Elle Macpherson’s Cancer Story and the Missing Tumor Info

(Title image: Photo by Pierre Bamin on Unsplash)

Following on the heels of my Elle Macpherson post last week, I wanted to fill in some missing info…

To back up, former supermodel Elle Macpherson revealed that she took the holistic route when deciding to treat her breast cancer in 2017. However, most of the news stories that reported and offered opinions on her choices left out some critical information, as noted by this article in The Guardian (“Crucial information missing in Elle Macpherson breast cancer story, experts warn“). In this case, that information makes a big difference.

While it seems that Elle’s cancer was HER2-receptor positive, which suggests a more aggressive cancer, it was considered “non-invasive”, meaning it was contained within the mammary ducts. Often, this is referred to DCIS, or Ductal Carcinoma In Situ, and at this point those of us with personal knowledge of the disease will knowingly go, “OOooooooh.”

This is basically a “precancerous” mass of cells and often the treatments are more conservative. It’s considered stage 0. Yes, it becomes more dangerous if you do nothing, but clearly Elle did something: she had it removed.

DCIS is a stage 0 cancer, which doesn’t necessitate the most aggressive treatment.
(Photo by Bernard Hermant on Unsplash)

Beyond that, there are other conventional treatments offered, depending on how aggressively you want to go. This introduces the issue of potential overtreatment, which is gaining more attention among physicians and the public. It’s easy to throw the kitchen sink at anything that looks like cancer, but that increases the chances that patients unnecessarily experience damaging side effects. Not everyone needs to be smacked that hard with treatment.

So, given that Elle’s cancer was DCIS, her holistic treatment starts looking less extreme. In perspective, for stage 0, a radical mastectomy topped off with chemotherapy and other treatments leans towards overkill with minimal benefits, potentially affecting quality of life. So this is less about the types of Elle’s holistic treatments and much more about her cancer not requiring the same level of aggressive action as stage 1+ tumors.

However, very few of the news stories mentioned this. As a matter of fact, my own blog post last week might have confused the issue—I was writing without having all the facts. This underscores the importance of learning as much about your cancer as you can and understanding that your version of the disease may be very different from that of a friend with cancer.

In light of this, the pile-on regarding Elle’s treatment seems unfair…but only as it regards her personal situation. Because all the opinion pieces that came out against her choices, including my post, did so for a critical reason: that Elle’s story (“follow your heart”) may turn a cancer patient away from much-needed and beneficial treatment that can prolong their lives.

Get the facts, talk to your team, understand what you’re up against and what your risks are—yes, meditate, pray, exercise, change your diet. But don’t try to wish your cancer away.

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To clarify, Elle did indeed decline even less radical treatments such as endocrine therapy, so one could argue that she’s still taking a risk. We don’t have a crystal ball to determine whether this was the wisest choice, Elle believed it was the right choice for her.

Before You Meet Your Oncologist, Be Aware…

…they don’t pull punches.

This is critical to be aware of when you’ve gotten your cancer diagnosis and are meeting your oncologist for the first time. We all go into that exam room fearful but hoping for good news. We want reassurance that it’s going to be okay.

The problem is, your oncologist can’t tell you that. They can’t say that you’ll get through this fine. Because they’re not going to promise you something they cannot guarantee. What they can give you is statistics. However, that may come in the form of something like, “You have an 85% chance of surviving…”, which sounds great, right, “…for 5 years.”

Is it good news or bad news? Their faces won’t tell.

Now, I don’t know how you feel about this, but honestly, when I heard that I thought, um, is that the best you can give me?

While I adore my oncologist, there was no cute wrinkled nose, no “I’m sure you’re gonna be okay” warm-and-fuzzies. It was all, “this is what’s next.”

I’m convinced that oncologists start their day by practicing how to deliver information without emotion, without giving away whether the news is good or bad. As patients, we literally hang on every word, every hesitation, every wrinkle on our oncologist’s face for an indication of just HOW bad the situation is. Some will reveal more than others, but in my own experience, it was “just the facts, ma’am” for quite a long time.

This could be very frustrating. I learned that I needed to get the “rah-rah” encouragement elsewhere.

On the plus side, however, I knew that if something was bad, my oncologist was going to tell me. He wouldn’t be like that friend who assures you your ugly outfit looks good just so that they don’t hurt your feelings. So if it’s any consolation, you’ll leave the office knowing what’s up, and what the doc doesn’t know yet if they’re still waiting for results. No false promises.

That helps get your head past the diagnosis and moving forward into treatment.

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I remember when, after my final infusion, I developed a horrible nail infection that landed me in the Emergency Room. I was stabilized, pumped full of antibiotics and my wound cleaned out. As I recovered, my ER doc came back to see how I was doing because he knew I’d just finished chemo and was familiar with the cancer experience. He told me that he was about to go notify another ER patient that they had liver cancer and wanted to take a breather and come talk to me before he had to break the news to them. It was obvious that he was moved by his patient’s plight.

So this was a great reminder for me that even though the doctors may seem to be stone-faced, they are by no means stone-hearted.