Hormone Replacement Therapy?

Hi Neets, thank you so much for your wonderful response; not only for the benefit of Shae and I, but also for all the other women who will not feel so alone in what is generally characterised by oncologists as an extreme position. Of course making out it’s an extreme decision (not to take Tamoxifen or aromatase inhibitors) as opposed to an informed and entirely appropriate life choice is a good device. It allows specialists to avoid answering the questions of the (“greater unwashed”) who don’t possess a medical degree and therefore have no place questioning current medical orthodoxy. Professional arrogance is alive and well.

As you mention, we need to ask questions and advocate for ourselves. However It’s not always as easy as it sounds. I was supporting my father through palliative care while going through BC treatment. Normally capable of questioning and pushing back I felt diminished, rushed and intimidated in my short, sharp, and perfunctory oncology appointments. Having BC is a vulnerable time for us all and understandably there’s a desire to just place yourself in the hands of the team (of complete strangers) and trust them entirely.

My oncologist was always running more than an hour late and I even felt pressured by the knowledge that there was a waiting room full of other women behind me looking at their watches and worrying about getting back to work, childcare etc. I did a fair bit of preparation to ready myself not to merely accept the Tamoxifen prescription and to ask questions. Yet the specialist made me wait in glacial silence for a response to the simple question of “what is the statistical likelihood of recurrence in my specific case. Finally as I walked towards the door his tone changed and he said almost jovially that I’d made a perfectly reasonable decision. 

The medical profession, particularly specialists have a knack of being entirely certain about many things that actually have no evidentiary basis. History amply demonstrates that doctors are often highly resistant to evidence that their deeply entrenched beliefs about medicine are wrong. A stark case in point being mid 19th century surgeons ignoring germ theory, offended by the notion that they themselves could be causing deadly infections in their patients. Bloody aprons were a status symbol of an experienced surgeon, rather than a sign of poor hygiene. The surgery mortality rate remained high throughout the 130 years that surgeons actively resisted washing their hands. 

So we come to the question of why we are still stuck with breast crushing machines called mammograms, grotesque biopsies and harrowing hook wire procedures. It’s easy (and convenient) to blithely discredit new technology and let’s face it, there’s huge costs involved in introducing it. There does however need to be more public open discussion and major patient representation about it. Let’s speak up for progress, get behind the Doctors Reform Society (DRS) and other such reform bodies; unless of course you personally feel adequately represented by the AMA.