What would you do?
Doctors hear this question often as they treat patients. According to Dr. Coral A. Quiet, a radiation oncologist specializing in breast cancer, it’s a difficult question to answer. Ideas about risks, benefits, and treatments vary so greatly from person to person that it can be a difficult question to assess. Every patient is different. Some women feel strongly about radiation or chemotherapy. Some are risk averse and will do everything they can to minimize risk. Others are willing to accept some risk for the benefit of cosmetic outcome. Moreso, every case is different. Part of a physician’s job is to help establish a patient’s biases and preferences, as well as the diagnosis at hand, to create treatment options that are tailored to the patient.
Coral A. Quiet, M.D.: It is very common for patients to ask me, what would I do? Or, what is the best kind of radiation? Here is what I tell them.
I commonly get asked in the office, what would I choose to do if it were me in that patient’s shoes? The problem is, we all have different risk benefit analysis and ideas. Some women may be very risk averse and they want to do everything possible to minimize their risk. Other women may be willing to accept some risk, but trade-off on cosmetic outcome. Or, some women may be very adverse to radiation or chemotherapy. We all have our different biases coming into things. So then that is part of the equation that we try to choose out with the patient, helping them understand what their biases are. When I get asked that question, what would I do, I try to tell them what my biases are. So, I think again it is always up to what is best for the patient, what is best for her disease. That is why I can spend all day seeing women newly diagnosed with breast cancer and it is never the same. Every patient is different, every scenario is different, so it is really important to have a good communication with your physician and patient.