An eminent Australian breast cancer specialist is expressing concerns that numerous media stories have failed to present accurate information regarding the treatment approach adopted by top Australian model Elle Macpherson for her breast cancer. This has consequently created considerable misrepresentation and misinformation among the readers.
On being diagnosed in 2017 with HER2 positive oestrogen receptive intraductal carcinoma, it was reported that Macpherson deviated from the conventional medical guidance provided by healthcare professionals. As revealed in an interview with the Australian Women’s Weekly magazine, she chose to rely on a more instinctive, emotion-led, and holistic methodology in place of the usual surgical procedurs, chemotherapy and radiation treatments typically recommended.
Nevertheless, Elle Macpherson had indeed resorted to a lumpectomy which entails the removal of a lump from the breast. Prof. Chris Pyke, the chief of medical services at Brisbane’s Mater private hospitals, explains that such a surgical procedure could be deemed an acceptable mainstream treatment strategy for the disorder, depending on the circumstances.
Prof. Pyke, a cancer specialist and an expert in assessing breast cancer risk, clarifies that HER2 positive oestrogen receptive intraductal carcinoma can, in several instances, be redefined as a preliminary, non-invasive cancer type that carries the risk of turning malignant if left untreated.
Prof. Pyke explains that the term “intraductal” implies pre-cancerous, hence the cancer cells have developed but are still confined within the breast ducts. In the absence of intervention, a fraction of these cases could mutate into invasive cancer over the following year, although the odds are low at around 5%. It’s quite possible that removing the lump could be all the treatment needed.
The media reports, based mainly on the Women’s Weekly’s intimate conversation with Macpherson during the promotion of her recent book, fail to provide specific details such as the size of the pre-cancer, the level of the cells, or other potential risk factors that Macpherson may have been associated with.
The Women’s Weekly and Penguin Random House, the book’s publisher, have been queried by The Guardian as to whether specifics about her treatments, both mainstream and unconventional, were provided or requested. Professor Pyke has stated that, in addition to removing it, adding radiotherapy is sometimes beneficial for this particular disease. This guidance is based on the size of the precancerous alteration, the grade of the cells, and the potential utilisation of gene expression profiling to assist in decision-making and risk evaluation.
Yet, it has not been ascertained whether Macpherson opted for gene expression profiling. Around a third of patients, Prof Pyke points out, may be recommended a mastectomy at their first diagnosis, not due to severity, but because a significant part of the breast is affected. In these circumstances, attempting to remove sufficient tissue with a lumpectomy could considerably distort the breast, leading to the suggestion of a mastectomy and reconstruction.
It remains unknown if Macpherson was diagnosed after detecting a lump or through screening, with the condition revealed via imaging. This could also impact treatment suggestions and the significance of radiation, chemotherapy, and mastectomy. Prof Pyke emphasises the crucial importance of early diagnosis for breast cancer even before palpable changes, stating that it is unlikely to shorten the individual’s life if detected early.
Consumers and patients alike must stay cautious of celebrities and social media influencers discussing wellness or alternative therapy strategies. According to Prof Pyke, patients with the earliest forms of breast cancer should get access to all treatment options with similar outcomes. This implies that patients with intraductal carcinoma might have been recommended a lumpectomy on its own, a lumpectomy along with radiotherapy, or a mastectomy.
For early detected disease, these three methods aim to hinder the spread of this type of precancer. All these options are proposed as some patients might favour a mastectomy over a lumpectomy due to fear of the disease returning. Despite similar long-term survival rates provided by lumpectomy followed by radiation and mastectomy, lumpectomy alone carries a marginally higher recurrence risk.
Professor Pyke is one who emphasises the significance of patients playing an active role in deciding their cancer treatment options, which may range from immune-modulation drugs to more traditional routes, such as lumpectomy. Regular monitoring will be required for those opting for less invasive treatments to ensure there is no resurgence or metastasis.
The growing debate surrounding the overdiagnosis and aggressive treatment of certain non-threatening breast cancers and precancers has led some experts to propose a more restrained form of treatment alongside regular check-ups and strong support from healthcare professionals, Pyke notes. Encouraging patient interaction, he highlights the importance of addressing any queries they may have regarding their treatment plan.
He conveys that most diagnosed cancer patients would incorporate something additional to the doctors’ prescribed treatment scheme, such as meditation or vitamins. As long as they do not interfere with the official treatment, extended remedies are welcomed. But he firmly states that only surgery, radiation, chemotherapy, and hormone treatments are established cancer therapeutics.
Vicki Durston, in charge of policy, advocacy and support services at Breast Cancer Network Australia, underlines the importance of accurately portraying the treatment journey and choices of celebrities like Macpherson, to prevent potential misinformation. She notes that such narratives have a broad influence that can impact how others perceive their own treatments and choices.
Accurate and contextually sound portrayal is essential as it may muddle the understanding of those already undergoing treatment leading to doubts about their approach and decisions, Durston adds.
Likewise, Dr Brooke Nickel, a research fellow specialising in healthcare media reportage, advises caution towards celebrities and social media influencers promoting wellness or alternative therapeutic approaches. It is crucial for patients to consider consultations with medical professionals and recognise any commercial biases that may stem from the celebrities’ affiliates to brands and products. Macpherson, she notes, is an owner of a wellness company, which is a factor worthy of consideration when discerning her comments.
The wellness trend frequently positions itself alongside the women’s health movement, which champions autonomy, empowerment, and valid objections to male-dominated medical systems. The increasing popularity of famous personalities and influencers utilising women’s empowerment rhetoric has propelled the wellness trend to greater heights. However, their discussions often lack factual backing. – Guardian