ASCO Connection

July 2017

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are overreacting, or even scaring patients and/or their partners. Risk is a difficult concept to understand at the best of times, and when the evidence behind the risk is scarce or non-existent, risk is even more difficult to assess. I believe that it is our responsibility to inform our patients to the best of our abil- ity, taking into consideration their health literacy and ability to assimi- late the often complex information we provide. An informed patient will make a decision that is right for them in the context of their life, and it is not for us as providers to order or expect total compliance. When I asked Sheila what she thought about the information I had given her, a synthesis of the paragraph above, she said that she would need to both think about what I had told her and discuss this with her husband. Ultimately, he was the one potentially at risk. Or was he? She told me that what she missed most, and what she had not done for the many months of her treatment, was to kiss her husband with an open mouth, and she missed this "deep kissing" more than the sex. After our talk, she thought that perhaps the risk to him from this was low and some- thing they could live with, all things considered. *Name and identifying details changed for patient privacy. Find full post and ref- erences online at Anees B. Chagpar, MD, MPH Smilow Cancer Hospital at Yale-New Haven @AneesChagpar Why It's Important to Make Your Voice Heard We've all seen it… the effect of silence. While it may be perceived as equipoise, lack of an opinion, or disengagement, silence has deafen- ing effects. Policies that affect all of us, and our patients, are made every day by leaders who may be unaware (or ignorant) of their effect on the masses. Whether in the political realm or at our individual institu- tions, advocacy is needed. Through the Women's March and the March for Science, thousands of peo- ple spoke up about the things that matter to them —and in democracies, where politicians should ultimately be responsible to the people they rep- resent, those voices were made loud and clear. Many members of ASCO went to the U.S. Capitol [in May] to let their political representatives in Washington know how changes to health care coverage will affect their practice and their patients, and how federal funding for research is critical to ensuring the health of our nation. If going to Washington or joining a march isn't your thing, picking up the phone or sending an email can ensure that your voice is heard. And for those who say, "Why bother? I'm just one voice," remember that if apathy is prevalent, the message this sends is that these issues are unim- portant. Your voice counts. Last year, I completed the Public Voices Fellowship through the OpEd Project, a mission-driven organiza- tion whose aim is to encourage diverse opinions to be heard. If you do not want to politically engage, write an op-ed to your local paper, any number of national outlets, or even post your thoughts here on ASCO Connection! Ideas, thoughts, opinions all count —but when we are silent, they are not counted. For those inclined towards social media, take a cue from our President, and tweet! And if you're thinking that your single tweet cannot possibly have an effect, just look at what hap- pened with movements like #Bring- BackOurGirls, #ILookLikeASurgeon, and #NYerORCoverChallenge. Thousands of people were brought together in national and international movements to voice their opinions on what matters to them. The world is shrinking, and as glo- balization takes hold and technology permits more rapid and widespread communication, what we do and say can have more impact than ever before, but only if we have the cour- age and the initiative to make our voices heard. As I learned in the OpEd Project, if you say things of consequence, there may be conse- quences; but the alternative is to be inconsequential… and who would want that?! Particularly in these tumultuous times for health care and research, we need to speak up! I 13

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