Oncologist out

Imagine feeling cared for, nursed, being someone special.  When you're waiting in a busy waiting room, in the oncology department of a big hospital, with no one to talk to, a nurse comes up to you, addresses you by name (almost right) and asks very nicely if she may weigh you.  Someone's paying you attention, aren't they?  They care whether you've put on weight or lost it and the nurse will pass the information to the doctor who knows that some anti-breast cancer drugs tend to make you put on weight, and the doctor will discuss that with you. 

But no, "that's just something the nurses do", explained the oncologist (B) I saw that time, saw just the once, never again.  The next time I came to the oncology department, I courteously though somewhat nervously refused to allow the nurse to weigh me.  She told the doctor - at least now I know that they communicate - and the doctor (C) talked about placebo treatment - visiting the doctor makes people feel better.  Yes, I understand that, having once visited my doctor anticipating our second baby, but wanting a home birth - he said he couldn't treat me because he didn't do home births, and I went home rather melancholy.  Being treated makes you feel good.

Nevertheless, last week when I went to the oncologist, I allowed the nurse to weigh me.  It amused me to note her complete lack of observation as I stood on the scales fully dressed and holding  two bags, one with a purse, a digital recorder, a camera, and a paper back book inside.  Needless to say, I weighed more than before. 

However, for the first time, I saw the same oncologist again.  This man (C) copes with me citing breast cancer research on predict, vitamin D, hyaluronic acid, aromatase inhibitors and that women diagnosed when over 60, gain less benefit from these drugs.  We had a discussion on the relative statistics of taking an aromatase inhibitor versus exercise (pdf), and he tells me not to stop taking the drug but that as far as the oncologists are concerned, I'm cured.  They removed the physical lump; they radiated the area in case they dropped anything; the aromatase inhibitor will prevent anything else starting up.  Keep up the annual mammograms, keep taking the aromatase inhibitor for five years (I can have a trial month out to see if the aches go away and if they do then they'll use a different aromatase inhibitor) but otherwise go away and don't come back. 

I'm cured.

Cancer statistics

Did I have cancer? Am I a survivor because that routine mammogram in February found the tiniest lump, diagnosed it as cancer and I had local treatment (operation & radiotherapy), followed by systemic treatment (these nasty anti-hormone tablets). I reasoned that it was such a small lump that it wouldn't have been feel-able for at least a year, and then some. So with treatment at that stage I'd certainly have lived longer than five years from last February. Now I've had the diagnosis and the treatment, of course I'm told I'm likely to survive five years and the survival statistics would look good, but I would have survived those five years anyhow!

Now there's a debate about routine mammograms resulting in over-diagnosis, consequent over-treatment and survivor stories that encourage greater take-up of mammograms. Here's the original research from America, in the Archives of Internal Medicine. Note that the authors, Welch & Frankel conclude:
"Most women with screen-detected breast cancer have not had their life saved by screening. They are instead either diagnosed early (with no effect on their mortality) or overdiagnosed."

Perhaps I don't need to keep taking these horrid tablets. I shall certainly argue this point with the oncologist at the next meeting in January. Perhaps it would be reasonable to stay on them only until the next mammogram in March shows that there are no more lumps. Last time I saw an oncologist, he said that if new lumps appear, it tends to be within the year or eighteen months after initial diagnosis. So perhaps I can come off the tablets after a clear year to eighteen months, instead of staying on them for five years.