PJCGAGNO’S MAR [15-05]:The Battle With Breast Cancer

Index Title: PJCGAGNO’S MAR [15-05]
MAR Title: The Battle With Breast Cancer
Period of Observation: May 2015
Tag: Patients loosing hope in their battle with breast cancer.
Category: Professional/Ethical-Reinforcement
It was one weekend when I was off from duty and was spending time with my family. We visited a family friend in Makati. As we entered her office, I already felt something was wrong with Aunt Lita (not her real name). Though, I already knew that she was complaining of a mass on her right breast, she looked different. She was in black dress with shawl covering her barely thin body. I asked her how she was. Aunt Lita said: “Okay lang” (I’m Okay) with a faint smile on her lean face. With these two words, I knew she was not okay.
I learned that her breast mass already had some skin ulcerations. Months before, she already consulted in our institution but failed to follow-up because she does not want to undergo biopsy. She sought other medical opinion but opted alternative medicine because she was afraid of being operated. She was financially constrained because her French husband was not supporting her. Instead, she was taking many herbal supplements. She even avoided eating rice, meat, sweets, and some vegetables because she and her husband read an Internet article telling that these foods will only worsen breast cancer. Basically, she only eats soup and crackers every single day.  
I told her not to lose hope and keep fighting as I encountered many patients who have quality lives despite their condition.  I advised her to go back at OMMC for follow-up, told the importance of biopsy in her management, offered other diagnostics and possible treatment options- chemotherapy and surgery. I encouraged her to consult at our institution, which has more reasonable and affordable health services as compared to other private hospitals. I reassured her that I would be there to assist her. I also emphasized the importance of proper nutrition, and that nothing is restricted in her diet.
Bahala na” (Come what may): she responded. I then felt an indescribable pain of despair as I listened to her hopeless voice.
(Physical, Psychosocial, Professional/Ethical)
(Stimulus, Discovery, Reinforcement)
Breast is something dear to my heart, particularly breast cancer cases.
According to the International Agency Research for Cancer last 2014, the incidence of breast cancer in the Philippines appears to be the highest recorded in Asia. Aunt Lita was just one of many Filipino women battling and suffering not only with the disease per se but also with the entailed psychogical and financial burden.
I typically encounter breast patients in my training but such wouldn’t make an impact if it were not on a personal level.  Last April, my closest aunt died because of breast cancer with metastasis in her brain, lungs, liver, adrenals, and bones. I saw all her battles and sufferings for almost 5 years. My late grandmother also passed away due to the same condition 27 years ago.
Now, I encountered another loved one suffering from breast cancer for almost 6 months. What makes the situation worse is her hopelessness. She had already surrendered even if her battle has not yet begun and I, a physician and her close friend, can only do so much. Her lack of knowledge, money, and support from her husband only hinders her from being treated and having at least a decent life. I cannot stand the situation of Aunt Lita. I felt the burden of helping and empowering her battles. I was constantly insisting to see us back in our department to help her start her treatment.  I also advised her to seek other support from her family and not to rely solely on alternative medicine.
All of us physicians carry the responsibility of diagnosing, treating, educating, and empowering our patients. We have to explain, with all our best, their condition, prognoses, and treatment options. Such role is way more critical and heavier when our relatives and people closest to our hearts are involved. But at the end of the day, after we did our part, it is still the patient’s choice whether he/she will follow our advice.
ROJoson’s Notes (17feb2):
All of us physicians carry the responsibility of diagnosing, treating, educating, and empowering our patients. But at the end of the day, after we did our part, it is still the patient’s choice whether he/she will follow our advice.
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