I chose lumpectomy, figuring I could always have a mastectomy later if necessary. I had the lumpectomy; it didn’t do the trick, so I had the mastectomy anyway. But oh, how I agonized over that initial decision!
A friend of a friend is going through a similar situation. After her diagnosis she had a lumpectomy, and no lymph nodes were involved. Having recovered from the lumpectomy, she recently went for an initial appointment with her oncologist, fully expecting to schedule radiation and go on her merry way. But hold on: the oncologist told her that if she did chemo, she’d reduce her risk of recurrence by 4%. And furthermore, he wanted her to join a clinical trial. “And oh, by the way–I need your answer on everything by tomorrow.”
Needless to say, this woman was shocked, then angry, then fearful, and starting to feel a mega-dose of guilt. “What if I refuse chemo? What if it comes back?” On the other hand, with a husband and two teenage daughters, she felt very reluctant to “put them through the hell of my going through chemo,” when the up side was a mere 4% improvement in her risk of recurrence. When last I heard, via our mutual friend, she was preparing to spend a sleepless night. What should she do?
First of all, that oncologist had no right to ask her for an answer in less than 24 hours. I’d suggest to her that she simply refuse until she’s good and ready. Heck, every decision we make as breast cancer patients feels fraught with danger. What if I make the wrong decision and my cancer comes back? What if I die and leave my children without a mother, my husband without a wife? It takes time to process those feelings, to separate emotion from fact, to talk with others who’ve been through something similar. An extra few days or week certainly won’t make the difference between life and death.
Next, I’d have her talk to her family, rather than try to spare them. Families are generally more resilient than we give them credit for. Husbands or significant others step up to the plate; kids can be surprisingly kind and mature, especially teenagers. It’s tempting to martyr yourself on the altar of your family, but is that what they really want? Probably not. Give them credit for loving you as much as you love them.