{"id":8154,"date":"2022-06-09T07:58:52","date_gmt":"2022-06-09T07:58:52","guid":{"rendered":"https:\/\/www.booksofall.com\/tw\/?post_type=product&#038;p=8154"},"modified":"2022-06-09T08:01:58","modified_gmt":"2022-06-09T08:01:58","slug":"the-do-nothing-dilemma","status":"publish","type":"product","link":"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/","title":{"rendered":"The do-nothing dilemma"},"content":{"rendered":"<h4 id=\"standfirst\" class=\"article__standfirst\">When Judy Refuerzo heard the word \u2018carcinoma\u2019, she began considering her treatment options. But two years on, she\u2019s chosen surveillance over surgery. Was she right to? Charlotte Huff meets her and other so-called watchful waiters.<\/h4>\n<aside class=\"article__aside\">\n<div class=\"article__aside__section article__share-buttons\" role=\"group\">\n<p>Imagine for a moment that you have a tiny but worrisome lung nodule or, say, a growing bulge in a crucial blood vessel. You have no choice but to continue with normal life: going to work, running errands, paying taxes, negotiating with your kids over screen time. But you\u2019re always living, at least to some degree, under the looming shadow of a medical question mark.<\/p>\n<p>Judy Refuerzo ventured further along that uncertain journey this summer, walking the full length of the Camino de Santiago \u2013 some 500 miles and 38 days across the Pyrenees into Spain \u2013 to commemorate her 60th birthday. It had been a long-planned trek, one that she tackled with a backpack and a close girlfriend for company. She\u2019s not in denial, she insists, about the malignant cells that doctors found in her breast nearly two years ago.<\/p>\n<p>She\u2019s been getting regular imaging tests to make sure that the cells \u2013 collectively called ductal carcinoma in situ (DCIS), or sometimes stage 0 breast cancer \u2013 have not migrated beyond the milk ducts. But the California yoga teacher has decided against any kind of treatment, including surgery \u2013 at least for now. \u201cI just don\u2019t want to be cut open for no reason,\u201d she says.<\/p>\n<blockquote><p>Through the ages, doctors have sometimes recommended hitting pause on treatment<\/p><\/blockquote>\n<p>In the process, Judy has joined a growing group of so-called watchful waiters, snared within a modern-day web of aggressive testing and medical uncertainty.<\/p>\n<p>The concept of watchful waiting (<a href=\"http:\/\/www.cancer.org\/cancer\/prostatecancer\/detailedguide\/prostate-cancer-treating-watchful-waiting\">synonymous, for some doctors at least<\/a>, with \u2018active surveillance\u2019) is nothing new. Through the ages, doctors have sometimes recommended hitting pause on treatment. Increasingly, though, more and more people are caught up in a peculiar medical purgatory, particularly in countries like the USA where an emphasis on screening and high-tech imaging to rule out medical problems can cascade into more testing and other uncertainties.<\/p>\n<p>\u201cI think our technologies are moving faster than our ability to know what to do with the conditions we find,\u201d says\u00a0<a href=\"https:\/\/www.dukemedicine.org\/find-doctors-physicians\/shelley-hwang-md-mph\">Shelley Hwang<\/a>,\u00a0a breast surgeon at Duke University Medical Center and a prominent DCIS researcher. \u201cAnd once you know it, you can\u2019t un-know it.\u201d<\/p>\n<p>Sometimes, as in Judy\u2019s situation, people will choose that wait-and-see path. While still quite controversial, some doctors are willing to delay surgery and other treatment for DCIS unless there are signs that the malignant cells are moving into the surrounding breast tissue. In other medical scenarios, patients are told flat out that monitoring is the only immediate option, as it\u2019s too risky to operate until circumstances become more life-threatening.<\/p>\n<h4>Reference:<\/h4>\n<ul>\n<li>In<strong>\u00a0<\/strong><a href=\"http:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hex.12036\/epdf\">this 2012 paper<\/a>, patients with a lung nodule that\u2019s being monitored for possible cancer discuss the strain of \u201cnot knowing\u201d.<\/li>\n<li>This\u00a0<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC26594\/pdf\/76.pdf\">2011 study<\/a>\u00a0looks at regret and anxiety in women at high risk of developing breast cancer who either chose or declined a preventive mastectomy.<\/li>\n<li>Women in the UK with a low-risk form of breast cancer, sometimes called stage 0, can enrol in an\u00a0<a href=\"http:\/\/www.cancerresearchuk.org\/about-cancer\/find-a-clinical-trial\/a-trial-comparing-surgery-with-active-monitoring-for-low-risk-dcis-loris#undefined\">ongoing study<\/a>\u00a0that will look at the psychological effects as well as the cancer outcomes of opting for surveillance only.<\/li>\n<\/ul>\n<\/div>\n<\/aside>\n","protected":false},"excerpt":{"rendered":"<p><iframe style=\"width: 100%; height: 750px; border: none;\" src=\"https:\/\/online.visual-paradigm.com\/share\/book\/the-do-nothing-dilemma-zcnqazzcb?enforceShowPromotionBar=true\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n","protected":false},"featured_media":8161,"template":"","meta":{"_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"Design flipbooks online. Keep the book content up-to-date with the instant update tool. Try Visual Paradigm Online, the free flipbook maker."},"product_brand":[],"product_cat":[15,181],"product_tag":[],"class_list":{"0":"post-8154","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-all","7":"product_cat-society","9":"first","10":"instock","11":"shipping-taxable","12":"product-type-simple"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.1.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The do-nothing dilemma - BooksOfAll Traditional Chinese<\/title>\n<meta name=\"description\" content=\"Design flipbooks online. Keep the book content up-to-date with the instant update tool. Try Visual Paradigm Online, the free flipbook maker.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/\" \/>\n<meta property=\"og:locale\" content=\"zh_TW\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The do-nothing dilemma - BooksOfAll Traditional Chinese\" \/>\n<meta property=\"og:description\" content=\"Design flipbooks online. Keep the book content up-to-date with the instant update tool. Try Visual Paradigm Online, the free flipbook maker.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/\" \/>\n<meta property=\"og:site_name\" content=\"BooksOfAll Traditional Chinese\" \/>\n<meta property=\"article:modified_time\" content=\"2022-06-09T08:01:58+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.booksofall.com\/tw\/wp-content\/uploads\/sites\/3\/2022\/06\/The-do-nothing-dilemma.png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:image\" content=\"https:\/\/www.booksofall.com\/tw\/wp-content\/uploads\/sites\/3\/2022\/06\/The-do-nothing-dilemma.png\" \/>\n<meta name=\"twitter:label1\" content=\"\u9810\u4f30\u95b1\u8b80\u6642\u9593\" \/>\n\t<meta name=\"twitter:data1\" content=\"3 \u5206\u9418\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/\",\"url\":\"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/\",\"name\":\"The do-nothing dilemma - BooksOfAll Traditional Chinese\",\"isPartOf\":{\"@id\":\"https:\/\/www.booksofall.com\/tw\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.booksofall.com\/tw\/wp-content\/uploads\/sites\/3\/2022\/06\/The-do-nothing-dilemma.png\",\"datePublished\":\"2022-06-09T07:58:52+00:00\",\"dateModified\":\"2022-06-09T08:01:58+00:00\",\"description\":\"Design flipbooks online. Keep the book content up-to-date with the instant update tool. Try Visual Paradigm Online, the free flipbook maker.\",\"breadcrumb\":{\"@id\":\"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/#breadcrumb\"},\"inLanguage\":\"zh-TW\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"zh-TW\",\"@id\":\"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/#primaryimage\",\"url\":\"https:\/\/www.booksofall.com\/tw\/wp-content\/uploads\/sites\/3\/2022\/06\/The-do-nothing-dilemma.png\",\"contentUrl\":\"https:\/\/www.booksofall.com\/tw\/wp-content\/uploads\/sites\/3\/2022\/06\/The-do-nothing-dilemma.png\",\"width\":\"596\",\"height\":\"843\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.booksofall.com\/tw\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Categories\",\"item\":\"https:\/\/www.booksofall.com\/tw\/categories\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"The do-nothing dilemma\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.booksofall.com\/tw\/#website\",\"url\":\"https:\/\/www.booksofall.com\/tw\/\",\"name\":\"BooksOfAll Traditional Chinese\",\"description\":\"Biggest IT eBooks library and learning resources - Free eBooks for programming, computing, artificial intelligence and more.\",\"publisher\":{\"@id\":\"https:\/\/www.booksofall.com\/tw\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.booksofall.com\/tw\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"zh-TW\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/www.booksofall.com\/tw\/#organization\",\"name\":\"BooksOfAll Traditional Chinese\",\"url\":\"https:\/\/www.booksofall.com\/tw\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"zh-TW\",\"@id\":\"https:\/\/www.booksofall.com\/tw\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/www.booksofall.com\/tw\/wp-content\/uploads\/sites\/3\/2022\/06\/booksofall-logo-2.png\",\"contentUrl\":\"https:\/\/www.booksofall.com\/tw\/wp-content\/uploads\/sites\/3\/2022\/06\/booksofall-logo-2.png\",\"width\":166,\"height\":30,\"caption\":\"BooksOfAll Traditional Chinese\"},\"image\":{\"@id\":\"https:\/\/www.booksofall.com\/tw\/#\/schema\/logo\/image\/\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"The do-nothing dilemma - BooksOfAll Traditional Chinese","description":"Design flipbooks online. Keep the book content up-to-date with the instant update tool. Try Visual Paradigm Online, the free flipbook maker.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/","og_locale":"zh_TW","og_type":"article","og_title":"The do-nothing dilemma - BooksOfAll Traditional Chinese","og_description":"Design flipbooks online. Keep the book content up-to-date with the instant update tool. Try Visual Paradigm Online, the free flipbook maker.","og_url":"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/","og_site_name":"BooksOfAll Traditional Chinese","article_modified_time":"2022-06-09T08:01:58+00:00","og_image":[{"url":"https:\/\/www.booksofall.com\/tw\/wp-content\/uploads\/sites\/3\/2022\/06\/The-do-nothing-dilemma.png","type":"","width":"","height":""}],"twitter_card":"summary_large_image","twitter_image":"https:\/\/www.booksofall.com\/tw\/wp-content\/uploads\/sites\/3\/2022\/06\/The-do-nothing-dilemma.png","twitter_misc":{"\u9810\u4f30\u95b1\u8b80\u6642\u9593":"3 \u5206\u9418"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/","url":"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/","name":"The do-nothing dilemma - BooksOfAll Traditional Chinese","isPartOf":{"@id":"https:\/\/www.booksofall.com\/tw\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/#primaryimage"},"image":{"@id":"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/#primaryimage"},"thumbnailUrl":"https:\/\/www.booksofall.com\/tw\/wp-content\/uploads\/sites\/3\/2022\/06\/The-do-nothing-dilemma.png","datePublished":"2022-06-09T07:58:52+00:00","dateModified":"2022-06-09T08:01:58+00:00","description":"Design flipbooks online. Keep the book content up-to-date with the instant update tool. Try Visual Paradigm Online, the free flipbook maker.","breadcrumb":{"@id":"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/#breadcrumb"},"inLanguage":"zh-TW","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/"]}]},{"@type":"ImageObject","inLanguage":"zh-TW","@id":"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/#primaryimage","url":"https:\/\/www.booksofall.com\/tw\/wp-content\/uploads\/sites\/3\/2022\/06\/The-do-nothing-dilemma.png","contentUrl":"https:\/\/www.booksofall.com\/tw\/wp-content\/uploads\/sites\/3\/2022\/06\/The-do-nothing-dilemma.png","width":"596","height":"843"},{"@type":"BreadcrumbList","@id":"https:\/\/www.booksofall.com\/tw\/the-do-nothing-dilemma\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.booksofall.com\/tw\/"},{"@type":"ListItem","position":2,"name":"Categories","item":"https:\/\/www.booksofall.com\/tw\/categories\/"},{"@type":"ListItem","position":3,"name":"The do-nothing dilemma"}]},{"@type":"WebSite","@id":"https:\/\/www.booksofall.com\/tw\/#website","url":"https:\/\/www.booksofall.com\/tw\/","name":"BooksOfAll Traditional Chinese","description":"Biggest IT eBooks library and learning resources - Free eBooks for programming, computing, artificial intelligence and more.","publisher":{"@id":"https:\/\/www.booksofall.com\/tw\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.booksofall.com\/tw\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"zh-TW"},{"@type":"Organization","@id":"https:\/\/www.booksofall.com\/tw\/#organization","name":"BooksOfAll Traditional Chinese","url":"https:\/\/www.booksofall.com\/tw\/","logo":{"@type":"ImageObject","inLanguage":"zh-TW","@id":"https:\/\/www.booksofall.com\/tw\/#\/schema\/logo\/image\/","url":"https:\/\/www.booksofall.com\/tw\/wp-content\/uploads\/sites\/3\/2022\/06\/booksofall-logo-2.png","contentUrl":"https:\/\/www.booksofall.com\/tw\/wp-content\/uploads\/sites\/3\/2022\/06\/booksofall-logo-2.png","width":166,"height":30,"caption":"BooksOfAll Traditional Chinese"},"image":{"@id":"https:\/\/www.booksofall.com\/tw\/#\/schema\/logo\/image\/"}}]}},"_links":{"self":[{"href":"https:\/\/www.booksofall.com\/tw\/wp-json\/wp\/v2\/product\/8154","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.booksofall.com\/tw\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/www.booksofall.com\/tw\/wp-json\/wp\/v2\/types\/product"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.booksofall.com\/tw\/wp-json\/wp\/v2\/media\/8161"}],"wp:attachment":[{"href":"https:\/\/www.booksofall.com\/tw\/wp-json\/wp\/v2\/media?parent=8154"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/www.booksofall.com\/tw\/wp-json\/wp\/v2\/product_brand?post=8154"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/www.booksofall.com\/tw\/wp-json\/wp\/v2\/product_cat?post=8154"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/www.booksofall.com\/tw\/wp-json\/wp\/v2\/product_tag?post=8154"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}