The gift of choice is what makes us human. The psychologist Albert Bandura wrote extensively about our free will to choose and described our human choice as “agency.” In his words, agency refers to the human capability to influence one’s functioning and the course of events by one’s actions. 

In our health experiences it is common that the medical system makes us feel out of control and as if we have no choice. Somehow when we walk through the door at a doctor’s office, many of us become powerless. We hand over our “agency” and act like the guru is there to “fix” us. This may be a carry-over of the past when doctors and professors were given an unquestioning deference as if their word was law. However, even though we may not be the person in the room with the most medical training, we are still the person in the room with the most knowledge of ourselves. 

The Paradigm Shift in Medicine Today

Knowing ourselves, our hopes and dreams, our patterns and our propensities is the foundation for being able to advocate for the best actions to build our health. Western medicine prizes “evidence” as the basis of a “one-size-fits-all” approach. Unfortunately, this doesn’t always yield the best outcomes for the individual. 

When I was diagnosed with breast cancer, I was grateful that my doctors told me what the standard-of-care would be, and I chose to proceed with a chemo regimen that had the greatest evidence of destroying the cancer cells. The practice of applying a studied protocol to a specific diagnosis that has proven outcomes was comforting, even if horrible to go through. At the same time, I was amazed to read about many women who had chosen a different path and also had good outcomes. The “Radical Remission Project” website and the book Cancer as a Wake Up Call gave me alternative paths to consider. The common denominator in these alternative ideas was individual agency. Each person had chosen their treatment based on their perspectives and needs. 

In the next phase of my treatment, my doctors recommended an anti-hormone medication as the established standard. This was where I had to dig in and look long and hard at my own health risks and knowledge, and choose my own way. Because my medical expertise is in hormone therapy, I knew that a lot of what I was being asked to accept as “truth” was, actually, controversial in the literature. In fact, the removal of all traces of estrogen from a woman’s body leads to a myriad of other health risks: loose teeth, vertebral fracture, diabetes, depression and joint degeneration, to name a few. The big issues for me were the risk of Alzheimer’s and heart disease which are both significantly elevated in women who have less estrogen over their lifespan. Because those risks are high in my family history, I had to weigh possible breast cancer recurrence against the potential of osteoporosis, Alzheimer’s or stroke. Obviously, I would like to avoid all of these, but the deciding factor for me was the answer to this question: “What will increase my health?” For me, this meant declining the anti-hormone medication and seeking other medical guidance to work with me to build the healthiest “me” possible.  This was agency, my choosing, knowing all the factors unique to me, my own path. Although this choice did not follow traditional oncology recommendations, there is mounting evidence in the medical world that it is a reasonable option. 

In your life, you will face your own option to exercise agency – likely almost daily. Right now you can choose to wear a mask or not. You can make dietary choices, you can seek out alternatives to medications, you can enlist trusted consultants to help you evaluate your options to increase your health. Whatever you do, I encourage you to ask the question, “What will increase my health?” And then, put your agency to work!

Recommended resources on this topic include Radical Remission: Surviving Cancer Against All Odds (book, docuseries, project); Cancer as a Wake Up Call by M. Laura Nasi, MD; and Estrogen Matters by Avrum Bluming, MD.

Dr. Brossfield is the founding physician of XO Health and medical director of Brain Performance Center, both in Rancho Mirage. She can be reached at (760) 573.2761 or and on Facebook @XOHealth.

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