Can We Say No to Our Oncologists?

Four years ago, while living in Hawaii, I was diagnosed with breast cancer, so my primary care physician recommended me a breast surgeon. At the time, I was the deer in the headlights, overwhelmed by the news that I had a cancer I never dreamed existed — breast cancer in a man. And I started looking to find anyone who could point me in the right direction, while offering me a chance to stay alive a little longer.

I had no knowledge from which to make my own choices back then, and very little time to seek out someone who could walk me through the process of diagnosis, mastectomy and recovery, along with a battle plan to help me decide on the best course of action to increase the odds of killing the cancer inside me.

It never occurred to me at that moment in my life to ask too many questions since I was totally unprepared to know what to ask. And because the only person on Earth who was able to offer me advice at the time was my primary care doctor, I elected to trust his guidance. I didn't consult my friends or family about my choices, and I had no time for second opinions. After all, the diagnosis was clear; I had cancer.

So, there I was — naked and ill-informed, vulnerable and frightened, looking to find any voice of authority that could give me hope for my future.

My surgery was performed by a remarkable woman at The Queens Hospital in Honolulu. My primary care doc said she was the best surgeon on the island and in retrospect, I think he was right.

Fast forward now, four years later, as I am fully involved in the maintenance routines for my breast cancer. I've had the blood work, the mammograms, the MRI, the ultrasound and the regular checkups. The only thing I have not received was the chemotherapy. This was a choice I made early on and have no regrets about.

But when my current oncologist recently pushed me for a second MRI of my remaining breast, I told her no. The trauma of the MRI experience, done in that long tube, face-down and looking only at the remaining breast I have, left didn't make sense to me.

I have no visible or physical symptoms. If my breast cancer should metastasize to another part of my body, the odds are good that it will show up in my lungs, brain or stomach. I wanted the current test she was requesting to look at those parts of my body. It seemed to me that a simple ultrasound of the missing breast area, combined with a mammogram of my remaining breast would be more productive.

I expected a fight, but to my surprise, my oncologist agreed.

Before we had our discussion, I wondered how it would feel to her if I questioned her assessment of my condition. I looked carefully into her eyes as I made my position clear. And I could see a woman who truly cared for my wellbeing while respecting my personal thoughts and research into male breast cancer and, more importantly, a doctor who sensed the intuitive decisions that just might influence my health and healing.

She didn't need to be right. She only needed to consider the logic of my request, and offer her own insight in the various possibilities that existed in my continuing health care.

My reason for relaying this story is not about "getting my way" or escaping a procedure that I find unpleasant and unnecessary. It's to acknowledge a doctor who has placed a value on my own thoughts about my own disease and opened a space for dialogue that benefits both of us.

The final lesson in this, at least for me, is that it's perfectly OK to say "no" to anyone on our recovery path. We are, in large part, responsible for our own health after all. We make choices throughout our lives that can certainly impact our futures. What do we eat, do we smoke, how's our stress, do we exercise, how much do we drink, how positive are we, what is our spiritual involvement in life and on and on. We must take responsibility for our health and accept that our cancer is also a life event that we can make easier by our attitude and by our belief in our own capacity to heal. If we're willing to do the research to understand our disease and make decisions based on our own intuition, supported by good science and common sense, we can say "no" and feel good about it.

The world of cancer is filled with so many ideas, thoughts, opinions and contradictions, that we owe it to ourselves to ask lots and lots of questions. Saying "no" to any part of our survival protocol isn't unkind or disrespectable.

It's just good medicine.

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