Can I, Should I Accept This Decision?

I will be as concise as I can, but it is necessary to tell you a lot about my wife before I come to the point of my post. Today she has been diagnosed with breast cancer, and I am at my wit’s end over her decision about it.

She is 55 years old and has a well-paid medical job (non-NHS) which requires a certain level of fitness. She studied long and hard to obtain this job, starting quite late in life; she has been doing it now for 3 years and doesn’t want to lose it if possible, together we are building up for our retirement in a few years, hopefully in sunnier climes where she is always at her happiest.

She is one of the most strong-willed people you could wish to meet; not in an arrogant way by any means, those who know her would say that she would move mountains to help you. She is not materialistic either, show her a fashion label and she will tell you you could get almost the same thing at Markies for a lot less and look just as good. I have found that when she makes a plan, or comes to a decision, she will stick with it until it’s done.

She considers herself lucky to be here, during her thirties she had acute peritonitis which nearly “saw her off”, and at the age of 40 (two years after we met) had a strangulated hernia which was life-threatening for a while. So she counts every day as an added bonus, and tries to live her life to the full. She has one son (by a previous marriage), their relationship has been stormy but beneath it all they love each other dearly.

And now we have been through this - a routine mammogram, leading to a biopsy, a lumpectomy and today a recommendation for a mastectomy.

Her decision is this - she will take a course of tamixofen, but under no circumstances will she consider surgery. Her reasoning is that she will lose her job (she has always been very proud of the fact that she never had to rely on anyone else - including me! - and will always pay her way), she might still get 5-10 years of a reasonable quality of life (her thinking here is that if she hadn’t gone for the mammogram she wouldn’t have found out anyway) and she doesn’t want to be a burden to anyone. When the inevitable happens, she will take morphine and go quite happily. She would say to you “we’re all headed in the same direction, some of us get there earlier than others, that’s just the way it is”. There have been no tears on her part (as yet), we knew this might be coming, and she is very open about it, everyone knows the situation and she is the calmest of everyone about it…

Needless to say I am torn by emotion here. I love this woman to bits, I respect her wishes and acknowledge that in the end she has the perfect right to make her own decision, but it’s not just me who will be affected. There is her son, her sister and family, and several close friends who will all be devastated if we lose her.

I think there may be time before a final decision is necessary, during the consultation it was confirmed that it is a slow-growing type of cancer, but the consultant was of the opinion that a mastectomy was the only answer. In order to delay the decision, I will be arranging through my company BUPA membership for her to have a full CAT scan and X-ray (surprisingly this has not yet been done or offered) to see what the full extent of her condition actually is.

Do I have the right to insist that she goes through this treatment? Ought I to persuade her that she should undergo a treatment that will (in her view) ruin her quality of life? Or should I accept that the decision is hers and hers alone?

Hello Coatimundi,

I am sorry to read of your wife’s diagnosis and the dilemma you find yourself in, but welcome to the forums where I am sure you will receive lots of help and support from the many informed users of this site.

Could I suggest that you give our helpline a call? Here you can talk in confidence with one of our trained helpliners who are all either breast care nurses or people with personal experience of breast cancer who I am sure will be able to offer you some good advice, or if you just want to talk be a ‘listening ear’. The number is a freefone number 0808 800 6000 the lines being open Monday to Friday 9am - 5pm and Saturdays 9am - 2pm.

I hope this is of help to you.

Kind regards

Lucy, Moderator
Breast Cancer Care

I wouldn’t have thought that your wife would lose her job. Surely she is protected from that by the usual rights ? I had to take time away from my teaching job for my operation and then more later for radiotherapy. I returned to fulltime work four months after diagnosis and coped, albeit with some tiredness at first. I’m a single mum and like your wife am proud to be self supporting.
Perhaps your wife feels that she can’t take on board another threat to her health. At diagnosis we are all terrrified I think, whether we reveal it or not. Her decision not to have surgery might be a way of denying what has happened.
Also, breast cancer brings an enormous threat to our femininity as well as to our lives. Your wife will need reassurance about that and time to come to terms with this unexpected and unwanted turn of events.
Perhaps by now she has spoken to someone on the helpline. I’d also recommend the peer support service which has helped me enormously.
After mastectomy and during hormone therapy so many women carry on with busy,fulfilling lives. There’s no reason why your wife shouldn’t be one of them. She can be!

Very best wishes to both of you.

Kitty

Your wife shouldn’t lose her job as its covered under the disability act. I am 50 and was diagnosied in Feb this year. I am taking at least 10 months of work without a problem - obviously your wifes job is different but I’m sure that they would all rally around her and support her during this time.
I really dont know what to suggest other than councilling. I take it she has been given facts on survival rates with and without surgery. I feel for you as if i were in your shoes I would want to insist that she has surgery but no one can force her into it. I would still try gentle persusion and try to get her to speak to as many people as possible regarding this as hopefully they should all give the same advice.

Hi there,

I am a practice nurse but non-nhs, having treatment for my 3rd primary cancer, which is my 2nd breast cancer, both quick growing and I’m still here 9 years after 1st episode. I’m sure your wife wouldn’t lose her job, in the job she does they don’t sack you for being abscent with medical proog. If she doesnt want to tell her employer why she will be away from work she can discuss with her gp what can be put on the sick not to explain why she is not at work. I agree with kittyhawk, it takes a while to come to terms with what is happening, and once she has thought about things a bit longer her ideas will change. She sounds a very brave and determined person, I wish you both the best of luck.

Hi there

I can sympathise with your wife. My history - major spinal surgery, major bladder surgery, hysterectomy, gall bladder removal, 6 arthroscopies, cruciate ligament rebuild right knee, and then 2 years ago total knee replacement left knee which took me about 18 months to get over due to complications. I swore then that I would not have more surgery and would take whatever was thrown at me! Guess what - diagnosed in February with 3 tumours in right breast - 2 different types of cancer and an “anomaly” in left breast. On the day of diagnosis I was told I would have to have a mastectomy as I had numerous tumours. I had thought long and hard about what to do prior to diagnosis day and asked the surgeon what would happen if I elected not to have surgery. He looked at me as though I was mad as said you could have Arimidex but surgery is really the only option. I thought I might get 5 years without surgery - then I would only be 67 and I thought about the 67 year olds I knew - all active people, hill walkers, swimmers, having a wonderful time in their retirement. Perhaps with surgery I hoped to get longer, so I opted for a double mastectomy! I was lucky as I did have cancer in the other breast as well which showed up under pathology reports. I have been issued with prosthesis but cannot come to terms with them - I’m happy to be without at the moment! I have wondered over the past 6 months or so what would have happened if I had not had surgery - I’d have been having a great time without going through chemo and radiotherapy which is to come. I feel it will be a complete year before I’m back to normal and feel that it is a lost year of my life.

However, I do some quite high level dog training and spend a lot of time in fields! Imagine my surprise when two of my dog training colleagues each spoke to me of their battle with breast cancer which I knew nothing about. Both are fit and healthy and underwent surgery - one 17 years ago and one 10 years ago. Things have improved since then dramatically, so I hope that my chances of survival are improved by having surgery. I decided I wanted to live as long as I could and enjoy life. Perhaps your wife may decide this too after she has had time to think things through and do a lot more research. My I recommend Dr Susan Love’s “The Breast Book”, perhaps for you as well as her. Like others who have posted, I am sure that her employer would not get rid of her at this time. She is probably very apprehensive and will need reassurance that you and her children love her no matter what she decides … but you would like her to stay around for a very long time!!

I hope this is some help to you and her. Good luck.

Sharon

Thank you all so much for your comments, this is truly a wonderful resource to have online.

We had a very sleepless night last night, which ended in a change of mind on my wife’s part (not unheard of, but slightly unexpected) after a lot of discussion and mutual tears. She has decided to go for the mastectomy, a further appointment has been made to see the specialist on Monday. We are however going to ask for further X-rays and scans to make absolutely sure that the cancer is confined to the breast area and is not a secondary from somewhere else (although the specialist did say that it was not a secondary).

We live in Aberdeen, and today somewhat hesitantly we decided to visit CLAN (Cancer Link Aberdeen & North) which for those who don’t know is a local charity offering help and advice to cancer patients. This was possibly the best thing we’ve done since the initial diagnosis, the people and facilities there are a fantastic help to both patients AND their partners, we will most certainly be seeing them again.

To those who commented about my wife’s job - it is a rather unusual arrangement, but without being too specific she works as a Medic on North Sea oilrigs on a temporary contract with little or no guarantee of continuation of work (I also work offshore, but on a permanent contract). The only guarantee she has is a promise that “when she gets better” they will consider her for work as it becomes available. On the positive side, if she gets through this and can return offshore, she has already proved to be one of the more popular Medics offshore in that certain installations are always asking for her to come back when they have a requirement.

She is computer-naive, but I have suggested to her that she herself should join these forums; I have pointed out that as she looks to be in for a long stretch out of work this would be the ideal training ground for doing more computer work that a few Word documents or Excel spreadsheets, she has already come to grips with Googling and I have provided her with a bookmark for this site.

Thank you all so much,
Mark

Mark

That’s great news. The more information you get the better you understand the problem. Good luck - thinking of you both.

Sharon

your wife could explore reconstruction, they have improved the appearance of these in recent years. Breast cancer is not an automatic death sentence although when you are first diagnosed it feels like it

I’m so glad she changed her mind. Afer or during treatment, work and all the other problems you used to worry about don’t matter… being together does… you wife might even decided on a differing career path… or just put her feet up, do some retail therapy… and get you to pay… !! Which i’m sure you will be only to happy to do

good luck… keep in touch…

regards

wendy