After 13 months I just told my oncologist that I didn't want to take it anymore because of all the joint pain, memory issues etc.  She said I understand.  If you don't want to try Tamoxifin we will just deal with issues as they come up.   I love the fact that she didn't question my decision.   Your mom can make her own decisions.  In the beginning whatever they told me I did.   Now I am doing my own research and making my own choices.   Quality of life to me is very important and I was not having that on Letrozole.   Good luck.