It is impossible to know if the women who brings a friend or family member to a breast cancer surgeon already had decided that the decision would be made together or whether upon hearing options, the patient’s companion spoke up.

Why does that matter? A woman accompanied by someone she has chosen to help her make treatment decisions already has started putting her support system in place or already has one. The other woman is just starting—and there is nothing wrong with that.

The point is, though, that people who already work together on medical matters don’t have to learn about one another’s decision-making style or what someone can be relied on to do especially well. It simply makes the wrenching process of dealing with a life-changing decision a little easier.

People do not walk around thinking, “How am I a patient today?”, unless they are chronically ill and that is the question of the day every day for them.

Every day, though, in talking with friends and families, a culture of coping develops as other people’s problems are discussed. In no way is this meant to sound insensitive, but we all learn from other people’s miseries as much as we do their victories.

“If I had it to do over again….” someone will say. Listen up.

“What would we do if that happened to us?” Pause and think about it for a moment. That’s all. This should not be an excruciating exercise because no one can plan for devastating news. The thoughtful pause is a deposit in your coping account when you need it later. How did the person in the situation handle it? Did that person’s approach work as well as it could have, given that it is about serious illness or loss? That’s all. Then go back to your every day concerns.

Then, too, there are situations it simply is impossible to imagine. Watching the office building your best friend works in on 9/11 go down, for example. Losing a child is another. Too horrible to contemplate. Don’t. Spend your emotional energy on things you may be able to do something about.

One of our internist’s wisest pieces of advice is: “Plan. Don’t over-plan. Whatever you plan for? Something else happens.”

Again, this is not advocating dwelling on the negative—-quite the opposite. It is suggesting that everyone benefits from learning from those they like or love about the job of being a patient.

Breast cancer is the diagnosis that brings out what one of my hospital friends calls “the best friend mafia.” She says that a woman’s best friend is not going to take any “no’s.” She is going to see about her best friend’s family. She becomes a commander-in-chief and everyone is grateful. The patient’s army is devastated and needs leadership.

This study shows how friend and family support works in the case of breast cancer.

Atlanta Journal-Constitution/HealthDay News

“Family and friends don’t just serve as emotional support for breast cancer patients, they also help patients decide which kind of surgery to have, a new study has found.

“About three-quarters of patients surveyed brought a family member or friend to their first appointment with a surgeon, and the accompanying person exerted influence on the patient, the University of Michigan researchers noted.

“In particular, women who had a friend or family member accompany them to the first appointment were more likely to receive a mastectomy, compared with women who went alone. Women were also more likely to choose mastectomy if they themselves played a major role in driving the decision instead of the doctor, according to the study published in the Aug. 31 online edition of the Journal of the National Cancer Institute.

“The study examined factors influencing a woman’s choice between a mastectomy to remove the entire breast or breast-conserving surgery, which involves removing only the tumor and is followed by radiation treatments.” (Emphasis added)

Source: Atlanta Journal-Constitution, September 3, 2009

Citation: Journal of the National Cancer Institute, Online Edition, August 31, 2009