I saw a medical oncologist last December. She was last in a long lineup of doctors who had varying opinions about my medical condition. A panel of doctors thought I should get lymph node surgery just in case cancer spread in there, but she wasn't as convinced. She leaned towards an estrogen inhibitor instead. Just one pill a day to prevent a relapse. She left me with a package of information about the drug, Letrozole, and I wandered off to contemplate my options.
Then I came across this article, which doesn't help maintain my faith in the system:
"It is distressingly ordinary for patients to get treatments that research has shown are ineffective or even dangerous. Sometimes doctors simply haven’t kept up with the science. Other times doctors know the state of play perfectly well but continue to deliver these treatments because it’s profitable — or even because they’re popular and patients demand them. Some procedures are implemented based on studies that did not prove whether they really worked in the first place. Others were initially supported by evidence but then were contradicted by better evidence, and yet these procedures have remained the standards of care for years, or decades."On the advice of a commenter here (and former colleague), I called CAREpath to help with all the differing opinions. They collected all the medical files generated and assessed them to come up with a comprehensive pros/cons list. Literally. They weighted heavily on the anti-surgery side, with a "risk of cure" rate of 97% without any intervention. In their opinion (a different panel of doctors and nurses that's in Toronto), surgery would only have a marginal effect and wasn't worth the general surgical risks, but the hormone inhibitors might be a good idea.