Elle Macpherson, 60, recently revealed that she turned down chemotherapy after being diagnosed with breast cancer.
The former supermodel said in a new interview with The Australian Women’s Weekly that she was diagnosed with a type of breast cancer called HER2-positive estrogen–receptive intraductal carcinoma seven years ago. Macpherson said she underwent a lumpectomy, which is how her cancer was diagnosed.
It was a shock; it was unexpected; it was confusing; it was daunting in so many ways, she told the outlet.
And though her care team recommended chemotherapy as part of her treatment, Macpherson said she opted for a different approach, which she described as intuitive, heart-led holistic. She added that she is now considered to be in remission.
How many people refuse chemotherapy?
It’s not just Macpherson who has refused chemotherapy; other celebrities, including Steve Jobs and Suzanne Somers, have reportedly refused chemotherapy after being diagnosed with cancer.
But the phenomenon overall is rare and has been scarcely studied: Some research shows less than 1% of patients have refused all types of conventional treatment for a cancer diagnosis; regarding chemotherapy specifically both partial and complete, that number jumps to 3%–19%.
In practice, experts say most people with cancer for whom chemotherapy is recommended take the treatment.
If oncologist recommends chemotherapy unequivocally, it is relatively rare to refuse, as most patients understand that this will give them the best chance of not having the cancer return or spread Amy Tiersten, MD, professor of medicine specializing in hematology and medical oncology and the clinical director of breast medical oncology at the Dubin Breast Center at Mount Sinai.
Why Some Patients Refuse Chemotherapy
Some patients express hesitancy over adhering to a chemotherapy regime due to the side effects of the drug—those common side effects include: fatigue, nausea and vomiting, hair loss, and increased risk of infection, among others. Patients may also decide to forego chemotherapy because they prefer to live with the unclear risk of cancer recurrence rather than the known risks of chemotherapy side effects. Associate attending in the breast medicine service at Memorial Sloan Kettering Cancer Center.
But while chemotherapy can cause uncomfortable symptoms, it provides relief for some.
Chemotherapy has been stigmatized so that people immediately think of its side effects, but often the symptoms from the cancer are worse than the side effects of chemotherapy. We want to emphasize that in many cases, chemotherapy can actually help a person feel better. If the cancer is causing symptoms like difficulty breathing, pain, organ damage, or something else, chemotherapy can rapidly reduce the size of the cancer and its associated symptoms.
Additionally, many of our more modern [chemotherapies] are quite tolerable, and with good supportive therapies—such as newer anti-nausea medicines, immune boosters, and cold capping to help reduce hair loss—most patients tolerate the treatment well.
But side effects aren’t the only reason people sometimes shy away from chemotherapy treatment. What worries me is that the fastest rising reason for refusing effective cancer therapies is also the most dangerous reason, and that is misinformation.
If a person with cancer decides to forego chemotherapy due to misinformation they’ve gathered, it can be challenging to address.
I always advocate for patients to be as informed as possible and to use trustworthy sources for cancer treatment information. Using a vetted source can significantly reduce misinformation; however, another critical consideration is the applicability of that information. You might be getting information from a trustworthy source, but it may only apply to your situation in varying degrees or not at all; this is usually the most difficult misinformation to deal with.
The question of whether or not someone can safely refuse chemotherapy is thorny, but experts said that if chemotherapy is strongly recommended, it’s probably not in a person’s best interest to refuse it. In most cases, the recommended treatment is life-saving and refusing treatment would be very dangerous
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How Doctors Decide to Recommend Chemotherapy
When deciding whether or not to recommend chemotherapy, doctors take into account many factors, including a person’s overall health, whether they have other health issues in addition to cancer, and how functional they are, said Iyengar.
In some cases, doctors strongly believe that chemotherapy can save and/or prolong a person’s life. For many cancers, there is a clear benefit to chemotherapy, including better quality of life by improving symptoms from the cancer and longer duration of life by reducing the chance of cancer growth,” said Iyengar. In other cases, he added, there is clearly no benefit to using chemotherapy.
However, sometimes it’s tough to determine whether the benefits would be worth the treatment. “The benefit-risk ratio often lies somewhere in the middle of the clear benefit and clear lack-of-benefit.
AMANI Nesta
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