In the long eighteenth century, women patients played a pivotal role in the formulation of the medical market in English towns. Medical culture in itself allowed this since the professionalization of medicine was not complete, and medicine still allowed for the patient’s voice to be heard. In practice, women shopped for treatment. Drawing especially from casebooks, this study looks at women with breast cancer in England, and explores the ways in which women with a horrible and feared disease such as cancer coped and negotiated with their treatment options. Breast cancer was customarily treated with medications, and also often with surgical means, as mastectomies were performed in the hope of saving lives. Breast cancer was an illness that eventually required much treatment and help, and is thus a good test case for looking at the patient’s activities in trying to fi nd a cure. The illness’s progress was usually slow, and it may have taken years of various kinds of treatment before the patient succumbed.1 These patients could be very lucrative for medical practitioners, and ‘the medical marketplace’ thrived because of them. When they made their choices, female patients had an infl uence on the economy of towns.