Correct. I do not argue with patients seeking alternative medicine. However, neither do I pull any punches when I tell them why alternative cancer cures do not work, as well as the real evidence for conventional treatments, including their downsides. 1/https://twitter.com/docranjana/status/1095852332103790592 …
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Nor do I pull any punches describing what happens when breast cancer is left untreated. En cuirasse disease, when breast cancer grows ro involve large parts of the chest wall with bleeding, necrotic, painful ulcers, is a horrible condition that's very hard to alleviate. 2/
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I figure that anyone contemplating eschewing effective treatment for fairy dust should be aware of just how unpleasant the consequences can be. That's real informed consent. So I calmly and respectfully provide it. 3/
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It won't dissuade them, of course, at least not at that visit, but I at least hope to plant a seed of doubt. Also, when family members are present, they get the message too. 4/4
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Replying to @SkepMedicine
You're not a cancer surgeon. My goal with these patients is to persuade them at least to let me operate on them. Surgery alone can cure breast cancer. Chemotherapy, radiation, and endocrine therapy decrease the chance of recurrence.
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Replying to @gorskon @SkepMedicine
My thought process with these patients seeking alternative cancer cures is simple: If I can get them to agree to surgery, at least they have a fighting chance, even if it's not as good as it would be if they accepted full multimodality treatment for their cancer.
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Replying to @gorskon @SkepMedicine
I don't care that much if such patients do what do many of them who accept surgery but refuse chemo/radiation/endocrine therapy do, which is to credit their survival to the quackery they chose and not to the surgery that actually cured them. At least they lived.
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In other words, I value saving the patient's life with what I CAN do (surgery) if I can, or at least giving her the best chance that *I* can give her and get her to accept.
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Replying to @gorskon @SkepMedicine
If she wants to attribute her survival to the quackery that she chose in addition to surgery I persuaded her to accept, so be it. Such is life. At least she's alive to do that.
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