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Never too old to make choices Last week, I met this lovely lady, pushing 80 years. I’m reluctant to call her old for her lively demeanour would put the chronologically young to shame. How I met her was because she had been diagnosed with breast cancer. Fortunately for her, she had early breast cancer. This is a delight for a breast surgeon like me, who is used to seeing advanced breast cancer. After going through the investigations, it was decided that she should have surgery. I started discussing the surgical options and just as I would do with all my patients amenable to all the options, I discussed breast conservation surgery, mastectomy ( surgical removal of the breast)and mastectomy with reconstruction. She was quick in making her decision and said she wanted to have a breast conservation surgery. I liked her firmness but her daughter was not so sure. When the time came for her to be admitted, the daughter came up to me and said that she and her brother thought it would be better if she went ahead with mastectomy. It was surely concern for their mother. They wanted her to be disease free and also thought that at her age, it did not matter if she lost her breast. At the same time, they were not sure that breast conservation and mastectomy yielded the same results. I spoke to her again and said that her mother had made a choice, which was scientifically tenable .Ten years ago, my warped mind might have encouraged her to go for mastectomy. Now I know, choice has nothing to do with age.The instances when husbands, brothers, parents, relatives and anyone else( read neighbors!) influencing surgical decisions have been too many and every time, my heart has gone out, especially, to the young ladies who have had no say in the choices imposed on them.Losing a breast is a self esteem, body image issue- the loss and its impact is borne only by the one who loses it.The lovely dame stood by her choice and it was executed. Choices are not about being right or wrong. Choices are about the freedom to make a decision and stick by it. The comfort of having made one’s choice is a confidence booster and can bring about unexpected results. I do know that, for a fact!
WOMEN SHOULD BE ALLOWED TO MAKE THEIR CHOICES.............. I see a lot of lady patients in my practice since I deal with breast cancer and other breast related conditions all the time. What has struck me as the rule rather than the exception, is that, women don't have a complete say in matters dealing with not just their breasts but their life.....whether she should keep her breast or sacrifice it, whether she should go for chemotherapy or not, how much should she be told about the disease etc. etc.The people involved in these crucial decisions involve men ranging from a husband to the father-in-law to a second degree male relative or sometimes even an 'educated' male neighbor. Women empowerment is the only answer....her issues are her own, her body, mind and intellect are all her own.Only she must be allowed the right to decide what is good for her, with gentle gestures of support from her immediate family.
How tough is the job of an oncologist? I am often asked this question and I have probably never admitted the whole truth. An oncologist is a strange amalgam of extremes of emotions....it is a never ending balancing act.While he or she has to create that environment of positivity to enable the patient to make the right choices for his/her treatment, without being overwhelmed by the side effects of treatment, he or she also has to ride the see saw of ups and downs that are likely to happen during the course of treatment with the patient. Being cheerful in the face of adversity yet remaining detached from the outcome of treatment is learnt painstakingly over years. The troubles don't end here. The oncologist is subject to scrutiny all the time....an innocuous expression could be read by the attendant or patient as despair or hopelessness, a phone call for another seriously ill patient could be extrapolated to one's own self by the patient across the table, a slight drop in the wattage of your smile could be interpreted as doomsday......and so on.It is a tough life but it becomes worth the effort when patients defy statistics, come back to meet you, year after year, treat you like a part of their extended family contributing to crucial personal decisions..... and threaten to outlive you! For more details, please contact Dr Geeta Kadayaprath, Head Breast Surgical Oncology, Max Cancer Centre, Patparganj, Delhi, India
One of the first decisions you may have to make is which type of operation you'll have. You may be offered a choice of breast-conserving surgery, (usually referred to as lumpectomy or wide local excision) or a total mastectomy (removal of all the breast tissue including the nipple area). Sometimes it can be helpful to talk through your choices with your breast care nurse and discuss how each would affect you. Dr. Geeta Kadayaprath - Breast Cancer Treatment in Delhi
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