The Power to Choose
You take it for granted, the power to choose. You go into a supermarket and arrayed before you are more choices than you can exercise. Go to Starbuck's for a cup of coffee. See how long it takes you just to read the menu and master the vocabulary before you can settle on your first choice. Want a new lipstick? Go to the shopping mall and choose a store, choose a counter, and then have fun choosing a color. You take choosing for granted, don't you? But what if your choices were few, or none? You face these little shocks on occasion: the power goes out in a storm (but comes back on eventually) or your favorite organic maple syrup is temporarily out of stock. You are annoyed but certain the inconvenience is only temporary.
But what if you're told you have breast cancer? That's not temporary, no matter how long you survive.
Patients with breast cancer have many choices but not as many as when they were healthy. They can choose a surgeon, a hospital, and an oncologist. They can sometimes choose whether to keep or remove the diseased breast, and they can even choose to remove a perfectly healthy breast if they like – though, with the exception of patients who carry a BRCA mutation, this last choice doesn't add a day to their lives. (They do it to relieve anxiety, but it does nothing to prolong survival except for those women with BRCA mutations.) Some women with breast cancer can choose whether to have chemotherapy, but most will benefit from it and so the choice becomes not one of preference but of what is rational. Women with Stage IV breast cancer, metastatic disease, have even fewer choices; many are completely out of choices and are compelled to wait out the end game of increasing symptoms and grueling demise. Sadly, the survival rate for women with Stage IV breast cancer is no different now than it was twenty years ago. The options are few and weakly effective, if at all.
The time to make good choices is when there are still many choices on offer - before breast cancer finds you. Exercise regularly: thirty minutes at least four times per week. Maintain ideal body weight. Don't smoke. Drink only very rarely. Avoid oral contraceptives and hormone replacement therapy. Choosing these breast-healthy lifestyle habits will reduce your risk for breast cancer by 40-50%. If you already have breast cancer, regular exercise will improve your chance of survival by 50% - at least as much as any other treatment on offer.
Don't wait until the shelves are nearly bare, or worse, until there is nothing left to choose from. Be grateful for your free will. Make good choices while you can, and while there are still so many good ones to choose from.
