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Thursday, July 28, 2016

The Michigan Daily — michigandaily.com NEWS

regiment — more extensive than 
it’s necessary,” Katz said. “For 
years, we’ve been talking about 
overtreatment 
of 
cancer, 
or 

overtreatment of anything and 
often blaming the doctors and 
characterizing the doctor being 
too aggressive. In one thing I 
have researched and learned 
was that patient’s partner often 
would have the preference to 
treat more extensive than it’s 
clinically indicated.”

Katz believes patients who 

think more extensive treatment 
is better contributes to the rising 
rates of double mastectomies. He 
warned that extensive surgery, 
not just mastectomies, can lead 
to such side effects as life-long 
swelling of the arms.

Katz believes there is a more 

general problem: working with 
patients to counter the immediate 
reaction to a health threat.

There is an enormous need 

for clinicians to help navigate 
patients in their cancer treatment 
since the decision is much more 
complex than before, Katz stated. 
Though the tests for breast 
cancer usually can identify which 
patient can benefit from which 
treatment, in some situations, it 
is uncertain what the best course 
of action is. For such situations, 
he said, patients want to go for 
the more extensive treatment to 
go back to their normal routine 
or to assure themselves that they 
did everything they could.

“It is the kind of psychological 

factor that drive people to prefer 
the most aggressive treatment 
when in fact the most aggressive 
treatment 
will 
not 
improve 

their health, life expectancy or 

survival,” Katz said.

Katz 
believes 
doctors 
are 

trying 
to 
encourage 
less-

intensive treatments to prevent 
harm. Physicians recognize that 
treatment can harm and even kill 
patients, he said.

Sabel 
wrote 
that 
double 

mastectomies may, nevertheless, 
be the right decision in uncertain 
situations.

“The peace of mind (the 

psychological 
benefit) 
of 

bilateral mastectomies might be 
a sound decision for them. It is 
hard to say if it is ‘the best one’ 
and my job as a doctor isn’t to 
make those decisions for the 
patient, but to (educate) and 
advise them,” he wrote. “Clearly 
I try to steer patients away from 
poor decisions, but when two 
treatments have equal survivals, 
even if one is more ‘drastic’ it is 
hard to say it is a wrong decision.”

Sabel added that the key is to 

learn why a patient wishes to 
have a double mastectomy, while 
informing what will or will not 
work.

“So women who think they will 

live longer because they have this 
operation need more education,” 
Sabel wrote. “But many women 
are frightful of a (second) cancer, 
even if the risk is low, and the 
idea of yearly mammograms can 
be stressful, particularly if they 
get a call-back or need a biopsy.”

Ruth 
Freedman, 
chief 

administrator of the University’s 
Molecular 
and 
Behavioral 

Neuroscience Institute, is an 
advocate who leads the University 
Breast Cancer Advocacy and 
Advisory 
Committee. 
The 

committee has monthly meetings 
to provide the best information 
for breast cancer patients and 
survivors, helping them with 
their decisions.

The committee aims to clarify 

facts so that patients understand 
their 
best 
course 
of 
action 

and 
become 
knowledgeable 

advocates. The committee also 
communicates 
regularly 
with 

researchers from organizations, 
such as the American Cancer 
Society, to give them feedback 
on their work and clinical trials 
on how it would affect their 
patients.

While 
acknowledging 
that 

the chance cancer can spread 
from one breast to the other 
breast is little and thus a double 
mastectomy may be unnecessary, 
Freedman 
emphasized 
the 

decision is ultimately left to the 
patient.

“For 
them, 
given 
their 

situation, (double mastectomy) 
may be the best course of 
treatment if they are young 
women or single moms,” she 
said. “Or if their own emotional 
status is one that they can’t live 
with the possibility of cancer in 
the other breast, even if it could 
go elsewhere as well, it’s not 
necessarily a guard against any 
other breast cancer.”

When it comes to decision 

making, 
Katz 
recommended 

patients 
not 
make 
rushed 

decisions. He stated that, being 
diagnosed with breast cancer 
is not a medical emergency, so 
patients should take the time 
to think, gather information 
and 
make 
careful 
decisions 

with their physicians. Patients 
should also find out rationales 
for 
recommendations, 
he 

emphasized, and be satisfied 
with them.

Along 
with 
the 
cognizant 

patients, 
doctors 
should 
be 

mindful of the patients and keep 
themselves updated on their 
patients, he added.

understandable. 
The 
idea 
that 

“Clinton won fair and square” 
is kind of out the window at this 
point after it was revealed that the 
party put its finger on the scale for 
Clinton. It’s difficult for many to see 
the nomination as legitimate.”

Kolenda added that he is unsure 

of exact numbers, but the support 
among members of his organization 
is divided, with many going in both 
directions.

With Michigan coming into 

greater play this election season, 
the turnout of students and whom 
they support will play an important 
role. Sanders, who endorsed Clinton 
earlier this month, has called upon 
his supporters to rally behind 
Clinton, but to little avail. Monday 
morning, he was booed when 
addressing fans when he requested 
that they stand behind the party’s 
nominee.

Protesters, when asked about 

Sanders’ endorsement of Clinton, 
had a common response, stating 
their movement is about more than 
Sanders. Green said she believes 
there needs to be change on a 
grander scale and people should not 
have to choose between only two 
candidates.

“We need to be the change,” she 

said. “That’s the bigger umbrella 
reason of why I’m here. Bernie 
Sanders is amazing, but he’s one 
person, and we all need to be in this 
together. … We believe that this is 
not the end and we do not have to 
choose between the lesser of two 
evils.”

Kolenda 
agreed 
with 
this 

sentiment, 
saying 
that 
the 

movement has become larger than 
just the presidential election and 
students.

“Sanders was incredibly popular 

with most people under 45,” he 
wrote. “He came incredibly close 
to the nomination, even with the 
DNC actively trying to harm his 
campaign ... There are also many 
Sanders supporters (some I know 
personally) who are now running 
for office. The movement is more 
than just young college students.”

Despite the large crowds of 

protestors at the convention, and 
the overarching movements, many 
still believe students will rally 
behind Clinton.

University Public Policy lecturer 

Rusty Hill said he believes most 
students will vote for Clinton, while 
those who will vote third party or 
for Trump will stem more from 
young working people.

“I think there is a divide among 

young people,” he said. “On college 
campuses, the youth that vote will 
overwhelmingly 
for 
Secretary 

Clinton, but among non-college 
youth, 
those 
people 
that 
are 

working, trying to scratch some jobs 
together, there may be some ground 
for a Trump or third-party vote.”

Kelly agreed with this sentiment, 

stating he believes students on 
campus will rally behind Clinton, 
with only a few stragglers voting 
third party.

“Sen. Sanders knows himself that 

it’s about the movement, not just 
one person,” he said. “I think we 
will see a lot of his supporters start 
going the fold and getting excited 
about electing Clinton.”

DNC
From Page 1

MASTECTOMY
From Page 3

The incumbent Warpehoski — 

who is the director of the local 
Interfaith Council for Peace & 
Justice — held his City Council 
seat since 2012 and disagrees 
with Leeser’s assessment of city 
affairs. While he acknowledges 
Leeser holds positions aligned 
with many locals, Warpehoski 
argues he pragmatically accounts 
for both his constituents’ needs 
and the opinions of experts.

“The role of elected officials 

is to listen to everybody, the 
constituents as well as the subject 
matter experts — the traffic 
engineers, the attorney — taking 
all of that in and making the 
best decision for the good of the 
community,” Warpehoski said. 
“It’s not always governing by the 

poll numbers. It’s not about doing 
whatever the experts say; it’s 
about bringing that all together 
into a holistic approach to public 
service.”

While 
Leeser 
has 
been 

outspoken in arguing the Ann 
Arbor deer cull has been a waste 
of city resources, Warpehoski 
maintains the opinion of expert 
ecologists in his support for a 
continued lethal cull. Leeser 
supports immediate action to 
petition for EPA intervention 
on the Gelman dioxane plume 
— a widely debated city issue — 
while Warpehoski insists city 
and county authorities pursue 
the federal option only if it can 
be better handled by federal 
authorities than by Michigan’s 
environmental regulators.

WARD
From Page 2

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