Do you think it's ethical to remove a cancerous breast of a terminally ill woman?

Well, if it’s medically called for then yes; if it will improved the quality of life for her, the or add to the time to the life she has left. And the doctor can’t remove a woman’s breast without her consent so I’m not sure if it’s an ethical issue on the part of the doctor unless he persuades the woman that a mastectomy is the right thing to do when it’s not necessary or won’t improve the quality of life during the time she has left.

If the breast cancer is going to cause her a lot of pain and suffering that she could otherwise avoid during the time she has left, then of course treating it is ethical. Why wouldn’t it be?

If the removal of the breast will make her quality of life better (regardless of how long that life is), then yes, it’s ethically the right thing to do.

Are terminally ill patients not required to give consent anyway?

As opposed to leaving it there to spead and kill her faster?

Why wouldn’t it be ethical? If she had a problem with it, she could have just not consented and not had the procedure done.

The question as it stands doesn’t give any information to indicate that consent was not granted, therefore why wouldn’t it be ethical?

I did not ask the question correctly. what I should have said was: what was accomplished by removing the breast of a terminally ill woman whose cancer had already spread? That diagnosis often has a prognosis of two years. She died in two years with extensive chemo and radiation. So why did he suggest, we’ll say, she have it removed? How did the surgery improve her quality of life which was downhill and miserable from the diagnosis of Stage 4 until her death? And now, thinking back on it, he did tell her “we are going to catch this cancer right now!” In other words, the poor thing was expecting a cure. She told me she was.

She may have misinterpreted what the oncologists said. I had three oncologists, I’ve known a number of others and in my experience they don’t promise cures. Ever. They try to give hope. Maybe the mastectomy gave her some time she might not otherwise have had.

From all that I’ve read about “cancer treatment”, it seems that there are equal parts art and science, and some of the “art” is recruiting the patient’s own hope and marshaling the “will to live” that seems to tip the balance in favor of survival sometimes.

Would you rather the surgeon had said, “Eh, what’s the use? You’ve got cancer. Go home and die. Next!” Surgeons are trained to operate to remove problems. That’s what they do. They don’t pray for the survival of their patients, they attempt to surgically remove and correct what they see as problems. Blame it on their “worldview”.

@CWOTUS No; I would not rather the guy have said that. I would rather he have said, “this cancer is spreading; you’re stage 4. So let’s try something no doctor in town has tried . Let’s starve the tumors. First, I want you to know that cancer feeds on sugar so I dont want you to touch sugar. Next, I will prescribe a lot of supplements with no side effects to build up your immune system; let’s fight this and feel good while we’re doing it! I want you to begin yoga classes and meditation classes and eat no meat at all . No sugar, no meat and lots of veggies and fruits. Exercise any spirituality that you possess, laugh as much as you can and I am sending you to a wonderful dietician who has had a lot of luck shrinking tumors without any chemicals or poisons.” That is what I wish he had said.

@Aster: Just out of curiosity, do you know how much energy cancer patients have, especially terminal cancer patients? This is an honest question.

Medical doctors use medical solutions. Your knowledge of tumors probably does not match that of someone who has extensively studied same. The chemicals and poisons you so decry saved my life and allowed me to raise my daughter to adulthood, and allows me a sterling quality of life now. We each do what we deem necessary for ourselves, no medical doctor is going to recommend non-proven New Age stuff.

Is she still alive? I know people that live in stage 4…are still living…may live for many more years.

No, Jill; they certainly won’t recommend what I believe in. My “knowledge” of cancer is quite limited. I’ve only followed my two best friends with it . I have seen a few things that go on that have surprised me, though, having to do with treatment that healed you but that I find barbaric. I’m glad you’re still with us, Jill.

@Aster But that’s what you would want if it was you who had cancer, not necessarily what your friend would want.

She really had lots of energy at first, even when starting chemo. I recall lots of brisk walking. Then as she got more treatments she began having terrible effects from it but they gave her radiation and she lived 2 years after that doctor visit. And @Aethelflaed she was in the majority. There is no way she would have ever done a thing her doctor didn’t suggest. I knew her very well; I stayed out of it . That is, I never said, “don’t do that.” She took each treatment he told (if that’s the right word) her to take, each pill he gave her, each shot -everything to the letter. Very trusting, sweet lady who felt if she did what he said she’d get well. After all, she had two fine sons to raise and was newly divorced.

It sounds to me like she was doing what she had to in order to survive for as long as possible. Sometimes in survival mode, people will do whatever they can do to buy time.

@Aster : I am truly sorry for your friends, it’s an ugly way to go, but I have known people who did the stuff you believe and died, when very likely medical intervention could have saved them. We each make our own decisions the best way we can with the information we have. It’s very likely that if your friend believed so strongly in traditional medical ways she would not have survived non-medical techniques. These days, oncologists are very much about mental approach as well as medical.

Not to be a cynic here, @Aster , but unless you’ve had the diagnosis yourself, you can’t really know how you’ll react. If you are presented with a choice of proven-to-work most of the time methods or meditation and a special diet, you may feel very differently.

I would worry about how the option was presented to the patient, and the realities of whether it will help her quality of life, or prolong her life. I don’t know enough about the science, but it would not surprise me if the doctor possibly presented removing the breast as though it should be done, when actually it would not help her much at all, or maybe without a clear explanation of how much it would help. Depending on the patient, they may not ask enough questions to make an informed decision.

I understand your question a lot better now that you clarified, @Aster, thanks.

The biggest thing I think it comes down to, is which option would mean better quality of life during her last days, living with the cancer or getting surgery? Obviously neither is a walk in the park but I’m sure she weighed the options heavily and made an informed decision. Her decision may have been also based on a desire to “go out fighting” – even if “giving up” would have given her a more comfortable road, she may have understandably not wanted to do so.

And if curing cancer were as simple as eating vegetarian I think a lot fewer people would be dying. And most fruits contain a lot of sugar.

@Mariah sadly, the surgery had zero affect on her quality of life. She recovered very quickly from it and , far as I recall, didn’t suffer. The sweet thing even told the surgeon, ” you did a great job.” She , of course, continued ‘living with the cancer.’ She never thought a mastectomy would cure her. She just said ok to it when he related their “protocol” to her. The only time she felt really badly and started going to the hospital every few weeks was when chemo began. The more drugs they gave her the worse she felt, the more weight she lost. Furthermore, I would never in a million years think “curing cancer is as simple as eating vegetarian.” If I said that I must have been half asleep. I will say, however, that giving poisons and radiation to cure cancer seems counter productive. No; it seems crazy to me. I think I’ve read somewhere that radiation causes cancer? There was a survey where doctors were asked, “if your loved one came down with cancer would you suggest chemo?” and most of them answered “no.”
My husband had an aunt who got breast cancer. It wasn’t stage 4. She had chemo and lived another 40+ years. She died a few years ago of bladder cancer. I researched it and found that it is fairly common for people who have had chemo get bladder cancer way down the road. Of course, you can get bladder cancer without ever having had chemo too.

Before she died in Hospice a close friend of mine asked her, “knowing what you know now, would you have had the mastectomy?” and she said, “no.” Why she asked her a question like that in Hospice I’ll never know. She was quite a lady. She wrote her own obituary, had me read it over but her husband changed it (I mean her ex husband). He got kidney cancer six months before she passed away and he’s still doing well.

Money. Unfortunately it might have been done for money. Sometimes measures are taken because the patient believes something must be done, the patient or the family insists on trying everything, so the doctors do everything. Mastectomy is a very painful recovery, to say it did not effect her much can’t be true. I have had a small area of my body removed, and I was stunned how emotional I was aferwards, I cried my eyes out saying I had mutilated myself.

Yes, @Aster , radiation can cause cancer. I was given that information before treatment began. At the time (12 years ago) it was estimated that there was a 12% to 15% chance that the radiation would cause a secondary cancer. But really, I already had cancer. That was 100%. I had friends telling me what you wanted to (but didn’t, good for you) tell your friend. I found it grossly disrespectful that my friends presumed to know what would be better for me and the illness I had to deal with. I didn’t have chemo and radiation because some doctor told me to, I had chemo and radiation because it statistically gave me the best chance for survival. Show me scientific studies that tell me my chances would have been as good with your methods. Yeah, it all sucks, but I’m still here.

http://www.curenaturalicancro.com/2-physicians-refuse-chemo.html
I find this link interesting but in no way advocate baking soda for cancer. A few alternative docs are also doing IV Vitamin C but again, I know nothing about it. If the surgery was painful she never said so. She was committed to being positive in every sentence she spoke and never complained so she could very well have kept any discomfort (other than crying about it beforehand) from me.

Oh, dear. Never mind.

@Aster I had a therapist who died of cancer who chose the treatment options you suggest and died on a plane coming back from a family trip. I understand what you are suggesting and agree that in terminal cases, alternative and/ or palliative care options may be the best. My MIL, who was dying of kidney failure did have a cancerous breast removed because the doctors said it would ulcerate. She was not put on dialysis at her choice. The issues are not simple and we must each make our own choices. And if we do not like the advice given, we should seek another provider. Like you, I am in favor of the least intervention possible.

There are so many crackpot theories out there, websites claiming this and that will cure cancer, and most of them don’t offer much of anything in the way of proof. Maybe one does work, but the point is that it’s simply not worth taking the risk to try something unconventional when your life is on the line. Most of the arguments you’re presenting seem to be negative – against chemo arguments. I think we can all agree chemo is not something anyone wants to go through. But just because chemo sucks doesn’t mean there are other options that actually work. Until I see any real positive arguments – for the effectiveness of other treatments, supported by real proof in the form of formal studies, I’m gonna stick with what’s known to work at least some of the time, because that is always more reliable than something I read on the internet, which more likely than not is one of a huge sea of crackpot theories.

The trouble I have with your dietary suggestion, other than the fact that I have no idea if it actually works or not, is that once you deprive a person of meat and sugar, since most fruits contain sugar, all they really have left to eat is vegetables, and you can’t get a balanced diet on vegetables alone. A cancer patient needs all the strength he can get and I think it’s more likely going to harm him by depriving him of protein and other very important nutrients.

I think this is about whether you ascribe more value to the breast than did that patient/friend of yours. I do question energy-draining chemo+radiation to the end of terminal patients’ lives since the oh-so-American doctor perspective of ‘hope first, rationality later’ is quite ingrained and really takes away months from people that could have been spent with good supportive at home hospice (if you know nothing more about hospice stays than hearsay, don’t argue me on this poing, I know how well-executed hospice stays are, it’s part of my job). Perhaps surgery didn’t seem like such a big deal given how invasive it all is, at that stage. Perhaps, the cancer would have spread faster, more aggressively.

@Simone_De_Beauvoir : I have been hugely impressed by the way hospice has evolved in the recent past. I saw my cousin have a good quality of life (terminal pain notwithstanding) his final weeks because of managed palliative hospice care. We should all have such dignity in our final days.

The question sometimes comes down to the decision to continue treatment or not, even if the prognosis is bleak. If the patient’s mental state is better because they feel they are going down fighting, it can be argued that their quality of life is better. All of this is so subjective, ultimely we are the only ones who can decide what is best for us. If someone chooses to eschew all medical intervention, I support them. If they choose to keep having horrid toxic treatments to the end because they never want to stop fighting, I support them. There is some comfort in being able to choose. And believe me, as a survivor, this is a subject about which I have pondered extensively.

Just agreeing, hospice is wonderful.

@Mariah I was trying to describe a vegetarian diet along with protein shakes and antioxidants. I thought beans and rice were a complete protein. I’m not suggesting patients live on lettuce but I do not know nearly as much as I should about vegetarianism. I do believe that with B12 supplementation it’s a pretty healthy way to eat as opposed to cheeseburgers and steak. I also suspect, but am not at all certain, that the sugar in , say, two apples is different from sugar in two candybars.

Two years ago I had an ulcerative colitis flare up that just wouldn’t end. I was trying to avoid needing to start a new drug that I was scared of, and I got pretty invested in the idea of alternative treatments. I researched one in particular, the specific carbohydrate diet. For reasons that I won’t take the time to explain as they’re not exactly relevant to this discussion, it recommends treating ulcerative colitis by cutting out all sugars except for glucose. This is why I know how difficult it is to completely avoid sugar. The list of permissible foods is not very long. I’m not sure why your suggested diet includes cutting out meat, but trying to do so in addition to the restrictions outlined by the specific carbohydrate diet seems almost impossible.

I’ve pulled out the book I have on the diet to help argue my case. It is called Breaking the Vicious Cycle by Elaine Gottschall. Gottschall is the woman who developed this diet.

Rice and all other carbohydrates aren’t allowed because all carbohydrates break down into simple sugars in the small intestine.
The allowable proteins listed in the book include: beef, lamb, pork, poultry, fish, eggs, natural cheeses, homemade yogurt, dry curd cottage cheese. So cut out meat from that and I guess there are still a few sources of protein, but it’s very difficult. Almost all commercially available protein shakes are VERY heavy in sugar. For beans, the book says the following are permissible: dried white (navy) beans, lentils, split peas, dried legumes (but only if prepared according to some very specific instructions outlined in the book), lima beans, string beans. Not permitted are garbonzo beans, bean sprouts, soybeans, mungbeans, fava beans. Milk is banned.
The sugar in apples is indeed different from sugar in candybars. But if tumors feed on sugar as you say, and we’re trying to starve the tumor, it doesn’t make a difference if the sugar comes from an apple or a candybar. Glucose is allowed in the SCD, so many fruits are permissible in this diet, but I don’t know whether this is true of the diet you are promoting.
I have to add that following this diet means preparing ALL your own food, since almost all pre-prepared foods have added sugars. I should hope any cancer patient following this diet would have a lot of help from loved ones, as I can’t imagine them having the energy to do all that work themselves.

And don’t discount the nausea associated with some of these illnesses; it can be nearly impossible to force yourself to eat foods you want sometimes, let alone foods complying with this very difficult diet.

I ended up deciding against using the SCD for my ulcerative colitis because it was so much effort for a treatment that isn’t even proven to work. But before making that decision I drove myself almost insane with the pressure of trying to make sure all my foods were “safe” according to this very restrictive diet. Having to be so paranoid can have some very bad effects on one’s quality of life too.