Famous supermodel Elle Macpherson revealed in an interview with Australian Women’s Weekly earlier this week she said she was diagnosed with breast cancer seven years ago.
Media reports around the world report that Macpherson he rejected several “conventional” treatments for the style of breast cancer she uncovered, generally known as HER2-positive, estrogen-receptive intraductal breast cancer.
This isn’t the first time we’ve seen how powerful celebrity cancer stories can influence the public health narrative. Sometimes, these celebrity stories change cancer screening and treatment.
For example, after singer Kylie Minogue announced in 2005 that she had breast cancer, there was an unprecedented the growth of mammography reservations.
Actress Angelina Jolie’s column in New York Times in 2013 about her preventive double mastectomy for breast cancer, which can have happened inadvertently fueled by excessive testing amongst women who are usually not at high risk.
And when the actor Ben Stiller announced in 2016 that a prostate-specific antigen (PSA) test he underwent in his late 40s saved his life, which was contrary to international screening guidelinesIt is really helpful that men under 55 years of age do not undergo PSA testing as prostate cancer can often be overdiagnosed.
Should we be concerned about the latest news?
Organisations corresponding to Breast Cancer Network Australia have made public statementsfearing that Macpherson’s comments could encourage an approach to the treatment of invasive breast cancer that features the use of unsupported evidence-based “health” products and interventions.
But media coverage of Macpherson’s situation largely omits a key piece of knowledge: her breast cancer is just not invasive.
The type she revealed is often generally known as ductal carcinoma in situ or DCIS. This is a cluster of cells from pre-invasive or non-invasive breast cancer. It differs from invasive breast cancer in that the lesions are limited and haven’t spread. This implies that treatment for invasive and non-invasive breast cancer differ.
In fact, Macpherson appears to be following really helpful cancer treatments. She underwent surgery, a lumpectomy, to remove DCIS. Guidelines recommends that patients weigh the possible advantages and risks of additional treatments, which Macpherson said her doctor has offered: mastectomy surgery, radiation therapy, chemotherapy and hormone therapy. Together with their treatment team, each patient can resolve whether any of those additional treatments are right for his or her individual situation.
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Research is ongoing to find out who’s most certainly to profit from these additional treatments and who may not need them in any respect. So Macpherson’s decision to say no additional treatments can have been each a wise and standard decision for a lady with noninvasive breast cancer.
The lack of media coverage can also be a missed opportunity to debate less invasive treatments for DCIS.
Rate DCIS has increased significantly since the introduction of breast cancer screening. They will be detected on mammograms but rarely cause symptoms. Many of those changes are unlikely to ever cause an issue in a girl’s life. As a result, some cases of DCIS are considered to be overdiagnosed.
Currently, approaches corresponding to lively surveillance (close monitoring without treatment until disease progresses) are considered reasonable and are being thoroughly evaluated in research studies to assist reduce overtreatment.
We should be wary of simplistic narratives about celebrity cancer journeys that don’t necessarily tell the whole story. This also needs to include skepticism about the “feel good” narrative because it might probably result in non-evidence-based treatments that waste consumers’ money and will harm them.
We all have to turn out to be higher at being suitably skeptical about health information without losing confidence in proven medical interventions.
I’m fearful about my breast cancer. What should I do?
A diagnosis of breast cancer can trigger a flood of emotions and expose a girl to many doubts, including the effectiveness of treatment, its potential unintended effects and long-term effects.
Women can seek the advice of their doctor questions about possible management options, including:
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What are my options? One of those options could also be to decide on less treatment, including an lively surveillance approach for low-risk DCIS
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What are the possible advantages and harms of those options?
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What is the probability that every of those advantages and harms will occur to me?