In your words

Don’t blame me for getting cancer

As a DO with invasive breast cancer, I find the current conversation about cancer to be insulting and misguided. Here’s why.

Gabrielle Koczab, DO
Contact gkoczab
Topics
Editor’s note: This story was originally published on KevinMD and is republished here with permission. It has been edited for The DO. This is an opinion piece; the views expressed are the author’s own and do not necessarily represent the views of The DO or the AOA.

I am a “jack of all trades” osteopathic physician. I practiced family medicine for over nine years and am currently on a leave of absence as I fight invasive breast cancer. Once I return to medicine, I will be moving into a more specialized role in integrative medicine and osteopathic manipulative medicine. I have also worked in urgent care.

I have to get something off my chest (no pun intended—I’ve had a double mastectomy). During Pinktober, I was bombarded by victim-blaming articles and posters. They all implied that breast cancer could be prevented by a healthy lifestyle.

Do’s and don’ts

“Don’t smoke, fast intermittently, don’t eat sugar, don’t eat fast food, avoid pollution, eat organic, exercise, maintain a healthy weight, eat kale, eat the right turmeric, drink moderately, stay calm, stay positive, get mammograms, drink tea, make sure you get vitamin D, don’t use a dry cleaner, eat salmon, follow a Mediterranean diet, etc.”

How many cancer patients could fill up an entire page with all the things we’ve been told would have, could have, even should have prevented our hearing those awful words, “It’s cancer”? I know I could.

Here are some facts for you: I never ate fast food. I didn’t smoke, drink or use drugs. I ran, walked, and did yoga. I drank green or herbal tea every morning. I didn’t drink soda. I was the one eating my veggies at lunch and drinking water or tea while my staff ate hot dogs and Doritos and drank soda. I ate almost completely vegan for nine years.

My only vice was chocolate. Dark chocolate was my favorite and is supposed to be an anti-cancer. I tried to avoid chemicals whenever possible. I didn’t dye my hair and rarely wore nail polish. We even use an organic, food-based, kid- and pet-safe fertilizer on our grass. I was only 37 when I was diagnosed and not even due for my first mammogram (USPSTF guidelines say 50, but ACOG recommends 40).

It turns out you can have every risk factor and never get cancer. And you can have zero risk factors and get cancer. It’s very random.

Cancer does not discriminate

There is also this myth that if your cancer is caught early, it will be curable. There are all different types of breast cancer. Some types are more aggressive than others. Some breast cancers are driven by estrogen or progesterone hormones, and some are not. Someone can have more than one type of breast cancer at once.

I had three different types of breast cancer found in my left breast: DCIS (cancer confined to the duct), invasive ductal carcinoma (cancer that ruptured out of the duct), and Paget’s in the nipple. I got checked out just days after symptoms developed, and I find myself with a 10-year survival rate of 50%.

Cancer does not discriminate. It doesn’t care if you are ultra-rich or ultra-poor. Cancer strikes the ultra-religious, atheists and everyone in between. Babies get cancer, and so do the elderly. Vegetarians and meat-eaters get cancer. Physicians get cancer. Let me say this again: Cancer does not discriminate. It’s an awful hand for anyone to be dealt. So please, let’s stop blaming the cancer patients for their diagnosis and support them in any way that we can.

Related reading:

DO cancer survivor develops intrauterine device with help from Bill & Melinda Gates

DO survivor lands prestigious oncology fellowship in Texas

More in Lifestyle

Confronting burnout and moral injury in medicine

Regarding burnout in medicine, “I knew there was more to the story than the frustration of dealing with administrative obstacles,” writes Jerry Balentine, DO.
Nearly 70% of doctors in their 40s want to retire in their 50s or early 60s, survey reveals

Medscape report finds that physicians, on average, would like to save $3.9 million to feel comfortable retiring from medicine.

7 comments

  1. Paul Hierholzer, DO

    Gabrielle:

    I wish you the best. Ten years ago they removed a large neuroendocrine tumor from my pancreas via distal pancreatectomy/splenectomy. It’s what Steve Jobs died from. I often wonder why I bothered living a healthy lifestyle. Though I’m hopefully cured now, they always see a small enhancing lesion on my surveillance MRI that’s always read as “possible recurrence,” even though no one really thinks it is. Nonetheless, it’s disconcerting to read that every time they do the MRI, even as a physician who understands why they read it that way.

    I don’t think anyone blames you for getting cancer. You might have guilt about having it (I did–it’s wierd), and therefore feel “blamed” (I did–it’s wierd). Clealry, some people get cancer no matter what they do. However, we shouldn’t throw healthy lifestyle completetly out the window because that happens. Otherwise, we would not bother trying to get people to quit smoking. We know that definitely causes cancer. Again, I wish you all the best.

    Reply

  2. Samuel J. Garloff, D.O.

    A great article. My wife underwent bilateral mastectomies several years ago for her cancer. She would share your viewpoint and add her anger about “patients winning/losing the war against cancer”. If you die of cancer is it because you didn’t fight enough? You weren’t strong enough? Good grief.
    Receiving the diagnosis is traumatic. Blaming the patient for the disease and/or dying of it horrific.

    Reply

  3. Perry Dworkin

    You did nothing wrong and are not to accept blame for getting three types of breast cancer,
    one of which is mild and one virulent. Statistically, if a woman lives long enough, she will have a breast cancer even if undetected until post mortem breast exams. Similar for prostate cancer in men. In neither case does the cancer contribute to demise of the patient. A healthy lifestyle helps, certain cancers are predictably associated with lifestyle. Breast cancer IS NOT.

    Reply

  4. daniel Harber

    Excellent points. I agree with you 100%. I have pts just like you with excellent health habits and either “bad luck”
    or possibly ” bad genes” and unfortunate disease states. Others live and eat like they are going to the chair and are healthy as a horse.
    God bless, and I wish you well on your battle with this damned dz.

    Reply

  5. Dr J

    I get it, so many people that like to ask, ‘Did you put off…{x, y, & z}?’ It’s as if they would rather blame the patient because they somehow they think cancer is catching. Great article, thank you for sharing.

    Reply

  6. Christina Daoud

    I’m so sorry for the battle you are fighting. Thank you for your words of wisdom. It’s hard enough for cancer patients to hear those dreaded words, “You have cancer,” but it would be even worse to hear it followed by “because you did…” I can’t even begin to think about the guilt that would go to a cancer victim’s mind as those accusing words went through their mind every time the underwent chemotherapy or radiation treatments. Thank you for opening our eyes to the patient’s perspective.
    I personally have a huge risk of getting cancer that began before I was even born. Three out of four grandparents died because of different cancers and who knows if the fourth would have gotten cancer since he died at a young age due to TB from being in the armed services. Almost all of my aunts and uncles also died from cancer as well.

    Reply

  7. Judith K Thierry, DO, MPH, FACOP

    Thank you for sharing your story. Thank you for your courage to express and caution us. This is always a timely discourse and at every bedside or exam room noting our habits to blame and label—It may well be both an art and science. Checking our biases and judgements may be a therapeutic act. Rigor in self assessment is as necessary as everything else we bring to our clinical acumen. Supporting patient self care in mind, body and spirit are not trite words. As with a diagnosis such as cancer that seems to be inextricably linked with fear we can do more by listening and taking the patient’s lead. Thanks Dr. K.

    Reply

Leave a comment Please see our comment policy