Feb 15, 2018 11:35AM Outfield wrote:
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.
