Opinion
I don’t want to pile on Elle, but if I’d ignored the doctors I’d be dead
Julia Baird
Journalist, broadcaster, historian and authorAccording to the Women’s Weekly, Elle Macpherson approached her breast cancer diagnosis the same way she has lived her life: “on her own terms”. Unconventional. Authentic. Real. She decided not to follow the “ordinary path” (so boring!) and, “eschewing traditional medicine, she instead chose a holistic approach”.
Eschewing, hey. The most important thing to note in this whole, irresponsibly publicised story is that this premise is false. Macpherson had a lumpectomy, which seems to have removed the cancer, or pre-cancer, that was found. Then decided not to have any potential follow-ups. In other words, she shunned medical treatment for cancer … after having medical treatment for cancer. To have a lumpectomy, then claim, as the Weekly reported, that anything other than science saved you, seems a stretch.
Elle Macpherson in a WelleCo campaign.Credit: Instagram
Here are the facts we know to date. This week the Weekly ran an interview with Macpherson about her new book, Elle, in which she revealed seven years ago she was diagnosed with cancer – HER2 positive oestrogen receptive intraductal carcinoma – and had a lump removed from her breast. Her doctor flagged a number of additional, more aggressive treatments which seemed to be aimed at reducing chances of recurrence, including, she says, a mastectomy with radiation, chemotherapy, hormone therapy, plus breast reconstruction.
She consulted 32 doctors and experts, though it is baffling why such a significant number was required. Diagnosis is an awful, vulnerable time, and she was shocked and confused.
Meditating on a beach in Miami, Macpherson decided to refuse chemo. “Saying no to standard medical solutions was the hardest thing I’ve ever done in my life. But saying no to my own inner sense would have been even harder.”
She then rented a house in Phoenix, Arizona, for eight months with a small crowd of specialists, including a naturopath, a “holistic dentist”, osteopath, chiropractor and two therapists. She spent “every single minute” on her own healing, a rare privilege. Now she says she is in clinical remission, though she prefers to use the term “utter wellness”.
Good news! But reading this account, cancer researchers, doctors, surgeons and survivors around the world smacked their foreheads. It’s dangerous to suggest the “authentic” response to cancer is to ignore science. And there are many gaps in information.
For example, the interview implies this remission occurred after treatment – but did it occur after the lumpectomy? We don’t have enough details. We don’t know the size, grade or stage of her cancer, how early it was detected and whether there were any other risk factors.
In many ways, this may be a failure of editing and journalism as well as promotion. Some have said, let her tell her story, her truth. Why dismiss her choice to heal another way? But, briefly putting aside the impact her account might have on less privileged women, no journalist should accept a first-hand account of a woman saying, “So yeah, I decided to ignore 32 doctors and camp out in Arizona, and hey presto! Cured!” Were any actual cancer experts consulted, given Macpherson’s influence?
People and cancers differ wildly. The prognosis for many breast cancer patients – especially in wealthy countries – is excellent. Recent figures cited by the National Library of Medicine show: stage 0 and stage I both have a 100 per cent five-year survival rate. The five-year survival rate of stages II and III breast cancer is about 93 per cent and 72 per cent, respectively.
Since the airing of Macpherson’s interview, a host of experts have issued warnings. Professor Cindy Mak, a surgeon at the Chris O’Brien Lifehouse, told the Herald: “I have met so many women with HER2-positive cancer who have declined chemotherapy, and they have done so to their detriment. And these are women who do yoga, they are vegan, they go on health retreats, they exercise every day, they do everything … and they still die from the HER2-positive breast cancer.”
“Breast cancer is a progressive disease that is fatal without medical treatment,” oncologist John Boyages, from the ANU Medical School, said. “In my 40-year career, I have never seen breast cancer disappear on its own or through alternative, holistic treatments.” What he has seen, though, is people trying options that lack evidence, then returning “in a far worse, desperate state”. “People go from curable situations to incurable situations.”
Some experts were just confused. Oncology professor Frances Boyle said Macpherson may have had ductal carcinoma in situ (DCIS), a non-invasive pre-cancer for which surgery (a lumpectomy) is recommended. Prof Chris Pyke, director of medical services at the Mater hospitals in Brisbane, agreed, telling the Guardian: “Intraductal means precancerous, so the cancer cells have formed but they are still housed inside the ducts in the breast. Left to its own devices, a certain proportion of these cases will turn into invasive cancer during the next year. But the number is not high – about 5 per cent.”
So what is the danger here? Well, British surgeon Dr Liz O’Riordan tweeted: “We have proof that women … who choose not to have mainstream cancer treatments for breast cancer are 6x more likely to die.” Six times.
Macpherson says in the interview that she doesn’t want to give people advice, then proceeds to: “I want to help and encourage others to follow their heart ... feel what truly resonates with you without the outer distractions of everybody else’s opinions.”
In an era of anti-scientific propaganda, every claim of self-healing must be forensically examined before being published or promoted. Especially when those making the claims have global profiles, and are selling books, lucrative elixirs and other expensive wellness products. Have we forgotten the likes of “wellness warrior” Jessica Ainscough, who died at 29 after trying to cure her cancer through alternative means?
Patients need to learn to advocate for themselves, hard as that can be, and women are right to carefully scrutinise invasive, patriarchal medical systems. But in recent years, researchers have noted how often anti-science sentiment is cloaked in the language of female empowerment, so that rejecting expert advice is not presented as harkening back to the dark ages of superstition and high death tolls but something women need to do to be strong and independent – girl bosses don’t have oncologists, they have holistic dentists! You go girl. Throw in celebrities, profit motives, and wellness influencers, and the propensity for evidence to slide off the map is even greater.
I don’t want to pile on Macpherson. I wish her good health and a long life. Nor do I want to dismiss those seeking to care for and nurture themselves during what can be brutal times. It’s smart to meditate, move our bodies, make good food, strip stress from our lives. But I do want to protect those with cancer from being told to thumb their noses at doctors.
I’ve been through the medical system as a cancer patient several times. I know the terror that shoots through veins after diagnoses, the frustration of impotence, the shortcomings of medical staff, the realisation that guesswork often exists alongside expertise. Yet I also know that I would not be here today without the competence and determination of my brilliant surgeon.
Julia Baird is a journalist, author and regular columnist. Her latest book is Bright Shining: how grace changes everything.