Moral Side of Medicine
Autonomy in the Age of Misinformation: Oncologist Perspective
by Laila Agrawal, MD
She noticed a mass in her breast in the shower. She didn’ t have a family history of breast cancer and had heard online that“ mammograms cause cancer” and preferred to avoid the radiation. Life was busy, and the breast mass fell off her radar for a while. A few months later, the mass had enlarged, now taking up the majority of the breast and causing retraction of the nipple. She went to her primary care physician and soon there was a flurry of tests and appointments. The diagnosis: invasive ductal carcinoma, hormone receptor positive and HER2 positive. The treatment plan: Chemotherapy, HER2 targeted treatment, surgery and radiation.
In our first appointment, she told me that this treatment seemed extreme to her. She wanted a more natural approach. She had found a clinic out of state that promoted an alternative approach. She wanted to try to make changes to her diet and eliminate chemicals from her home. She heard stories of remarkable cures, using medications like ivermectin and fenbendazole, even after doctors told people they were going to die.
I took a deep breath. I had the unmistakable feeling that what would happen next may be the difference between life and death. This time I wasn’ t only fighting cancer. I was fighting an ocean of misinformation and medical distrust.
As an oncologist, my role is to guide their cancer treatment, creating personalized and evidence-based treatment plans. We have a professional responsibility regarding informed consent. We detail the benefits and the risks of any treatment. We have a duty to aim to understand our patient’ s wishes and explain how treatment may impact their goals.
We are unprepared for this conversation. We study cancer biology, mutations, receptors. We identify, mitigate and treat toxicities of treat-
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