“You’re committing suicide.”

That was the chilling statement delivered to one of my friends when she told her oncologist she was considering skipping the chemotherapy he’d recommended.

My friend’s no fool; she’s an intelligent, well-educated woman. She’d done her homework, carefully researching her particular cancer, studying her pathology report, and listening as her oncologist outlined his treatment plan, and how much each protocol – surgery, chemo, radiation, and hormone therapy drugs – would reduce her risk of recurrence.

She’d also read all she could about side effects from each of those treatments: what they were, how likely they were to occur, and whether they were temporary, or permanent.

After all of this research, she’d come to the conclusion that the benefits of surgery, radiation, and hormone drugs outweighed their potential side effects; but not so those of chemo. She decided the added benefit of chemo, statistically speaking, wasn’t enough for her to risk its side effects. 

Being a woman with a positive outlook, one not prone to second-guessing, she figured she’d take the chance and skip chemo.

But when she told her oncologist her decision, he replied with anger and scorn. And left her feeling unheard, under-valued… and uncertain.

Was she REALLY making the right decision?

As breast cancer survivors, we know that the disease itself isn’t usually painful; it’s the treatments that are difficult. In fact, some treatments are so difficult that they make you wonder whether they’re actually worth it.

Chemo is the main culprit. The hair loss is devastating, but temporary. It’s the other side effects – those with potential to last for years, or forever – that make you stop and think.

Many women experience neuropathy: tingling in the hands and feet that can be alternately annoying, painful, and sometimes downright dangerous, when it affects balance and the ability to grasp things. Neuropathy can last just a few months – or it can be permanent.

And how about that Neulasta shot the day after your infusion? It strengthens your immune system, and reduces your risk of infection. But for many of us, it also produces incapacitating bone pain. Pain so bad it prevents work, pleasure, or doing anything else beyond gritting your teeth and getting through it.

Most oncologists are loath to back off on treatment due to side effects; after all, it’s their job to save your life. But it’s YOUR job to weigh sometimes excruciating, often debilitating side effects against their possible benefit.

How do you decide whether to skip chemo, or stop taking Arimidex? And how do you talk to your oncologist about your decision, without leaving the office feeling like you’ve been beat up emotionally – or simply dismissed as weak?

Or “suicidal”?

First, understand where your oncologist is coming from. Of course s/he wants you to follow “doctor’s orders.” After all, your oncologist is a highly trained professional, someone who’s studied cancer for years; someone with access to information on the latest, cutting-edge treatments.