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Breast Cancer: Making the Right Choices for You
Introduction
If you have just been diagnosed with breast cancer or have a strong
suspicion that you might be, you are probably feeling overwhelmed, anxious,
and powerless... all normal feelings when confronted with a disease
that effects one in eight women in the United States. All too often
women travel blindly through the health care system not knowing if they
are in the best of hands that they could be.... and should be. For treatment
of the common cold and other common disorders it is fine to seek out
care from local physicians who would normally provide you primary care.
When dealing with a life threatening situation like breast cancer however,
choosing the wrong doctor or the wrong breast center can be fatal. You
must choose carefully and wisely. After all, we are talking about your
life.
I am a breast cancer survivor. I am also a nurse. I have
been where you are right now and know the anxiousness that you feel.
For more than a decade I was the director of quality of care and utilization
management at Johns Hopkins Hospital, striving every day to measure
and assess quality of care and work with the health care professionals
here to continuously improve the care we provide. I joined the team
of the Johns Hopkins Breast Center to further accomplish this goal,
but have chosen to channel all my energies and expertise into the area
of breast cancer. My goal is to make it easier for women like you who
come behind me to also become one of the survivors like myself.
There have been many women who come to the Johns Hopkins
Breast Center who have been seen by physicians elsewhere who did not
provide them the ideal care and treatment they needed, this resulted
in major medical problems for them long term-- wrong diagnosis, incomplete
or inaccurate information, misleading information, confusing information.
As an institution committed to patient care and teaching, we want to
provide you some guidelines as to how to go about choosing a physician
and facility that is right for you. We want you to know how to choose
who will take good care of you and give you your best opportunity to
defeat this disease. The best answer is not always the same for each
person. We want you to have the tools needed to make the very best choices
for you and your family in the battle against this disease.
Though a diagnosis of breast cancer is devastating to
hear, it is not something that requires emergency treatment. This is
often a misleading piece of information for women. They assume that
because they now have breast cancer that it must be treated immediately.
Not true. Though delaying for a prolonged time period (more than a couple
of months) is not advisable, in most cases, you do not have to rush
into making decisions. More importantly, if a doctor tells you that
you must have surgery immediately take caution. If your cancer
was diagnosed with either a mammogram or because you or a physician
felt a lump, the cancer has probably been growing for 5 to 8 years.
It took a long time for a few tiny cells to mature enough to become
a tumor which could be seen on x-ray or felt. So you don't have to have
surgery right away. You don't have to make hurried decisions without
adequate information about your treatment options and about what is
really best for you. You have time to gather information. You have time
to gather your family and friends for support. You have time to seek
out the best doctors and facilities to take of you.
At a time when you feel powerless having heard the verdict
of breast cancer, it is important to seek out constructive ways to empower
yourself once again and gain some stability over your life and the
situation placed before you. The breast cancer specialists of the Johns
Hopkins Breast Center are strong believers in the value of providing
women with information about their disease and its treatment options.
An informed patient is a patient who will do well psychologically. An
informed patient is someone who can participate in the decision making
about her care and feel confident in the choices made. An informed patient
knows what to expect along each step of the way from point of diagnosis
through to completion of treatment and beyond so that she is actually
a member of her own health care team... an equal partner with the
breast cancer specialists who have her best interest in mind--survival,
good quality of life, confidence in the choices made about her health
and well-being.
We have spoken to patients who have been to other physicians
elsewhere and made them feel pressured to proceed quickly with treatment
before they've had time to think things through and really participate
in the decision making about what is best for them. If you are confronted
with a doctor who is pressuring you to have surgery "right away" or
who is not informing you about what all your options are you need to
seek care elsewhere. In the same light, if you are being told by a doctor
information that sounds "too good to be true" compared to opinions you
have gotten elsewhere (for example, if you have been told that you probably
have a large tumor and/ or positive lymph nodes based on physical exam,
biopsy results and mammography which would definitely require chemotherapy
as part of your treatment don't be fooled by a doctor who tells you
"if you have your treatment here you won't need chemotherapy." It simply
isn't true... and isn't logical.) Though getting good news like this
from another physician can at first sound great, if you have done your
homework and study up on your clinical situation, you would know that
this doesn't sound right. Don't be fooled by such an opinion. Get a
third opinion if you need it. You are far better off with a breast cancer
specialist who tells you frankly and honestly what your situation is
than to have someone paint a rosy picture which in the end isn't so
rosy.
The decisions you make can and will effect the rest
of your life. That's why it is so important that you empower yourself
with information so that you can determine for yourself if you are in
good hands. It doesn't mean that you have to have a medical degree either.
It does mean that you need to take some time and read about breast cancer,
the various treatments that are available to treat this disease, and
how to best determine for you personally what will be the right choices
for your situation. You have time to gather information too through
reading literature. Many sources are helpful in explaining in laymen's
terms what the nature of this disease is all about, what are the types
of surgery done and types of adjuvant therapy (chemotherapy and radiation
therapy) are available to irradicate this disease and have you become
a long term survivor.
So how do I start?--by taking a deep breath, sitting
down, talking with family and friends who can offer you emotional support,
and tackling this new crisis one step at a time. Below is a guide to
help you become an empowered, informed woman who will have the knowledge
and resources needed to make decisions confidently about her breast
cancer treatment.
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