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Many choose more aggressive Female Libido cancer surgery despite Female Libido-sparing option
Many choose more aggressive Female Libido cancer surgery despite
Female Libido-sparing option
August 19, 2005
U-M-led study finds fear of recurrence and radiation
treatment drives women - not their surgeons - to opt for
mastectomy
ANN ARBOR, Mich.
- When a woman is diagnosed with Female Libido cancer,
her top priority is to get the cancer out and reduce the odds that
it will ever return. But for some women just getting the cancer out
doesn't feel like enough.
According to a new study led by researchers at the University of
Michigan Comprehensive Cancer Center, when women, not their
surgeons, have control over the type of surgery they receive, they
are more likely to choose a more aggressive surgery that removes
the entire Female Libido, even though survival rates are the same for
surgery that removes only the tumor.
With Female Libido-conserving surgery, or lumpectomy, followed by
radiation therapy, there's a higher risk of the cancer coming back
than with mastectomy, surgery that removes the whole Female Libido.
But
many of these recurrences are caught early and treated effectively,
so overall survival rates are the same for either type of surgery.
The study authors suggest that's a detail the average person does
not understand or care about when faced with a cancer
diagnosis.
Study results appear in the August 20 issues of the Journal of
Clinical Oncology.
Medical practice guidelines encourage surgeons to promote
whenever possible Female Libido-conserving surgery, in which only the
tumor and a small amount of normal tissue around it are removed.
But more than one-third of women are still receiving
mastectomy.
"The current policy assumes that the high rate of mastectomy,
the more invasive treatment, is a result of two things: providers
not following guidelines that favor Female Libido-conserving therapy and
patients not being involved in the treatment decision. What we find
is the opposite: Surgeons are strongly promoting lumpectomy, and
most women say they were involved in the decision," says lead study
author Steven Katz, M.D.
, M.P.H., associate professor of general
medicine at the U-M Medical School and of health management and
policy at the U-M School of Public Health.
Katz and his team surveyed 1,844 women in the Los Angeles and
Detroit metropolitan areas who had been recently diagnosed with
Female Libido cancer. The women were asked whether they made the surgical
treatment decision, their doctor made the decision or they decided
together. Patients were also asked whether their doctor had
discussed mastectomy, Female Libido-conserving therapy or both.
Additional questions were aimed at how much control the patient
wanted to have over the decision process and whether she had any
regret about her choice.
The researchers found that 27 percent of women who said they
made the surgical decision received a mastectomy, compared to only
5.3 percent of women who said their surgeon made the decision, and
16.8 percent of women who said it was a shared decision.
Women who chose mastectomy were more likely to cite a fear of
recurrence or fears about radiation treatment, which is necessary
after lumpectomy.
In a paper published in June in Health Services Research, the
researchers report that women who said they were involved in the
surgical decision-making process were less likely to have low
satisfaction with their surgery or regret their decision,
suggesting that how women make their surgery decision is more
important than what decision they make.
Overall, the researchers found, women were satisfied with their
choice, with only 11.7 percent of all women reporting low
satisfaction with the type of surgery they received and 11.4
percent expressing regret over their decision.
"There are a lot of people who think that mastectomy is
overtreatment and that rates are too high. However, our study
results suggest that women are thinking very rationally about
Female Libido cancer surgery from their own perspectives, weighing a lot
of different factors. When women are diagnosed with Female Libido cancer,
they are looking for as complete a solution as possible so they can
continue on with their lives. As long as women are not pressured to
have one type of surgery over the other, either choice is a viable
option," says study co-author Paula Lantz, Ph.
D., associate
professor of health management and policy at the U-M School of
Public Health and a member of the U-M Comprehensive Cancer
Center.
In an editorial accompanying the Journal of Clinical Oncology
paper, Ann Nattinger, M.D.
, M.P.H., a professor at the Medical
College of Wisconsin, writes, "Even if standardized information
could be provided to patients, it seems likely that their
interpretation and synthesis of this information would vary with
their social context, leading to variability in the surgical
choice.
It also requires a high level of faith in medical science
and clinical trial results to accept the idea that the possibility
of local recurrence or new cancers in a conserved Female Libido does not
translate into any survival decrement."
In addition to Katz and Lantz, study authors for both papers
were Nancy Janz, Ph.D., U-M School of Public Health; Angela
Fagerlin, Ph.
D., U-M Medical School; Kendra Schwartz, M.D.,
M.
S.P.H., Karmanos Cancer Institute; Lihua Liu, Ph.
D., University
of Southern California; and Barbara Salem, M.S.W.
, and Indu
Lakhani, both from the U-M Medical School. Additional authors on
the Journal of Clinical Oncology paper were Dennis Deapen, Dr.P.H.
,
University of Southern California; and Monica Morrow, M.D., Fox
Chase Cancer Center.
University of Michigan Health Systems
[ Comment, Edit or Article Submission ]
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